Dialectical Behavior Therapy (DBT) was originally developed to help people with intense emotional experiences, including borderline personality disorder. Today, it’s used for a wide range of mental health concerns including depression, anxiety, substance use, eating disorders, and self-harm.
At Artisan Counseling, our counselors offer DBT-informed treatment in Newport News, Suffolk, and via telehealth across Virginia.
What “Dialectical” Means
The word “dialectical” refers to holding two seemingly opposite truths at the same time:
- Acceptance of who you are right now
- Change in behaviors that are causing harm
This balance is the foundation of everything DBT does.
Where DBT Came From
DBT was developed in the late 1980s by psychologist Marsha Linehan. She found that traditional CBT alone wasn’t effective for clients with severe emotional dysregulation. These clients often felt invalidated by approaches focused solely on behavior change without first acknowledging their pain.
Linehan combined:
- Change-based strategies from CBT
- Acceptance-based strategies from mindfulness traditions
The result was a therapy that meets people where they are while helping them build the life they want.
The Four Core DBT Skill Areas
1. Mindfulness
The foundation of DBT. Learning to observe the present moment without judgment interrupts automatic emotional reactions.
2. Distress Tolerance
Skills for surviving painful moments without making things worse. Techniques like TIPP (Temperature, Intense exercise, Paced breathing, Paired muscle relaxation) change your body’s chemistry during crisis moments.
3. Emotion Regulation
Learning to identify, understand, and manage emotions. Includes skills like opposite action — doing the opposite of what an unhelpful emotion urges you to do.
4. Interpersonal Effectiveness
Communication skills for asking for what you need, setting boundaries, and maintaining self-respect in relationships. Frameworks like DEAR MAN, GIVE, and FAST provide structure for difficult conversations.
How DBT Is Structured
A comprehensive DBT program includes:
- Individual counseling sessions — applying skills to your specific life
- Skills training groups — structured learning alongside others
- Phone coaching — real-time support between sessions
- Counselor consultation team — ensuring quality care
Not every setting offers all four components. Many counselors at Artisan Counseling incorporate DBT skills into individual counseling sessions.
Who Benefits from DBT?
DBT is especially effective for people who:
- Experience intense emotions
- Have a history of self-harm or suicidal thoughts
- Struggle with impulsive behaviors
- Have borderline personality disorder
- Deal with chronic relationship conflict
- Are in eating disorder recovery
It’s also increasingly used for anyone who feels things deeply and reacts quickly.
How DBT Differs from CBT
| Feature | CBT | DBT |
| Primary Focus | Thought patterns | Emotional regulation |
| Validation Emphasis | Moderate | Central |
| Group Component | Typically no | Often included |
| Acceptance vs. Change | Primarily change | Balance of both |
| Best For | Anxiety, depression, specific patterns | Emotional intensity, BPD, self-harm |
Learn more:
Getting Started with DBT
If you think DBT might help, contact Artisan Counseling at 757.503.2819. Our counselors will assess your needs and determine which DBT components are the best fit.
The skills take practice. But the people who commit to the process consistently report lasting improvements in emotional stability, relationships, and daily functioning.
According to the National Institute of Mental Health, DBT has demonstrated effectiveness in reducing suicidal behavior and hospitalizations.
(Source: https://www.nimh.nih.gov)
