Dialectical behavior therapy (DBT) is a skills-based talking therapy for people whose emotions hit hard and fast. It teaches practical ways to get through a crisis, calm strong feelings and handle relationships. It was first built for people with frequent thoughts of suicide and self-harm.1,3
You do not need a diagnosis to learn from DBT skills. Many people use them for everyday stress, grief or family conflict. This page explains what DBT is, who it helps, what the research shows and how to use our four skill lessons.
Key points
- DBT balances two goals: accepting yourself and your situation as they are, and changing what keeps hurting you.1,3
- Full DBT has four parts: weekly individual therapy, a weekly skills class, phone coaching between sessions and a team that supports the therapist.4
- It has the most research for borderline personality disorder and repeated self-harm. Studies show it can reduce self-harm and improve daily life, but the evidence is still limited in quality.7,8 Moderate evidence
- The skills come in four groups: mindfulness, distress tolerance, emotion regulation and interpersonal effectiveness.6
- If you are thinking about suicide, call or text 988 any time. If someone is in immediate danger, call 911.12
What DBT is
Psychologist Marsha Linehan developed DBT, starting in the 1970s. It grew out of cognitive behavioral therapy (CBT), which looks at how thoughts, feelings and actions affect each other.1
The word "dialectical" means holding two ideas that seem to clash. In DBT, the main pair is acceptance and change. You learn to accept yourself and your situation as they are. At the same time, you work to change the actions that keep causing pain.1,3
DBT puts a lot of weight on validation. This means a therapist shows that your feelings make sense, given your life and what you have been through. Feeling understood often makes change easier.3
DBT also uses mindfulness, which means paying attention to the present moment without judging it.2 You can read more about this on our mindfulness page.
Who DBT can help
DBT was designed for people with borderline personality disorder (BPD). BPD is a condition marked by intense, quickly changing emotions, unstable relationships and impulsive actions, often including self-harm.2 NIMH says DBT teaches skills to manage strong emotions, reduce self-destructive behavior and improve relationships.2
Over time, DBT has been adapted for other problems. These include:1,3
- Self-harm and suicidal behavior
- Substance use problems
- Binge eating and bulimia
- PTSD (post-traumatic stress disorder)
- Depression and anxiety, especially when emotions feel out of control
For teens who self-harm often and struggle with strong emotions, a teen version called DBT-A is an option in national guidelines in England. Parents or caregivers often join the skills group.4,10
Full DBT versus a skills group
The word "DBT" is used for several kinds of help. Knowing the difference helps you choose.
Full (comprehensive) DBT
DBT skills group only
- A class that teaches the four skill areas, with homework.
- No individual DBT therapist, unless you have one separately.
- Can help people who want better coping tools and are not in danger.
- Many skills-only studies also gave people a case manager, so skills alone may not be enough for serious problems.11
- Easier to find and often shorter.
A DBT skills class is a class, not a talk group. Each week the leader reviews homework and teaches something new.4 Adults seem to do best when they go through the full set of skills twice.4
What the research shows
DBT is one of the most studied therapies for BPD. Here is what the major reviews say.
A short course is usually not enough for BPD. England's guideline advises against brief therapies of less than 3 months aimed at BPD.9 A psychology society review describes DBT as usually lasting 1 to 1½ years.6
The four skill areas
DBT skills are grouped into four modules (sets of lessons). Each of our lesson pages explains one module step by step.6
| Skill area | What it helps with | Examples you will learn | Lesson |
|---|---|---|---|
| Mindfulness | Noticing what is happening now, without judging | Wise mind, the "what" and "how" skills | Mindfulness skills |
| Distress tolerance | Getting through a crisis without making it worse | TIPP, STOP, self-soothing, radical acceptance | Distress tolerance |
| Emotion regulation | Understanding feelings and lowering how strong they get | Check the facts, opposite action, PLEASE skills | Emotion regulation |
| Interpersonal effectiveness | Asking for what you need and saying no while keeping respect | DEAR MAN, GIVE, FAST | Interpersonal skills |
Mindfulness skills support the other three, so it is a good place to start. If you are in a hard stretch right now, the distress tolerance lesson may be the most useful first step.
