If you live with intense emotions, feel overwhelmed by your reactions, or struggle to keep relationships steady, you’re not alone. These are tough experiences—and they’re also the kinds of things dialectical behavioural therapy (DBT) was designed to help with.
In this guide, we’ll break down what DBT is, how it works and what to expect if you’re thinking about giving it a try.
Table of Contents:
What is dialectical behavioural therapy?
Dialectical behavioural therapy (DBT) is a type of talking therapy. It helps people manage strong emotions and improve relationships. DBT was created in the 1980s by psychologist Marsha Linehan to treat borderline personality disorder (BPD). Today, it’s also used for other mental health issues like depression, PTSD, anxiety and eating disorders.
The word dialectical means balancing two opposite ideas at the same time—like accepting yourself while also working to change harmful behaviours. DBT teaches you to live in the moment, deal with distress, manage emotions and build better relationships.
It’s built on four key areas, often called the four pillars:
Mindfulness
Mindfulness means noticing what’s happening around and inside you without judgement. It helps you stay present, calm your mind and understand your feelings.
Distress tolerance
These skills help you get through tough times without making things worse. Instead of acting on impulse, you learn ways to ride out the storm—like distraction, self-soothing or acceptance.
Emotion regulation
This helps you understand your emotions, name them and manage them. You’ll learn how to reduce emotional outbursts and feel more in control.
Interpersonal effectiveness
These skills help you deal with other people. You’ll learn how to ask for what you need, set boundaries and improve communication—without hurting yourself or others.
What does dialectical behavioural therapy look like?
DBT usually includes one-to-one therapy, group sessions and sometimes phone coaching. Treatment often lasts 6–12 months, but this can vary.
In one-to-one therapy, you’ll work with a DBT therapist to apply the skills to your life. You’ll look at what’s working, what’s not and how to keep going.
Group sessions are more like classes. You’ll learn and practise DBT skills with others. You don’t have to share personal details unless you want to.
Things to consider before starting DBT
- It’s a commitment: DBT often means weekly sessions, group work and homework. It can feel like a lot, especially when life is hard.
- It’s focused on skills: DBT is about learning tools for now. It doesn’t go deep into your past straight away.
- It’s structured: Sessions follow a clear plan. This helps some people feel safe and others feel restricted.
- You don’t need to be perfect: Mistakes and setbacks are normal. DBT encourages self-kindness as you learn.
DBT vs traditional therapy
DBT and traditional therapy work in different ways. Here’s how they compare:
Focus:
- DBT: Focuses on the present and teaching practical skills
- Traditional therapy: Explores your past and the root of emotional patterns
Structure:
- DBT: Highly structured with a set programme and weekly goals
- Traditional therapy: More flexible and open-ended
Style:
- DBT: Includes one-to-one sessions, group skills training and sometimes phone support
- Traditional therapy: Usually one-to-one sessions only
Tools:
- DBT: Teaches specific skills like mindfulness, emotion regulation and distress tolerance
- Traditional therapy: Helps you reflect, gain insight and understand yourself more deeply
Approach:
- DBT: Balances change with self-acceptance
- Traditional therapy: Focuses more on exploration and emotional insight
Some people start with DBT to feel more stable, then move to traditional therapy later. Others use DBT on its own as a long-term support. It depends on your needs and goals.
Finding DBT support in the UK
You can access DBT through the NHS, privately or through charities.
- NHS: Many NHS teams offer DBT for people with BPD or similar struggles. You’ll need a referral from your GP or mental health team. Waiting times can be long.
- Private therapy: You can find DBT-trained therapists who work privately. Some offer full programmes, others offer one-to-one skills work. Prices vary. Some offer lower-cost sessions.
- Charities and online: Organisations like Mind and Rethink sometimes run DBT-style groups. There are also books, online courses and apps that teach DBT skills. These aren’t the same as full therapy, but they can still help.
To find a qualified DBT therapist, check if they’ve had proper training. The British Isles DBT Training website is a good place to start.
FAQs about DBT
Is DBT only for BPD?
No. DBT was created for BPD but now helps with many other issues like:
- Depression
- PTSD
- Eating disorders
- Anxiety
- Bipolar disorder
- Addiction
It’s helpful for anyone who struggles with intense emotions or relationships.
How effective is DBT for BPD?
Studies show DBT works well for BPD. It can reduce self-harm, suicidal thoughts and hospital stays. Many people feel more stable, more hopeful and more in control after DBT.
But it’s not magic. Like any therapy, it works best when you practise the skills and have support.
What if I’m not ready for DBT?
That’s OK. DBT can feel intense. You might start with another therapy or support group. Some people try mindfulness or read about DBT skills first. Talk to a professional about what feels doable for you right now.
Final thoughts: What is DBT?
DBT is a practical, proven way to handle big emotions and build a better life. It teaches skills to stay calm, cope in tough times and improve your relationships.
It won’t change who you are—but it can help you feel more in control, more understood and more like yourself.
Whether you’re living with BPD or just want help managing strong feelings, DBT could be worth exploring. or are just beginning to explore your options, know that support is out there – and you deserve it.
