Understanding Dialectical Behavior Therapy (DBT): Key Skills, Benefits, and Techniques
- Kaitlyn Boudreault
- Feb 14
- 6 min read
Updated: Jun 7
In recent years, society’s attitude toward mental health and therapy in Canada has shifted from judgment to compassion, which has opened the door for more people to seek help.
According to a poll from the Canadian Mental Health Association, one in four Canadians now pursue professional mental-health support, which is up from just 9 % two years earlier.
This is a significant difference and this surge has driven unprecedented demand for evidence-based counselling approaches.
One of the most widely researched and clinically proven therapies used by mental health professionals is Dialectical Behavior Therapy (DBT).
Below we break down what DBT is, how it works, its techniques, why it can be effective for many neurodivergent and neurotypical clients alike, and various DBT strategies.
What is Dialectical Behavior Therapy?
Dialectical Behavior Therapy (DBT) is a skills-based therapy rooted in cognitive-behavioral therapy (CBT) that can be delivered in person or online. It helps individuals learn strategies to manage intense emotions, improve relationships, and enhance self-awareness.
The key concept behind DBT revolves around the “dialectical” aspect of its name, which refers to opposites where clients balance acceptance (“this is my reality”) with change (“and I can grow from here”).
The Four Core DBT Skill Modules
DBT consists of four core components that work together to help individuals navigate their emotions and develop more fulfilling lives and relationships. These components that a counsellor aims to teach a client include:
Mindfulness: Staying fully present in the moment and recognizing your thoughts, feelings, and surroundings without judgment. This practice allows you to create a pause between your emotions and actions so that you are less likely to act on impulse.
Distress Tolerance: Ride out crises and stressful situations effectively without resorting to harmful coping mechanisms.
Emotional Regulation: Naming, understanding, and reshaping difficult feelings.
Interpersonal Effectiveness: Assertive communication and boundary-setting that strengthens relationships.
What Conditions Does DBT Treat?
DBT was originally designed in the 1970s by Marsha M. Linehan for treating Borderline Personality Disorder (BPD), and is now backed by research for:
Depression and mood dysregulation
Post-traumatic stress disorder (PTSD)
Motivational challenges Self-harm and suicidal ideation
Substance-use disorder (SUD)
Sensory Overload and Rejection Sensitive Dysphoria in Neurodivergent Individuals
DBT is particularly effective for these conditions and neurotypes, as they all involve difficulties in regulating intense emotions and managing interpersonal relationships.
DBT to Neurodivergence
Neurodivergent individuals, including those with ADHD, autism, or learning differences, often struggle with emotional regulation and social cues.
DBT's structured skills training can provide practical tools to:
Reduce emotional overwhelm
Foster self-validation and self-compassion
DBT Techniques You Can Practice Today
Now that you know what dialectical behavioral therapy is, Below are beginner-friendly DBT strategies you can practice.
Mindfulness Techniques
Mindfulness involves living in the present moment and becoming aware of your thoughts and feelings without being consumed by them.
Here are some key mindfulness practices in DBT:
Observing Thoughts – Focus on one object within your environment. Notice the color, texture, and other sensory aspects of this object. Acknowledge intrusive thoughts without judgment and let them float by like leaves on a river.
4-7-8 Breathing – Inhale for 4 seconds, hold for 7 seconds, and exhale for 8 seconds to calm the nervous system. During this exercise, focus on your breath to center yourself.
Body Scan – Choose a place that is quiet. Sit comfortably in a chair with your feet flat on the floor. Close your eyes. Focus your attention on each part of your body. Progressively tense and release muscles to locate and ease tension.
Distress tolerance strategies help individuals cope with crises without resorting to self-destructive behaviors. Here are some techniques for riding the wave of emotions:
STOP Technique
This involves pausing or stopping your current activity, taking a step back, observing your thoughts and feelings, and then mindfully proceeding with awareness instead of from an emotional position.
ACCEPTS
A strategy for building distress tolerance. This acronym helps manage intense emotions effectively.
Activities: Engage in activities that distract you and occupy your mind.
Contributions: Volunteer or contribute to the community, redirecting focus away from personal distress.
Comparisons: Reflect on times when the situation was worse or other individuals who are facing greater struggles.
Emotions: Cultivate positive emotions through humor or uplifting content.
Pushing Away: Mentally distance yourself from distressing situations, allowing time for reflection.
Thoughts: Engage your mind in counting or other mental exercises to divert focus from negative thoughts.
Sensations: Utilize comforting physical sensations, such as holding onto a heating pad or a cool object.
Self-Soothing
Engage your five senses to calm and comfort yourself. This could involve listening to relaxing music (hearing), using a comforting blanket (touch), smelling essential oils (smell), eating a favorite food mindfully (taste), or looking at calming scenery (sight).
