DBT Therapy

By the clinical team at Next Step Psychiatry • Lilburn, GA

What Is DBT?

Dialectical Behavior Therapy (DBT) was developed by psychologist Marsha Linehan in the 1980s for people with intense, overwhelming emotions—particularly those with borderline personality disorder (BPD). Since then, it has proven effective for a wide range of conditions including chronic suicidal thoughts, self-harm, eating disorders, substance abuse, and emotional dysregulation of any kind.

The word “dialectical” refers to the balance between two opposites: acceptance and change. DBT teaches you to accept yourself as you are right now while simultaneously working to change behaviors that aren’t serving you. This balance is what makes DBT unique and effective for people who haven’t responded to other therapies.

The Four Core Skills of DBT

DBT is structured around four skill modules that form the foundation of treatment.

• Mindfulness: The practice of being fully present without judgment. This is the core skill that supports all others—learning to observe your thoughts and emotions without being swept away by them.
• Distress Tolerance: Skills for surviving crisis moments without making things worse. Techniques like TIPP (Temperature, Intense exercise, Paced breathing, Paired muscle relaxation) help you ride out intense urges.
• Emotion Regulation: Strategies for understanding, labeling, and managing your emotions. You learn to identify vulnerability factors and reduce emotional reactivity.
• Interpersonal Effectiveness: Tools for communicating your needs, setting boundaries, and maintaining self-respect in relationships—without damaging the relationship.

How DBT Is Different from CBT

While CBT focuses primarily on changing negative thoughts, DBT adds an emphasis on acceptance, emotional regulation, and interpersonal skills. DBT also typically includes both individual therapy and a skills group. The group component is crucial—practicing skills with others who understand emotional intensity reduces shame and provides accountability.

DBT is generally recommended when emotions are the primary problem, while CBT is often preferred when distorted thinking patterns drive the condition. Many patients benefit from elements of both.

Who Benefits Most from DBT?

DBT was designed for people whose emotions feel unmanageable—and it remains most effective for this population. Common candidates include people with borderline personality disorder, chronic suicidal thoughts or self-harm behaviors, eating disorders (particularly binge-purge cycles), substance use disorders, and anyone who experiences emotions more intensely than those around them and struggles to regulate them.

What to Expect in DBT Treatment

Comprehensive DBT typically involves weekly individual therapy sessions, a weekly skills group (2–2.5 hours), phone coaching for crisis situations between sessions, and a therapist consultation team. A full DBT program usually lasts 6–12 months. The skills group alone (without individual therapy) is also available and can benefit people with milder emotional regulation difficulties.

At Next Step Psychiatry, we work closely with DBT therapists in the Atlanta and Gwinnett County area. Our medication management services complement DBT by stabilizing mood and reducing emotional reactivity so you can engage more effectively in skills training.

This article is for informational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment. Always consult a qualified healthcare provider. If you or someone you know is in crisis, call 911 or the 988 Suicide & Crisis Lifeline.