4 Skills of DBT (Dialectical Behavior Therapy)

DBT treatment can benefit those with borderline personality disorder, PTSD, eating disorders, and substance-abuse issues. DBT skills also increase our acceptance and compassion for ourselves and others.

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May 12, 2022 UPDATED
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If you want to gain more acceptance and awareness of yourself and others, DBT may be the right type of therapy for you.

DBT stands for dialectical behavioral therapy, and it’s a type of cognitive behavioral therapy (CBT) initially created to help treat people living with borderline personality disorder.

Over the years, the dialectical behavior therapeutic approach has been adapted and developed to effectively treat other mental health disorders including binge eating, PTSD, and substance abuse disorder.

If you want to gain more acceptance and awareness of yourself and others, DBT may be right for you.

In the 1980s and 1990s, now-retired University of Washington psychology professor, Dr. Marsha Linehan, PhD, ABPP, created DBT to help fill in the gaps in the therapeutic effectiveness and benefits of cognitive behavioral therapy —particularly for those individuals at high risk of suicidal and self-injuring behaviors.

Each of the four key DBT skills contributes toward increasing our acceptance and compassion for ourselves and others.

DBT has a number of evidence-backed benefits, which we’ll go into in more detail ahead.

We’ll also describe how the typical DBT program is structured, as well as some of the ways DBT treatment differs from CBT.

If you’re wondering how to find a DBT therapist, we’ve got you covered.

On Monarch, you can browse over 120 therapists who specialize in DBT —many who offer free initial consultations. 

Let’s dive into more on how DBT works and what you can expect from this type of therapy.

Science-backed benefits of DBT

DBT is the only empirically supported treatment for borderline personality disorder.

Research-backed benefits of DBT for individuals with BPD include:

  • Reducing suicidal behaviors

  • Reducing hospitalizations related to mental health

  • Higher rates of adherence to mental-health treatment than other treatment

“In our DBT work, even clients who don’t finish the program benefit based on improvement in borderline symptom checklist scores,” says DBT therapist Lara Ashbaugh, MS, LPC, NCC. 

DBT is also effective in treating other mental health disorders including:

  • Substance-use disorders

  • Eating disorders (including binge eating, bulimia nervosa, and anorexia nervosa)

  • Bipolar disorder 

  • Depression

  • PTSD

What are the 4 DBT skills you’ll learn in therapy?

Much of the work in a DBT program is focused on skill development, so let’s find out what they are and how they are helpful.

The 4 DBT skills, also called DBT modules, are:

  • Mindfulness

  • Interpersonal effectiveness

  • Emotion regulation

  • Distress tolerance

"Although it may take a bit of time and a great deal of practice to master DBT skills, the outcome of clients being able to self-regulate, improve relationships, and deal with life is immeasurable," says DBT therapist Ellen Biros, MS, LCSW, C-PD.

1. Mindfulness

Each of the core DBT skills modules builds on mindfulness. 

Mindfulness is defined as our ability to be fully present—essentially it’s the mental state of intentional awareness of the here and now. 

The wise mind combines both the logical and emotional parts of our minds.

When we’re mindful, we focus on the thoughts, feelings, and behaviors that arise in the present moment. 

Mindfulness education teaches the concept of the wise mind. 

The wise mind combines both the logical and emotional parts of our minds. If we’re using a wise mind, we’re aware of the benefits of our brains’ reasoning and emotional parts. 

As a result, we can intuitively take the middle path to remain calm in situations and interactions with others. 

2. Interpersonal effectiveness

If you’ve ever wanted to learn how to respect yourself and relate to others better, DBT interpersonal effectiveness skills can help. 

When we learn interpersonal effectiveness skills, we respect ourselves, assert what we need, and better set effective boundaries.

We also remain more open to others' thoughts, opinions, and perspectives. 

what is db

3. Emotion regulation

You may sometimes feel like your emotions have taken the driver’s seat, causing you distress and difficulty in making rational, healthy choices. 

When we work on learning emotion regulation skills, we can regain control of our emotions. 

Additionally, emotion regulation skills teach us more about the function of emotions and helps us in assessing whether we should interact with an emotion or apply an opposing action. 

If you’ve ever wanted to learn how to respect yourself and relate to others better, DBT interpersonal effectiveness skills can help. 

2021 research published in Psychotherapy Research examined the impact of DBT skills group on emotion regulation in 136 individuals and found that each of the four skills training modules were associated with emotion regulation improvements. 

