DBT Based Approach

What is Dialectical Behavior Therapy?

DBT, which stands for Dialectical Behavior Therapy, was pioneered by psychologist Marsha M. Linehan in the late 1980s. Dialectical behavior therapy (DBT) was initially created to help individuals with borderline personality disorder (BPD) but has evolved to address a wide range of mental health issues such as depression, anxiety, and addiction. The flexibility of DBT has made it a popular choice for therapists working with patients who struggle with emotional regulation.

Drawing upon the principles of dialectics, the therapy explores the notion that opposing ideas can coexist and hold truth simultaneously. This core concept is applied in DBT by encouraging individuals to embrace self-acceptance while also acknowledging the importance of personal growth and transformation.

As a multifaceted approach to healing, DBT integrates various components such as individual therapy, group therapy, and skills training. The treatment is structured and typically conducted within a specific timeframe, with regular sessions aimed at providing support and guidance. Patients undergoing DBT can expect to engage in weekly one-on-one therapy sessions as well as participate in group sessions focused on developing practical skills for coping and managing emotions effectively.

However, at Fig Tree Therapy, we offer abbreviated form of this approach. Please see below for more information.

The Four Modules of DBT

DBT is divided into four modules, each focusing on a different set of skills:

  1. Mindfulness is a transformative practice that encourages individuals to cultivate a deep sense of awareness and presence in the present moment. This practice involves paying deliberate attention to one’s thoughts, emotions, and bodily sensations, without any form of judgment. Through this intentional focus on the present moment, individuals can develop a heightened sense of self-awareness and gain valuable insights into their internal experiences and reactions to different stimuli. By observing their thoughts and feelings from a place of non-judgmental acceptance, individuals can learn to respond to challenges in a more calm and balanced manner, ultimately leading to a greater sense of clarity and emotional well-being.
  2. Distress Tolerance: This crucial module is designed to provide individuals with the necessary skills to effectively cope with distressing situations that may arise in their lives. By emphasizing the importance of remaining calm and composed in the face of difficult emotions, participants will learn valuable techniques to prevent the escalation of challenging situations. Furthermore, this module aims to empower individuals to resist the urge to act impulsively when faced with overwhelming emotions, thus promoting more thoughtful and proactive responses to distress. Through practical exercises and strategies, individuals will cultivate the ability to handle intense emotions in a healthy and constructive manner.
  3. Emotion Regulation: In this crucial module, individuals will be equipped with the tools and techniques necessary to recognize and articulate their various emotions, allowing for a deeper understanding of the underlying causes and triggers. By gaining insight into the purpose and function of emotions, participants can begin to navigate their emotional landscape with greater clarity and control. Through instruction and practice, individuals will discover effective strategies for managing intense emotions and cultivating a sense of balance and well-being in their daily lives. This module also emphasizes the importance of developing healthy coping mechanisms to promote emotional resilience and enhance overall emotional intelligence.
  4. Interpersonal Effectiveness is a crucial module that places a spotlight on enhancing communication skills and fostering healthier relationships with others. This module equips individuals with the tools and strategies necessary to effectively set boundaries, assert their needs, and navigate complex social interactions. By honing these skills, individuals can cultivate more meaningful and fulfilling relationships while also promoting their own well-being and mental health. Through guided practice and feedback, participants can gain valuable insights into their communication styles and learn how to approach challenging situations with confidence and clarity. Ultimately, mastering interpersonal effectiveness can lead to greater harmony in personal and professional relationships, as well as a heightened sense of self-awareness and emotional intelligence.

How Does DBT Work?

Dialectical Behavior Therapy (DBT) is founded on the belief that individuals who experience difficulties regulating their emotions often struggle with managing their relationships as well. These challenges can arise from a complex interplay of biological, environmental, and social influences. By addressing these factors, DBT seeks to equip individuals with the necessary tools and techniques to better navigate their emotions and cultivate healthier relationships with others. The ultimate goal of DBT is to empower individuals to lead more fulfilling and balanced lives.

Individual Therapy

Individual therapy is a crucial aspect of Dialectical Behavior Therapy (DBT) as it provides a safe and confidential space for the therapist and client to collaborate on identifying and addressing specific issues and behaviors. Through the process of therapy, the therapist assists the client in setting achievable goals and devising a personalized plan to work towards achieving them.

