If your emotions often feel too big, too fast or hard to manage, DBT offers practical skills for riding them out without being swept away.
DBT stands for Dialectical Behaviour Therapy. It was developed by psychologist Marsha Linehan in the 1980s and has since grown well beyond its original use. Here’s a plain-language guide to the ideas behind it.
The basic idea
“Dialectical” simply means holding two things that seem opposite at the same time. DBT’s central balance is this: you’re doing the best you can, and you can also learn new ways to cope. Acceptance and change, together.
That means feelings are never treated as “wrong”. Instead, DBT helps you understand your emotions and build skills so they’re easier to live with.
The four skill areas
DBT teaches practical skills in four areas:
Mindfulness. Staying present and noticing thoughts, feelings and sensations without judging them.
Distress tolerance. Getting through painful moments without making things worse, for example by using grounding or self-soothing techniques.
Emotion regulation. Understanding what you feel and why, and learning to ease intense emotions or reduce how often they overwhelm you.
Interpersonal effectiveness. Asking for what you need, setting boundaries, and keeping relationships steady while respecting yourself.
What does it look like in practice?
Formal DBT programs are structured and often include individual therapy, a skills group, and extra support between sessions, delivered by a trained team. Many counsellors also draw on individual DBT-informed skills, such as grounding and emotion regulation tools, without delivering the full program. Either way, it’s practical: you learn skills, practise them between sessions, and review how they went.
What can DBT help with?
DBT-style skills are commonly used for:
Intense or rapidly changing emotions
Stress and feeling overwhelmed
Anxiety and worry
Difficulties in relationships
Impulsive reactions you later regret
Struggling to calm down once upset
DBT was first developed for people with boarderline personality disorder, and it remains an important treatment in that area. Research supports it for several concerns, such as depression and anxiety, but it doesn’t suit everyone.
How is it different from CBT and ACT?
All three are practical and skills-based. CBT often focuses on changing unhelpful thoughts. ACT focuses on acting on your values. DBT places particular emphasis on managing intense emotions and building skills for relationships and getting through crises, while balancing acceptance with change.
Is DBT right for me?
DBT-style skills may help if you like practical tools and want better ways to handle strong emotions. If you’re experiencing very intense distress, frequent crises or thoughts of harming yourself, a full DBT program with a specially trained team, or support from your GP or a psychologist, may be more appropriate than counselling alone. If so, I’ll tell you and help you find the right support.
In my practice, I draw on DBT-informed tools such as mindfulness and grounding alongside a warm, person-centred approach.
Taking the first step
If you’d like to talk about what might suit you, a good first step is a conversation. I offer a free 15-minute consultation where you can ask questions and see how it feels.