What is DBT and other FAQ

What is Dialectical Behavior Therapy? (DBT)

DBT is an evidence-based psychotherapy that began with the purpose of treating borderline personality disorder. It's been a key player in treating mood disorders, substance abuse, eating disorders, and self-harm. Using mindfulness as its core, DBT teaches both acceptance and change. Dialectical in fact means, acting through opposing forces. With it's four main skill groups, Mindfulness, Emotion Regulation, Distress Tolerance, and Interpersonal Effectiveness, DBT teaches it's learners how to accept circumstances out of their control and tolerate the suffering that goes along with that while changing unwanted behaviors.


How is DBT different from CBT? (DBT VS CBT)

DBT and Cognitive Behavior Therapy are both talk therapies, DBT being a sort of an offspring of cognitive behavior therapy. However, while CBT focuses on changing thoughts to counter hurtful feelings, DBT validates thoughts and feelings, with hopes to replace unhelpful ones with new coping ones and strategies. CBT is great for people with depression while DBT manages destructive behaviors. 



How does DBT work?


DBT relies on talk therapy with a therapist that clients trust. While there are one on one sessions with a professional, DBT involves homework and group sessions where clients can benefit from the therapist-supported live practice of their interpersonal skills. Relationships are the things that people with mood disorders in particular struggle with, so learning from the four skill modules while in a group setting really pushes people into action and helps with overall recovery.


What are DBT skills?

DBT skills are mindfulness and coping strategies that teach radical acceptance and change. With it's four main skill groups, Mindfulness, Emotion Regulation, Distress Tolerance, and Interpersonal Effectiveness, DBT skills include (but not limited to) the following:



What is DBT for anxiety?

Since DBT has a Zen Buddhism foundation it is great for anxiety that trains our thoughts to judge, think in catastrophizing ways, and focus on too many things at once. While the four modules don't mention anxiety specifically, there are in fact anxiety management benefits to most individual skills. There is also a fifth skill group that focuses on anxiety. The skills taught are:

  • Facing Fears – exposure

  • Challenging Negative Thoughts

  • Recognizing Thinking Traps

  • Using “worry time”

  • Box Breathing


What is the hardest personality disorder to treat?


It is said some personality disorders mellow with age while others get worse. First of all there are 2 clusters. The odd/eccentric cluster includes people with paranoid, schizoid, and schizotypal personalities and the flamboyant cluster which includes people with histrionic, antisocial, borderline, and narcissistic personalities. While the latter are the most severe types of personality disorders, borderline personality disorder from the flamboyant cluster is typically the most challenging to treat. Here at OK, Level Up, however, we believe success is totally in the hands of people who are determined to live better, be happier, and most of all, put in the work it takes.

What are the six main points of dialectical behavior therapy?


  1. DBT is supportive.  

  2. DBT is behavioral. 

  3. DBT is cognitive.  

  4. DBT is skill-oriented. 

  5. DBT balances acceptance and change. 

  6. DBT requires a collaborative relationship.



Is DBT good for depression?


DBT is great for depression because it includes the cognitive aspects of cognitive behavior therapy that is typically taught in talk-therapy with depression patience. This includes changing thoughts to change your feelings, self-encouragement, and planning for the future. DBT also stresses the value and importance of building and maintaining relationships with various skills. This aspect can hugely benefit people with depression who are isolated.


What are the 4 modules of DBT?


The four modules of DBT skill groups: Mindfulness, Emotion Regulation, Distress Tolerance, and Interpersonal Effectiveness,


Who benefits from DBT?

While DBT was created with borderlines in mind,  others and even the general public can benefit from DBT. These include, but are not limited to:

  • Sufferers of ADHD

  • People who are grieving

  • Sufferers of self-harm

  • People with binge-eating disorders and other eating disorders

  • Obese people

  • Chronically ill people

  • Adults and children with Asperger's syndrome or autism

  • People in abusive homes

  • People dealing with narcissists in the workforce

  • Students dealing with bullies

  • Entrepreneurs dealing with setbacks in the fast-paced society we live in

  • Employers



How can you tell if someone has borderline personality disorder?