Furthermore, in individual therapy sessions, the therapist plays a significant role in supporting the client to integrate and practice the skills learned in group therapy into their daily life. By applying these skills to real-life situations, the client can further enhance their ability to manage their emotions and behavior effectively. Typically, individual therapy sessions are scheduled on a weekly basis and last between 45-60 minutes to allow for in-depth exploration and problem-solving.

Group Skills Training

Group skills training is an essential and highly structured component of Dialectical Behavior Therapy (DBT), which is designed to help individuals develop crucial coping strategies and improve their emotional regulation. These training sessions are led by a therapist who has been specifically trained in DBT techniques and methodologies, and typically involve a small group of 6-8 individuals who come together to learn and practice various skills. Throughout these sessions, participants are guided through the four key modules of DBT, which include mindfulness, distress tolerance, emotion regulation, and interpersonal effectiveness.

The group skills training sessions are carefully planned and organized to ensure maximum effectiveness and long-term success for participants. Lasting between 2-3 hours each week, these sessions are held consistently over a period of 24 weeks, allowing individuals the time and space they need to fully absorb and integrate the skills being taught. Through this intensive and comprehensive format, participants have the opportunity to not only learn new skills but also practice applying them in real-life situations, both in individual therapy sessions and in their day-to-day interactions with others.

Furthermore, the skills learned in group therapy are not simply left behind once the sessions are completed. Rather, they are meant to be carried forward and utilized by participants long after the group skills training has ended. By incorporating these newly acquired skills into their individual therapy sessions and daily lives, individuals can begin to see tangible improvements in their ability to manage emotions, cope with stress, and effectively navigate interpersonal relationships. Thus, the impact of group skills training extends far beyond the confines of the therapy room, empowering individuals to create meaningful and lasting changes in their lives.

Phone Coaching

In addition to individual therapy and group therapy sessions, Dialectical Behavior Therapy (DBT) offers clients the opportunity to engage in phone coaching as part of their treatment plan. This unique aspect of DBT allows individuals to have ongoing access to their therapist outside of their regular appointments. By being able to reach out for support and guidance between sessions, clients can feel more supported and empowered in their journey towards healing and growth.

Phone coaching serves as a valuable resource for clients, especially during times of crisis or when they are encountering challenges in applying the skills they have been learning in therapy to their daily lives. It provides a way for individuals to receive immediate assistance and guidance when they need it most, helping them navigate difficult situations and make informed decisions. This real-time support can be instrumental in helping clients cope with overwhelming emotions or difficult circumstances, ultimately enhancing their ability to effectively manage their mental health and well-being.

Benefits of Dialectical Behavior Therapy

Dialectical Behavior Therapy (DBT) has been extensively researched and proven to be highly effective in treating a wide range of mental health conditions. Among the conditions that DBT has shown positive outcomes in treating are borderline personality disorder, major depression, generalized anxiety disorder, and substance abuse disorders. Individuals who struggle with these conditions often find great relief and improvement in their symptoms through the practice of DBT techniques and interventions.

One of the key benefits of DBT is its focus on incorporating both acceptance and change-oriented strategies to help individuals develop coping skills and improve their emotional regulation. By learning to accept their emotions as they are, individuals can then work towards making positive changes in their thoughts and behaviors, leading to improved overall mental health and well-being. This combination of acceptance and change is a unique aspect of DBT that sets it apart from other forms of therapy, making it particularly effective in addressing complex and chronic mental health issues.

Another important benefit of DBT is its emphasis on mindfulness practice, which helps individuals become more aware of their thoughts, emotions, and behaviors in the present moment. By practicing mindfulness techniques, individuals can learn to observe their thoughts without judgment, allowing them to let go of harmful patterns of thinking and reacting. This increased awareness and self-regulation can lead to greater emotional stability, improved relationships, and overall better quality of life for those participating in DBT therapy.

