Understanding Dialectical Behaviour Therapy (DBT): an introduction to DBT, its principles, and how it differs from other therapeutic approaches
- Matthew Frener
- Sep 8
- 4 min read
Dialectical Behaviour Therapy (DBT) has emerged as a powerful and evidence-based approach for individuals struggling with emotional dysregulation and a range of mental health challenges. Developed in the late 1980s by psychologist Dr. Marsha Linehan, DBT was originally designed to support people living with Borderline Personality Disorder (BPD). Today, its principles are widely applied to help people facing difficulties such as eating disorders, addiction, trauma, and overwhelming emotions.
This blog post aims to provide an introduction to DBT, explore its core principles, and highlight how it differs from other therapeutic approaches.
What is Dialectical Behaviour Therapy (DBT)?
DBT is a form of cognitive-behavioural treatment that blends acceptance and change. The word dialectical refers to the synthesis of opposites, and this balance underpins every part of DBT: learning to accept yourself and your current situation, while also making meaningful changes in how you respond to life’s challenges.
DBT treatment is structured around four essential components:
Individual therapy: weekly one-to-one sessions focused on your personal goals
Group skills training: learning and practising DBT skills in a supportive group setting
Phone coaching: real-time support to help apply skills during crises
Therapist consultation teams: ensuring therapists receive support to deliver DBT effectively
Core Principles of DBT
Dialectics: Balancing Acceptance and Change
The foundation of DBT is recognising that two seemingly opposite truths can exist at once. For example, that you are doing your best and that you can learn new ways of coping.
Validation and Acceptance: Feeling Understood
Many people with emotional struggles have experienced invalidation. DBT therapists make space for your feelings as real and understandable, creating trust and reducing shame.
Behavioural Focus: Understanding Patterns
DBT uses behavioural analysis to identify what leads to unhelpful behaviours and what follows them, paving the way for healthier responses.
Skills Training: Four Practical Modules
DBT teaches skills you can use daily. These modules include:
Mindfulness - the cornerstone of DBT, helping you stay present without judgment
Distress Tolerance - coping with crises safely and effectively
Emotion Regulation - reducing vulnerability to intense emotions and building resilience
Interpersonal Effectiveness - improving communication, boundaries, and relationships
Treatment Hierarchy: Setting Priorities
Therapy follows a clear structure, addressing issues in this order:
Life-threatening behaviours
Therapy-interfering behaviours
Quality-of-life issues
Skills development
Commitment to Change: Staying Motivated
Both therapist and client regularly revisit motivation, recognising that change is difficult and possible with persistence.
The Therapeutic Relationship: A Collaborative Partnership
The relationship in DBT is supportive, validating, and honest. It combines empathy with gentle challenge, helping you grow in a safe environment.
Balancing Individual, Group, and Real-Life Support
Progress happens through weekly therapy, group learning, and between-session support. This balance makes DBT practical and applicable in daily life.
Therapist Consultation: Supporting Effective Care
DBT therapists work within consultation teams to remain effective and aligned with the model, preventing burnout and ensuring high-quality treatment.
DBT Assumptions About Clients: A Compassionate Starting Point
DBT assumes that:
Clients are doing their best
Clients want to improve
Clients need to learn new skills
There is no such thing as failure, only opportunities to learn
How DBT Differs From Other Therapies
Many therapies aim to reduce distress and DBT stands out because of its balance of acceptance and change. Here’s how it compares:
Cognitive Behavioural Therapy (CBT): CBT focuses on challenging unhelpful thoughts and behaviours. DBT builds on this foundation but adds mindfulness and acceptance, making it particularly effective for intense emotions.
Psychodynamic Therapy: Psychodynamic approaches explore unconscious processes and past experiences. While this can bring insight, DBT offers practical tools to manage distress in the present.
Acceptance and Commitment Therapy (ACT): ACT also values acceptance but emphasises aligning with personal values. DBT provides more structured skills training for regulating emotions and relationships.
The Role of a DBT Therapist
A DBT therapist does more than listen. They teach skills, offer support, and help you apply what you learn in everyday situations. They are trained to understand the challenges of emotional dysregulation and work actively with you to build stability and resilience.
Group skills training also plays a key role. These sessions provide a space to practise skills, share experiences, and learn from others, often creating a valuable sense of community and belonging.
Online DBT Therapy
With the rise of online therapy, DBT is now accessible online. This allows people to take part in therapy from the comfort of home, making it easier for those with busy schedules or mobility challenges. Online DBT follows the same principles and structure as in-person therapy, ensuring consistent and comprehensive support.
The Benefits of DBT
Research has shown that DBT can help people:
Manage emotions without feeling overwhelmed
Reduce harmful or impulsive behaviours
Improve communication and relationships
Build long-term coping strategies and resilience
Who Can Benefit From DBT?
DBT can be especially helpful for people experiencing:
Borderline Personality Disorder (BPD)
Emotional dysregulation and trauma
Eating disorders
Substance misuse and addiction
Cycles of intense emotions and relationship difficulties
Is DBT Right for You?
If you often feel stuck in cycles of strong emotions, harmful behaviours, or relationship difficulties, DBT may be a powerful option for support. With its mix of acceptance, skills training, and compassionate guidance, it can help you build a more balanced and fulfilling life.
Finding DBT Therapy in Central London, Fitzrovia, or Online
As a qualified DBT practitioner, I split my time between working at Priory, facilitating Dialectical Behaviour Therapy with clients, and my
In both settings, I combine the structure of DBT with an integrative, trauma-informed approach. My aim is to provide a safe and supportive space where you can learn skills, gain insight, and move toward meaningful change.
If you’d like to explore whether DBT is right for you, please feel free to get in touch to arrange a confidential consultation.
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