DBT: A compassionate path to emotional well-being

Dialectical behaviour therapy (DBT) is a specialised and compassionate approach to mental health treatment, developed by psychologist Marsha M. Linehan in the late 1980s. Initially designed to support individuals with borderline personality disorder (BPD), DBT has proven to be incredibly effective for a variety of mental health challenges. At its core, DBT harmonises acceptance and change, guiding individuals toward a balanced and fulfilling life.


How DBT helps

Dialectical behaviour therapy is built around four essential pillars: mindfulness, distress tolerance, emotion regulation, and interpersonal effectiveness. Each pillar plays a unique role in nurturing emotional resilience and personal growth:


This foundational practice involves staying present in the moment and observing thoughts and feelings without judgment. By cultivating mindfulness, individuals develop a deeper awareness of their inner experiences, which fosters a sense of calm and enhances emotional control. Mindfulness helps individuals step back from their thoughts and feelings, allowing them to observe and experience their emotions without being overwhelmed.

Distress tolerance

These skills help individuals navigate crises without resorting to harmful behaviours. Techniques such as distraction, self-soothing, and radical acceptance empower individuals to endure and move through intense emotions with grace and stability. Distress tolerance skills are crucial for managing moments of crisis, providing practical strategies to withstand emotional pain and stress without making impulsive decisions.

Emotion regulation

This aspect of DBT teaches individuals to understand and manage their emotions effectively. By identifying and labelling emotions, individuals can reduce emotional vulnerability and foster positive emotional experiences, leading to greater emotional well-being. Emotion regulation skills enable individuals to recognise their emotional triggers, develop coping strategies, and build resilience against emotional ups and downs.

Interpersonal effectiveness

This component focuses on nurturing healthy communication and relationship skills. It includes strategies for assertiveness, setting boundaries, and maintaining self-respect, allowing individuals to build and sustain meaningful connections with others. Interpersonal effectiveness skills are vital for creating and maintaining relationships that are both satisfying and respectful.

Conditions DBT helps with

Dialectical behaviour therapy has been successfully applied to a wide range of mental health issues, providing relief and fostering growth for many individuals. Some of the conditions and challenges that DBT effectively addresses include:

Borderline personality disorder (BPD)

DBT was initially developed to treat BPD, and it remains one of the most effective therapies for managing its symptoms, such as intense emotional swings, impulsive behaviours, and unstable relationships. The structured and validating approach of dialectical behaviour therapy provides a lifeline for individuals struggling with BPD, helping them build a more stable and fulfilling life.


DBT helps individuals break the cycle of negative thinking and self-destructive behaviours, promoting healthier emotional responses and a more positive outlook. By addressing both the cognitive and emotional aspects of depression, DBT offers a comprehensive approach to recovery.

Anxiety disorders

By teaching skills to manage and tolerate distress, DBT reduces anxiety and helps individuals cope with overwhelming feelings. Techniques like mindfulness and emotion regulation are particularly effective in reducing anxiety symptoms and improving overall quality of life.

Substance abuse

Dialectical behaviour therapy addresses the underlying emotional issues that often drive substance abuse, promoting healthier coping mechanisms and reducing the risk of relapse. The skills learned in DBT help individuals manage cravings, deal with triggers, and build a sober lifestyle.

Eating disorders

DBT helps individuals develop a healthier relationship with food and their bodies by addressing emotional regulation and distress tolerance. By teaching individuals how to manage their emotions and cope with stress without resorting to disordered eating behaviours, DBT supports long-term recovery.

Post-traumatic stress disorder (PTSD)

DBT provides tools for managing the intense emotions and distress that can arise from trauma, helping individuals regain a sense of control and safety. Techniques like mindfulness and distress tolerance are particularly beneficial for individuals with PTSD, offering ways to process and move beyond traumatic experiences.

Self-harm and suicidal behaviours

DBT equips individuals with strategies to manage intense emotions and urges, reducing self-harm and suicidal behaviours. The comprehensive and structured approach of dialectical behaviour therapy provides the necessary support for individuals to develop healthier coping mechanisms and stay safe.

For those seeking a personalised approach, dialectical behaviour therapy offers individual therapy sessions tailored to each person's unique needs.

What to expect in DBT

In one-on-one sessions, therapists work closely with clients to address specific challenges and apply DBT skills to real-life situations. These sessions provide a safe and supportive space for personal exploration and growth.

The therapist helps the client identify patterns of behaviour, understand the underlying causes of emotional distress, and develop compassionate strategies for change. Individual DBT therapy allows for a highly personalised and focused therapeutic experience, ensuring that the client's unique needs and goals are met.

Individual DBT therapy is particularly beneficial for those who may feel uncomfortable in group settings or who require more intensive, personalised support. This individualised approach allows therapists to tailor interventions to the client's unique experiences and goals, fostering a deeper and more meaningful therapeutic journey.

Why finding a trained therapist is essential

Given the specialised nature of DBT, it is crucial to find a therapist who has received proper training in this therapeutic approach. Trained DBT therapists create a validating and compassionate environment while gently challenging clients to change harmful behaviours. They are skilled at balancing acceptance and change, a core principle of DBT, and can effectively teach and reinforce DBT skills.

DBT therapists adhere to a comprehensive treatment model, ensuring that clients receive the full benefits of this evidence-based therapy. They participate in ongoing supervision, which provides support and maintains the therapist's adherence to DBT principles and practices. This commitment to professional development and adherence to DBT protocols ensures that clients receive the highest standard of care.

Through dialectical behaviour therapy, individuals can find the guidance and support they need to achieve emotional balance and well-being. It is a journey of healing and growth, where hope is restored, and a brighter future becomes possible. Whether you are struggling with intense emotions, relationship difficulties, or any other mental health challenges, DBT offers a path to resilience, stability, and a fulfilling life. Embrace the hope and possibilities that DBT brings, and take the first step toward a more balanced and joyful existence.

The views expressed in this article are those of the author. All articles published on Counselling Directory are reviewed by our editorial team.

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St. Neots PE19 & Bedford MK40
Written by Donna West, MBACP (Accred)ACTO (Snr) Psychotherapist/Clinical supervisor
St. Neots PE19 & Bedford MK40

I have worked with an array of clients whom have accessed counselling for varying reasons that they feel are inhibiting them from living an authentic life. My role within the therapeutic relationship is to work alongside an individual to facilitate self-exploration and consider alternative routes that may lay before them.

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