4. Distress tolerance 

If you find yourself in crisis or in situations where you have trouble pinpointing or acknowledging reality, DBT distress tolerance skills can benefit you. 

Distress tolerance skills teach us how to accept uncomfortable emotions and painful truths that are tough to face. 

A key component of distress tolerance is the concept of radical acceptance. 

These particular skills also help us become more aware of our bodies and five senses.

Learning distress tolerance skills can help us implement self-soothing techniques when we feel overwhelmed. 

A key component of distress tolerance is the concept of radical acceptance. 

Radical acceptance means we accept our thoughts and feelings as they are—without attempting to change them. 

This type of acceptance can help us to recognize the reality that there are times when unpleasant emotions can’t be changed. And it can also free us from suffering by allowing us to accept the feeling. 

Radical acceptance does not mean we approve of the situation or uncomfortable reality. It simply means that we don’t allow our pain to make us stuck. 

4 comps of dbt

What are the 4 components of DBT?

DBT treatment programs have 4 components:

  • Skills training group

  • Individual therapy

  • DBT phone coaching

  • Consultation team

In a DBT program, you attend a skills training group as well as individual therapy, and you also get access to phone coaching.

Additionally, DBT therapists have access to a consultation team. 

The DBT skills training group is run like a class where the group leader teaches the skills and assigns homework for clients to practice the DBT skills in their everyday lives, according to University of Washington’s Behavioral Research and Therapy Clinics.  

The group setting helps us learn behavioral strategies and skills that can help us develop healthier ways of managing emotions, relating to others, and managing distress. 

In the individual therapy sessions, you receive additional personalized support in how to apply the DBT skills you learned in the training group to the specific situations in your life.

Phone coaching is a useful benefit of DBT programs.

If you’re having a difficult time or if a crisis comes up, you can call your therapist who can help coach you through applying DBT skills to the situation. 

The consultation team component of DBT programs is designed to help the therapists providing dialectical behavioral therapy.

All therapists who provide DBT in a program typically meet once a week to support each other and assist each other in providing the best treatment to their clients. 

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What are the 6 main points of DBT?

When you see a dialectical behavioral therapist, they may use the six main points of DBT to help you develop new methods of thinking and behaving. 

6 main points of DBT include: 

  1. Acceptance and change- We can’t always change the situation, but we can work on creating a healthier life if we can accept the situation. 

  2. Cognitive transformation- We are aware of and seek to replace actions and thoughts that aren’t helpful. 

  3. Behavioral modification- Analysis of problems and behaviors and replacing unhealthy behaviors with healthier patterns of behavior

  4. Learning new skill sets- We understand and acquire new skills and methods of coping.

  5. Collaboration with others- We learn what it’s like to work with a team. 

  6. Recognition of strength- We learn our strengths and how those are beneficial in our relationships with others. 


As mentioned earlier, dialectical behavioral therapy was developed 40 years ago to fill the gaps in meeting the treatment needs of individuals that weren’t met by the earlier behavioral therapies such as CBT. 

Even today DBT and CBT share many of the same components.

For one, both modalities are empirically based.

Additionally, both types of therapy also focus on unhealthy cognitions and involve behavioral and cognitive aspects in their treatment approaches. 

An essential distinguishing factor of DBT is the principle of dialectics—working to accept opposing ideas. Change in DBT occurs when we can accept our reality without aiming to change it. 

An distinguishing factor of DBT is the principle of dialectics—working to accept opposing ideas.

Although dialectical behavioral therapy is an extension of CBT, one key difference is that DBT tends to focus more on the social and emotional aspects of a person’s life. 

In addition, DBT and CBT differ in the structure of therapeutic treatment protocols. For instance, CBT is generally short-term and goal-directed, while DBT encompasses more long-term treatment. 

Finally, while CBT is most effective at treating anxiety and depression, as mentioned earlier, DBT is primarily utilized for treating borderline personality disorder, high-risk behaviors, substance-abuse disorders, PTSD, and suicidal behaviors, and self-harm. 

How to find a DBT therapist near you

If you think DBT may be the best style of therapy for your needs, check out the Monarch Directory by SimplePractice to find a licensed therapist who specializes in DBT.  

You can browse the profiles of over 100 DBT therapists —many with online booking and free initial consultations.

Need to find a therapist? Check out the Monarch Directory by SimplePractice to find licensed therapists near you with availability and online booking.

Article originally published May 10, 2022. Updated May 12, 2022.

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