The term “dialectical” refers to the integration of opposites—in this case, the need to accept oneself as they are while also striving to change problematic behaviors. This dual focus on acceptance and change is what sets DBT apart from other therapeutic models.

DBT is typically delivered through a structured program that includes four main components:

Individual Therapy: One-on-one sessions with a therapist focus on helping clients apply DBT skills to their personal challenges. The therapist and client collaborate to identify target behaviors (such as self-harm or emotional dysregulation) and develop strategies to address them. These sessions also work on enhancing motivation and resolving obstacles to progress.

Skills Training Groups: Clients attend weekly group sessions where they learn and practice DBT skills. The curriculum is divided into four key skill areas:

Mindfulness: Learning to observe and describe thoughts, emotions, and sensations without judgment. This foundational skill helps clients stay grounded in the present moment and increases awareness of internal experiences.

Distress Tolerance: Techniques to survive crises and tolerate emotional pain without resorting to impulsive or destructive behaviors.

Emotion Regulation: Strategies to identify, understand, and manage intense emotions more effectively.

Interpersonal Effectiveness: Skills for maintaining healthy relationships, asserting needs, and setting boundaries while preserving self-respect.

Phone Coaching: Clients can contact their therapist between sessions for brief support in using DBT skills during difficult situations in real life. This helps bridge the gap between therapy and everyday challenges and ensures that skills are practiced when they are most needed.

Therapist Consultation Team: DBT therapists participate in regular team meetings to support each other, maintain adherence to the treatment model, and improve their skills. This component is vital for preventing therapist burnout and ensuring quality care.

A central goal of DBT is to help clients build a life worth living. This means not only reducing self-destructive behaviors but also increasing emotional resilience, improving relationships, and fostering a sense of purpose. The therapy is highly structured and often involves the use of worksheets, homework assignments, and diary cards to track behaviors and emotional states.

One of the key features of DBT is its nonjudgmental stance. Clients are encouraged to recognize and validate their emotions and experiences, even when those feelings are painful or seem irrational. This compassionate approach often helps reduce shame and self-criticism, which are common in individuals struggling with emotional dysregulation.