In addition, DBT offers a strong focus on developing interpersonal effectiveness skills, helping individuals learn how to communicate effectively, set boundaries, and build healthy relationships. By learning how to assert their needs and navigate social interactions more successfully, individuals can improve their ability to connect with others and maintain stable and fulfilling relationships. This aspect of DBT can be particularly beneficial for individuals who struggle with interpersonal difficulties as a result of their mental health conditions.

Improved Emotional Regulation

Mindfulness meditationby Tatum Bergen (https://unsplash.com/@tatumbergenphoto)

One of the primary objectives of Dialectical Behavior Therapy (DBT) is to empower individuals with the necessary tools and techniques to effectively handle and manage their emotions. By actively engaging in and mastering mindfulness skills, distress tolerance strategies, and emotion regulation techniques, individuals can acquire the ability to recognize, process, and regulate their emotions in a more constructive and productive manner.

This comprehensive approach to emotional well-being can prove to be significantly advantageous for individuals who find themselves overwhelmed by intense emotions such as anger, anxiety, or sadness. By developing the skills to regulate their emotional responses, individuals can experience improved mental health and a heightened sense of overall well-being. Moreover, by effectively managing their emotions, individuals are better equipped to avoid engaging in impulsive or harmful behaviors that may have negative consequences on their mental and emotional health.

Increased Mindfulness Skills

Mindfulness, a fundamental element of Dialectical Behavior Therapy (DBT), is widely recognized for its positive impact on mental health. It involves cultivating a non-judgmental awareness of the present moment, allowing individuals to observe their thoughts and feelings without reacting impulsively. This practice has been shown to decrease stress levels, enhance concentration, and foster a deeper understanding of oneself.

Furthermore, the cultivation of mindfulness skills can be especially beneficial in managing challenging emotions and impulsive behaviors. By integrating mindfulness techniques into their daily routines, individuals can significantly improve their quality of life and enhance their emotional resilience. Research has demonstrated that regular mindfulness practice can effectively alleviate symptoms of anxiety and depression, leading to a more balanced and fulfilling mental well-being.

Better Relationships

Interpersonal effectiveness is a crucial element within Dialectical Behavior Therapy (DBT), a therapeutic approach that emphasizes the development of skills to help individuals navigate their relationships more effectively. By acquiring the ability to communicate assertively, establish and uphold boundaries, and foster healthy connections with others, individuals can make strides in improving the quality of their interpersonal interactions.

This aspect of DBT becomes even more significant for individuals grappling with Borderline Personality Disorder (BPD), a condition characterized by pervasive difficulties in maintaining stable and fulfilling relationships. Enhancing one’s relational skills not only holds the potential to alleviate the strain caused by interpersonal challenges associated with BPD but can also have a positive ripple effect on one’s mental health. By fostering healthier and more supportive relationships, individuals may experience a reduction in symptoms of depression and anxiety, ultimately fostering a greater sense of overall well-being.

Coping with Distress

Distress tolerance skills are essential components of Dialectical Behavior Therapy (DBT), a therapeutic approach that emphasizes the importance of emotional regulation and mindfulness. These skills empower individuals to navigate challenging situations without succumbing to impulsive actions that may exacerbate their distress. By honing their ability to withstand difficult emotions and urges, individuals can effectively manage their mental health and enhance their overall resilience.

In the realm of mental health treatment, distress tolerance skills are especially invaluable for individuals grappling with self-harming behaviors or substance abuse issues. By cultivating the capacity to cope with distressing feelings in a constructive manner, individuals can fortify their defenses against the allure of harmful coping mechanisms. This, in turn, can promote sustained recovery and contribute to a higher quality of life characterized by improved emotional stability and personal well-being.

Who Can Benefit from DBT?

In addition to its effectiveness in treating various mental health conditions, DBT has also been utilized in settings beyond traditional therapy, such as in schools, hospitals, and correctional facilities. This widespread application of DBT speaks to its versatility and the growing recognition of its value in promoting emotional regulation, interpersonal effectiveness, distress tolerance, and mindfulness skills across different populations.:

Borderline Personality Disorder (BPD) is a mental health condition characterized by a pattern of unstable relationships, self-image, and emotions. Individuals with BPD often experience intense mood swings, impulsivity, and difficulty regulating emotions. They may also have a strong fear of abandonment and engage in risky behaviors in an attempt to avoid real or perceived rejection. People with BPD may also struggle with a chronic sense of emptiness and engage in self-harming behaviors as a way to cope with emotional distress. Additionally, individuals with BPD may have difficulty with impulse control, resulting in behaviors such as substance abuse or binge eating. Treatment for BPD typically involves a combination of therapy, medication, and support from loved ones. It is important for individuals with BPD to seek help from mental health professionals to effectively manage their symptoms and improve their quality of life.