TIPP Skills for Relief
TIPP (Temperature, Intense exercise, Paced breathing, and Progressive muscle relaxation) provides tactics for managing overwhelming emotions in acute situations.
Temperature: Change your body temperature (e.g., splashing cold water on your face).
Intense Exercise: Engage in brisk physical activity to release pent-up energy.
Paced Breathing: Use deep breathing techniques to stabilize emotional responses.
Progressive Muscle Relaxation: Tighten and relax muscle groups to relieve tension.
Emotional Regulation Techniques
Emotional regulation aims to help individuals identify and manage overwhelming emotions. Effective techniques include:
ABC PLEASE
Accumulate Positives: Seek and engage in positive experiences to balance negative emotions.
Build Mastery: Tackle small challenges that boost confidence.
Cope Ahead: Anticipate future emotional challenges and prepare strategies to address them.
Treat Physical Illness: Address underlying physical health issues that might affect mental well-being.
Eating: Monitor diet for its impact on emotional stability.
Avoid Mood-Altering Substances: Substances can alter your state of mind and ability to regulate your emotions. Try to avoid mood-altering substances as much as possible.
Sleep: Your sleep is intimately connected to your ability to regulate your mood. Make sure you are getting the recommended amount of sleep for your age.
Exercise: Incorporating physical activity to enhance mood and emotional balance.
Opposite Action
Identify the emotion you are feeling and then intentionally engage in behavior that is the opposite of what that emotion urges you to do.
Interpersonal effectiveness focuses on communicating needs and boundaries assertively. Two essential skills are:
DEARMAN
Describe the situation.
Express your feelings.
Assert your needs.
Reinforce the positive outcome.
Mindful: Remain aware during the interaction.
Appear Confident.
Negotiate if necessary.
GIVE FAST
Be Gentle: Show respect and avoid aggression.
Act Interested: Engage actively and validate the other person's point of view.
Validate: Acknowledge the feelings of others.
(Use an) Easy Manner: Maintain a light tone and humor to ease the conversation.
(Be) Fair: Be fair to yourself and the other person. Remember to validate yourself and them.
(No) Apologies: Don’t over-apologize. Don’t apologize for being alive or asking for something. Don’t look ashamed by having your shoulders slumped and eyes downcast.
Stick to your values: Be clear on what you believe and “stick to your boundaries.” Don’t sell out your values or integrity for something or someone else.
(Be) Truthful: Don’t lie and don’t make up excuses or exaggerate.
What to Expect in DBT Treatment
DBT is an intensive therapeutic approach that may require your therapist to work in consultation with a treatment team. What you engage in is up to you and what works best for you.
A standard DBT program may include:
Weekly individual sessions (60 min)
Weekly skills-training group
Between-session coaching via phone or secure text
Diary cards to track emotions, urges, and skill use
Individual DBT sessions usually last an hour and you may complete a diary card to track treatment targets, identify, rate, and manage the intensity of emotions, indicate positive coping mechanisms, improve relationships, and enhance self-awareness.
Since DBT is present-oriented and skills-based, you will most likely be asked to practice your skills between sessions. For example, you may be tasked with taking specific, concrete steps to practice communicating more effectively in your relationship.
Treatment length varies, but many clients commit to six months to one year for lasting change.
Choosing the Right DBT Therapist
A DBT therapist is a licensed mental health professional who has additional training and experience in DBT. A strong therapeutic alliance, and a therapist versed in comprehensive, evidence-based DBT, is critical for success.
In therapy, if you don’t feel comfortable, there may not be a strong therapeutic alliance, and this can be detrimental to reaching your goals.
Ask prospective therapists the following to determine if they may a fit to work with:
How much experience do you have treating issues like mine with DBT?
How do you know whether my situation is a good candidate for DBT?
What will DBT look like with you?
What is your formal DBT training and certification?
What is a typical plan of treatment, and how long is a typical course of therapy?
How do you measure progress and adjust goals?
What length of time do you initially ask a client to commit to?
Book a Free Consultation with Blue Sky Learning
If you or a loved one struggles with emotional dysregulation, relationship conflict, or self-destructive coping, DBT could be the path to healing.
Email hello@blueskylearning.ca, call 1-437-291-8807, or click below to schedule your free 20-minute consultation with a DBT therapist, in Ontario, Canada.
References and Recommended Readings:
Swales, M. A., & Heard, H. L. (2017). Dialectical behaviour therapy: Distinctive features. Routledge.
Linehan, M. M. (2015). DBT skills training manual (2nd ed.). Guilford Press.
American Psychological Association. (2021). Dialectical behavior therapy (DBT). Retrieved from [https://www.apa.org](https://www.apa.org)
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