DBT works best with practice. Many programs use a diary card, a simple daily log of feelings, urges and skills used.4 You can try a paper version, or use our calm plan to write down the skills that help you most.
Using DBT skills in later life and as a caregiver
DBT skills are not only for young people. Strong emotions can come with chronic illness, loss of a spouse, pain or the strain of caring for someone with dementia. Skills like self-soothing, checking the facts and asking clearly for help can fit many stages of life.
Some tips if you are older or caring for someone:
- Ask a program whether its groups include people your age, or whether it offers individual skills coaching.
- Ask whether sessions can be done by phone or video if travel is hard. See online therapy and apps.
- If memory problems make homework hard, a written skills card on the fridge can help.
- Caregivers may find the interpersonal skills useful for talking with family and doctors. See our caregivers section.
How to find DBT
Not every therapist who lists DBT offers the full program. Before you start, ask:4
- Has the therapist had intensive DBT training, or are they certified?
- Is the skills group a teaching class with homework?
- Is phone coaching available between sessions?
- Does the therapist meet with a DBT consultation team each week?
The DBT-Linehan Board of Certification, a nonprofit, keeps a free search tool for certified clinicians and programs. You can search by state, city or zip code.5 For more help, see how to find a therapist and paying for therapy.
DBT skills do not replace crisis care. If you have thoughts of suicide or self-harm, call or text 988, or chat at 988lifeline.org. It is free, private and open 24/7.12 If someone is in immediate danger, call 911. Making a safety plan with a trusted person or clinician can also help. Families can read when a family member is in a mental health crisis.
Is DBT the same as CBT?
Can I learn DBT skills on my own?
You can learn and practice the skills from our lessons. For self-harm, suicidal thoughts or BPD, full DBT with a trained therapist has the most support.11
How long does DBT take?
In this section
DBT mindfulness
Learn the DBT mindfulness skills in plain words: wise mind, the three "what" skills and three "how" skills, with simple practice steps for daily life.
Read →Distress tolerance
Step-by-step DBT skills for getting through a crisis without making it worse: TIPP, STOP, self-soothing and radical acceptance, with safety tips.
Read →Emotion regulation
Learn DBT emotion regulation skills in plain words: name your feelings, check the facts, use opposite action and care for your body with PLEASE.
Read →Interpersonal skills
Learn the DBT people skills DEAR MAN, GIVE and FAST in plain words, with everyday examples for asking, saying no and keeping your self-respect.
Read →Sources
- Cleveland Clinic. Dialectical behavior therapy (DBT). Cleveland Clinic, accessed October 2026. Cleveland Clinic
- National Institute of Mental Health. Borderline personality disorder. NIMH, accessed October 2026. NIMH
- National Alliance on Mental Illness. Psychotherapy. NAMI, accessed October 2026. NAMI
- DBT-Linehan Board of Certification. Components of a comprehensive DBT program. DBT-LBC, accessed October 2026. DBT-LBC
- DBT-Linehan Board of Certification. Search for certified programs and clinicians. DBT-LBC, accessed October 2026. DBT-LBC
- Society of Clinical Psychology (APA Division 12). Dialectical behavior therapy for borderline personality disorder. Society of Clinical Psychology, accessed October 2026. SCP
- Storebø OJ, et al. Psychological therapies for people with borderline personality disorder. Cochrane Database Syst Rev, 2020. Cochrane
- Witt KG, et al. Psychosocial interventions for self-harm in adults. Cochrane Database Syst Rev, 2021. Cochrane
- National Institute for Health and Care Excellence. Borderline personality disorder: recognition and management (CG78). NICE, 2009. NICE
- National Institute for Health and Care Excellence. Self-harm: assessment, management and preventing recurrence (NG225). NICE, 2022. NICE
- Behavioral Tech Institute. DBT evidence and research. Behavioral Tech, accessed October 2026. Behavioral Tech
- 988 Suicide & Crisis Lifeline. Home page. 988 Lifeline, accessed October 2026. 988lifeline.org
Education only. This page is general information written from the sources listed. It is not medical, legal or financial advice and does not replace a doctor, therapist or lawyer who knows your situation. How we write and check pages.
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