Depression is a mental health disorder that impacts individuals in a variety of ways. This condition can manifest as persistent feelings of sadness, hopelessness, and disinterest in activities once enjoyed. Additionally, depression can also lead to physical symptoms such as changes in appetite, sleep disturbances, and decreased energy levels. It is important to note that depression is a common and treatable condition, but it often requires professional intervention in the form of therapy, medication, or a combination of both. If left untreated, depression can have a significant impact on a person’s overall well-being and quality of life. Therefore, it is crucial for individuals experiencing symptoms of depression to seek help from a healthcare provider.

Anxiety disorders are a diverse group of mental health conditions that can cause individuals to experience excessive worry, fear, or nervousness in various situations. These disorders can manifest in a wide range of symptoms, such as panic attacks, difficulty concentrating, irritability, and physical symptoms like racing heart, sweating, and muscle tension. It is important to note that anxiety disorders are not simply a temporary feeling of stress or worry, but rather a persistent and overwhelming presence that can significantly impact a person’s daily life and functioning.

Individuals with anxiety disorders may find it difficult to cope with the constant stream of negative thoughts and feelings that accompany their condition. This can lead to avoidance of certain situations or activities that trigger anxiety, further exacerbating their symptoms and isolating them from sources of support. Additionally, the chronic stress of living with an anxiety disorder can take a toll on a person’s physical health, leading to issues such as insomnia, digestive problems, and weakened immune function.

Treatment for anxiety disorders typically involves a combination of therapy, medication, and lifestyle changes to help individuals manage their symptoms and improve their quality of life. Cognitive-behavioral therapy (CBT) is often used to help individuals identify and challenge negative thought patterns and develop coping strategies for managing anxiety. Medications such as selective serotonin reuptake inhibitors (SSRIs) or benzodiazepines may also be prescribed to help alleviate symptoms. In addition, lifestyle changes such as regular exercise, healthy eating, and stress management techniques can play a significant role in reducing anxiety and promoting overall well-being.

In conclusion, anxiety disorders are a complex and challenging group of mental health conditions that can have a profound impact on an individual’s life. It is essential for those affected by these disorders to seek treatment and support to help them effectively manage their symptoms and improve their quality of life. By addressing the underlying causes of anxiety and developing effective coping strategies, individuals can regain a sense of control and find relief from the debilitating effects of this condition.

Substance abuse, also known as drug abuse, is a patterned use of a substance in a way that results in harm to one’s physical or mental health. This harmful usage may include the use of drugs, alcohol, tobacco, or other substances that are taken in excess or in a manner that is not recommended by medical professionals. Substance abuse is a complex issue that affects individuals of all ages, backgrounds, and socioeconomic statuses, and can lead to a range of physical, psychological, and social problems.

When individuals engage in substance abuse, they may experience a variety of negative effects on their physical health. These effects can include damage to vital organs such as the heart, liver, and kidneys, as well as impaired immune system function and increased risk of developing chronic diseases. Substance abuse can also impact an individual’s mental health, leading to symptoms of anxiety, depression, paranoia, and other mental health disorders. In addition to physical and mental health effects, substance abuse can also have serious social consequences, such as strained relationships with family and friends, legal troubles, and difficulties maintaining employment or fulfilling other responsibilities.

Eating disorders are serious mental health conditions that can have detrimental effects on a person’s physical and emotional well-being. They often stem from a combination of genetic, biological, behavioral, psychological, and social factors. The most common types of eating disorders include anorexia nervosa, bulimia nervosa, and binge eating disorder. These disorders can manifest in different ways, such as restricting food intake, binge-eating followed by purging, or compulsively overeating.

