Dialectical Behavior Therapy (DBT)

At Contemporary CBT, we provide Dialectical Behavior Therapy (DBT) for children, teens, adults, couples, and families. DBT is an evidence-based therapy approach that helps clients build practical skills for managing emotions, improving relationships, tolerating distress, and responding more effectively to difficult situations. We offer DBT in-person at our Chicago (Lakeview) and Skokie offices, as well as virtual therapy for clients located in Illinois, Florida, Michigan, South Carolina, and Wisconsin.

What Is Dialectical Behavior Therapy?

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Dialectical Behavior Therapy, often called DBT, is a structured, skills-based form of therapy that helps people better understand and manage their emotional reactions. DBT teaches clients how to pause, notice what is happening internally, and choose responses that are more effective and aligned with their goals.

The word “dialectical” refers to balancing two things that may both be true at the same time. In DBT, this often means balancing acceptance and change. Clients learn how to accept their emotions and experiences without judgment, while also building skills to change patterns that are no longer working.

DBT is not about ignoring emotions or pretending things are fine. Instead, it helps clients understand their emotional system, tolerate distress, communicate more effectively, and make choices that support their well-being.

What Can DBT Help with?

DBT can be helpful for people who feel overwhelmed by emotions, are stuck in reactive patterns, are struggling with relationship instability, or are unsure how to cope in difficult moments. 

DBT may also help with:

  • Emotional overwhelm

  • Anxiety and panic

  • Depression and low mood

  • Mood swings

  • Intense anger or irritability

  • Impulsive behaviors

  • Relationship conflict

  • Family conflict

  • Parent-child communication

  • Self-criticism and shame

  • Perfectionism

  • Stress and burnout

  • Difficulty setting boundaries

  • Difficulty tolerating uncertainty

  • Avoidance and shutting down

  • Trouble communicating needs

  • Difficulty recovering after conflict or disappointment

DBT can also be used alongside other evidence-based approaches, including Cognitive Behavioral Therapy (CBT), Acceptance and Commitment Therapy (ACT), Exposure and Response Prevention (ERP), behavioral activation, and mindfulness-based strategies.

How Does Dialectical Behavior Therapy Work?

DBT focuses on helping clients build skills they can use in everyday life. Many people come to therapy because they feel like their emotions take over, their reactions feel bigger than they want them to be, or they struggle to communicate effectively when they are upset.

In DBT therapy, your therapist may help you:

  • Understand emotional triggers

  • Notice thoughts, feelings, body sensations, and urges

  • Pause before reacting

  • Tolerate distress without making things worse

  • Communicate needs more clearly

  • Set boundaries

  • Reduce impulsive or avoidant behaviors

  • Practice mindfulness and present-moment awareness

  • Build healthier relationship patterns

  • Make choices based on long-term goals instead of short-term relief

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DBT is practical, collaborative, and skill-based. The goal is to help clients feel more capable of handling difficult moments without becoming overwhelmed or disconnected from what matters to them.

Mindfulness

Mindfulness skills help clients notice what is happening in the present moment without immediately judging it or reacting to it. This can include noticing thoughts, emotions, physical sensations, urges, and surroundings.

Mindfulness can help clients slow down and respond more intentionally, instead of being pulled automatically into anxiety, anger, avoidance, or self-criticism.

Distress Tolerance

Distress tolerance skills help clients get through difficult moments without making the situation worse. These skills are especially helpful when emotions are intense and the goal is to ride out the moment safely and effectively.

Distress tolerance may include grounding strategies, self-soothing, crisis coping skills, distraction used intentionally, and tools for managing urges.

Emotion Regulation

Emotion regulation skills give clients practical tools for understanding, managing, and responding to emotions more effectively. Rather than feeling controlled by intense emotions, clients learn strategies to reduce emotional vulnerability, calm the body, check the facts, increase positive experiences, and choose behaviors that help emotions shift over time.

Interpersonal Effectiveness

Interpersonal effectiveness skills help clients communicate more clearly, ask for what they need, set boundaries, and navigate conflict. These skills can be especially helpful for people who struggle with people-pleasing, anger, avoidance, guilt, or fear of rejection or abandonment.

Clients may practice how to express themselves while maintaining self-respect and preserving important relationships.

Core DBT Skills

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  • DBT can be helpful for anxiety because anxiety often creates strong urges to avoid, escape, seek reassurance, or over-control situations. DBT skills help clients slow down, tolerate discomfort, and choose responses that are more effective in the long term.

    In DBT-informed therapy for anxiety, clients may learn to improve mindfulness, distress tolerance, uncertainty tolerance, emotional awareness, and minimize avoidance patterns.

  • Low or volatile moods can make it difficult to stay connected to routines, relationships, goals, and self-care. DBT skills can help clients identify patterns that worsen mood, build coping strategies for painful emotions, and take small steps toward stability and connection.

    DBT may also help with self-critical thoughts, shame, withdrawal, and difficulty asking for support.

  • DBT skills can be especially helpful for children and teens who struggle with big emotions, anxiety, perfectionism, conflict, impulsivity, school stress, friendship, or difficulty communicating what they need.

    DBT for children and teens may focus on:

    • Naming and understanding emotions

    • Managing intense feelings

    • Reducing emotional outbursts

    • Coping with school or peer stress

    • Building confidence in communication

    • Practicing flexible thinking

    • Improving family communication

    • Learning healthy ways to handle conflict

    Parents may also be included when it would be helpful to support skill use at home, reduce conflict cycles, and improve communication.

  • Adults may benefit from DBT when they feel stuck in emotional reactivity, relationship stress, burnout, self-criticism, or difficulty setting boundaries. DBT can help adults understand their patterns and build practical tools for responding differently.

    DBT is often a good fit for adults who want therapy that is compassionate, structured, and focused on tangible skills.

  • DBT can be especially useful for clients who want to improve communication, boundaries, and conflict patterns. Many people know what they want to say but struggle to say it clearly when emotions are high.

    DBT skills can help clients ask for what they need, say no, tolerate disappointment, repair after conflict, and stay connected to their values in relationships.

  • In your first sessions, your therapist will get to know you, understand what brings you to therapy, and identify the patterns you want to change. You may discuss emotional triggers, relationship dynamics, coping behaviors, stressors, and goals.

    Ongoing DBT-informed sessions may include:

    • Identifying current stressors and emotional patterns

    • Learning specific DBT skills

    • Practicing mindfulness and grounding strategies

    • Building distress tolerance tools

    • Exploring communication and boundary-setting

    • Creating plans for difficult moments

    • Applying skills to real-life situations

    • Reflecting on what worked and what needs adjustment

    DBT is active and practical. Your therapist will help you apply skills in a way that fits your life, relationships, and goals.

  • DBT and CBT are related, but they are not exactly the same. CBT focuses on the connection between thoughts, emotions, and behaviors, and helps clients change patterns that keep them stuck. DBT includes many CBT principles but places additional emphasis on mindfulness, emotional regulation, distress tolerance, acceptance, and relationship skills.

    Many clients benefit from a combination of CBT and DBT skills, depending on their needs.

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