Borderline personality disorder is typically characterized by intense and frequent mood swings, identity disturbances, and unstable relationships. There about 9 symptoms of borderline personality disorder that doctors look for when making a diagnosis.

1. Fear of abandonment

2. Unstable relationships

3. Unclear or shifting self-image

4. Impulsive, self-destructive behaviors


6. Extreme emotional swings 

7. Chronic feelings of emptiness

8. Explosive anger

9. Feeling suspicious or out of touch with reality

Is CBT good for BPD?


Cognitive behavior therapy is good for all kinds of people including sufferers of BPD. It is more directed towards people with depression, however, as it is a thought-based practice where therapists aid patients out of harmful thinking patterns. While CBT on its own is good, DBT outshines it by helping BPD sufferers with Buddhism practices such as radical acceptance, mindfulness, and skill that specifically target painful emotions. People with Borderline personality disorder greatly suffer due to being emotionally invalidated, therefore the acceptance and validation roots of DBT outshines CBT which takes a more old-fashioned approach in redirecting thoughts rather than accepting them. 

How long does DBT take to work?


As every person with Borderline personality disorder or any emotional disorder is different, there is no definite answer. However, DBT programs can usually have an immediate effect. It doesn't mean that the patients are completely treated but practices and treatment are daily and to be incorporated into their lifestyle. An average DBT program often ranges from 6-12 months in length where a client spends most of their day in group sessions 5 days a week. There are also other factors such as the domestic environment of the patient and whether or not he or she needs help from medications as well.


Is DBT good for trauma?


DBT helps with emotional trauma as well as physical trauma by teaching patients how to live in the present and work through crisis and distressing emotions. DBT has many skills that can help patients get unstuck from PTSD symptoms such as intense physical activity or the cold temperature trick, problem-solving, and self-soothing with the 5 senses. DBT involves a lot of thought-management skills too that can help patients quickly who suffer from paranoia or intense distress from racing thoughts.



What is the main cause of borderline personality disorder?


The main cause of Borderline personality disorder seems to be an invalidating environment, however, some therapists have suggested it could also be a genetic temperament. People with BPD are usually more physically and emotionally sensitive making them more susceptible to trauma and external stimuli that others are more likely to not even notice. Because of this sensitivity BPD sufferers can sometimes be targets of family members or people in general who feel they are difficult to work with.

What is the goal of DBT?

The goal of DBT is to help patients first get out of any intense emotional state that may threaten their life. Then it's aim is to improve the quality of life. This can mean everything from job placement, career, and relationship help or simply getting the patient to feel good about getting out of bed in the morning. A life worth living is individually unique to every patient. In a nutshell, however, the goal of DBT is to keep patients in their Wise mind, not Emotion mind or a rigid logical state. It is to have them balanced and able to participate in life in a way that is more tolerable than they were living before.

How many sessions is DBT?

DBT can have sessions of 365 days or shorter depending on whether or not non-business days are included. Therapists recommend a year-long program. Then there are programs that are only 6 months long or shorter depending on the funding and resources. DBT should be a lifestyle though as only through repeated hands-on practicing of the skills can the program have full effect.

Who is DBT appropriate for?


DBT is appropriate for diagnosed patience of DBT, eating disorders, or any other emotional issue. It is also beneficial for people with self-harm behaviors including cutting and addiction. However, DBT can be useful for just about anyone.


How long does DBT treatment last?


As mentioned before, DBT sessions can take a year to complete. As for the results, that depends on each patient. Treatment should have a long-lasting effect but some therapist recommends brushing up on skills every 3-6 months. Here at OK, Level Up we encourage DBT students to practice skills every week and even every day. There will be a point when you'll eventually know most of the skills like the back of your hand and only then will DBT skills become the way you think and operate. When this happens one can say the treatment lasts for someone's entire life.


Is DBT therapy covered by insurance?

DBT can be covered by insurance such as in the case of Ontario, Canada where some hospitals and community programs allow any citizen with a health card to enroll in an in-patient or out-patient DBT program. This is because it is funded by OHIP. Some places are private-ran practices, however, and should be contacted about their insurance feature.