Individuals with eating disorders often have distorted perceptions of their body image and weight, leading to unhealthy behaviors around food and exercise. They may experience intense feelings of guilt, shame, and anxiety related to eating. In severe cases, eating disorders can lead to serious medical complications, such as malnutrition, electrolyte imbalances, organ damage, and even death. The road to recovery from an eating disorder can be long and challenging, requiring a comprehensive treatment approach that addresses the physical, emotional, and psychological aspects of the disorder. Therapies such as cognitive-behavioral therapy, nutritional counseling, and medication may be recommended to help individuals overcome their struggles with food and body image.

It’s important for individuals struggling with eating disorders to seek professional help and support from a qualified mental health provider. Early intervention and treatment can greatly increase the chances of a successful recovery and improve long-term outcomes. Family and friends can also play a crucial role in providing emotional support and encouragement throughout the recovery process. By addressing the underlying issues contributing to their eating disorder and learning healthier coping mechanisms, individuals can regain control over their relationship with food and achieve a more positive self-image.

Bipolar Disorder is a mental health condition characterized by extreme mood swings that fluctuate between episodes of mania and depression. People with bipolar disorder often experience intense feelings of happiness, excitement, and energy during manic episodes, followed by periods of sadness, hopelessness, and low energy during depressive episodes. These mood swings can be severe and disruptive to daily life, affecting a person’s ability to function at work, school, or in relationships. Additionally, bipolar disorder can also be accompanied by changes in sleep patterns, appetite, and behavior. It is important for individuals with bipolar disorder to seek professional treatment in order to effectively manage their symptoms and improve their overall quality of life.

Post-Traumatic Stress Disorder (PTSD) is a mental health condition that can develop after a person has experienced a traumatic event. This condition can manifest in a variety of ways, including flashbacks, nightmares, and severe anxiety. Individuals with PTSD may also experience difficulty regulating their emotions or maintaining healthy relationships. It is important to recognize the symptoms of PTSD and seek treatment from a mental health professional in order to address these issues and improve overall well-being.

Dialectical behavior therapy (DBT) is a specialized form of therapy that can be particularly beneficial for individuals who experience difficulties in regulating their emotions. Such individuals may find it challenging to cope with intense emotions and may benefit from learning skills and strategies to manage their emotional reactions effectively. In addition, DBT may also be helpful for those who have difficulties in maintaining healthy relationships, as the therapy focuses on improving communication and interpersonal skills. Furthermore, individuals with a history of impulsive or harmful behaviors may also find DBT to be beneficial, as the therapy can help them develop more adaptive coping mechanisms and decision-making skills.


Dialectical behavior therapy (DBT) is a multifaceted approach to treatment that encompasses a range of interventions to address various aspects of an individual’s mental well-being. This form of therapy includes not only one-on-one counseling sessions, but also group skills training sessions and access to phone coaching for additional support outside of scheduled appointments. By utilizing a combination of these modalities, individuals can build a toolkit of skills to effectively manage their emotions, navigate relationships, and cope with difficult situations as they arise in their lives.

Research has demonstrated the efficacy of DBT in addressing a wide array of mental health conditions, making it a valuable option for those who struggle with issues related to emotional regulation, interpersonal relationships, and impulsive behaviors. If you or someone you care about is faced with these challenges, it may be beneficial to consider reaching out to a therapist who has specialized training in DBT techniques. With the help of a skilled professional, you can work towards improving your mental health and enhancing your overall quality of life through the implementation of evidence-based strategies and interventions.

DBT Skills Group for Adults & Teens

Faciliated by Stephen Handley, LCSW

Join Stephen to learn the core four skills of DBT: Distress Tolerance, Emotional Regulation, Interpersonal Skills and Mindfulness.

DBT teaches you to regulate your emotions, improve your relationships, understand your emotions without always acting on them, and reducing undesired behaviors.

FOR ADULTS: Stephen will be faciliating two groups, one virtually and on in person, beginning Wednesday, September 20th. Virtually from 12 noon to 1:30pm and in person from 5:15p to 6:45pm.

FOR TEENS: Stephen will be facilitating an in person group, every Thursday, from 4-5pm beginning September 21st.

The cost is $50 per week, due at the start of each of the four modules.

Please call 804-239-7688 or reach out via email as [email protected] for more information.