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    1. DBT: Dialectical behaviour therapy
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    Learn more about DBT: Dialectical behaviour therapy

    Dialectical Behaviour Therapy (DBT) is a structured form of talking therapy that teaches practical skills for managing intense emotions, tolerating distress, and improving relationships. It grew out of cognitive behavioural therapy and was originally developed by psychologist Marsha Linehan for people who experience emotions very strongly and struggle to regulate them. The word "dialectical" points to its central balance: accepting yourself as you are, while also working to change the patterns that cause you difficulty. DBT is usually more structured than open-ended talking therapy. It combines individual sessions with skills training, often delivered in a group, and follows a defined curriculum rather than a free-form conversation.

    DBT is built around four skills modules that your therapist works through with you, either one-to-one or in a group alongside individual sessions. The aim is to give you concrete tools you can use in daily life, not just insight. The four modules are:
    • Mindfulness. Noticing your thoughts, feelings, and surroundings in the present moment without judging them, which underpins the other skills.
    • Distress tolerance. Getting through crises and painful moments without making things worse, rather than trying to escape or suppress the feeling.
    • Emotion regulation. Recognising, understanding, and influencing strong emotions so they are less overwhelming.
    • Interpersonal effectiveness. Communicating needs, setting boundaries, and handling conflict while keeping self-respect and relationships intact.
    In practice, sessions often use worksheets, roleplay, and practise, and your therapist may model the skills with you. Between sessions you apply what you have learned and review how it went. DBT is a therapeutic approach, not a diagnostic assessment; if you think you may have a specific condition, a qualified clinician can assess that separately. If you are in crisis or having thoughts of harming yourself, contact your local emergency services or a crisis helpline in your country straight away.

    DBT is most useful where difficulty regulating emotions drives distress, impulsive behaviour, or conflict in relationships. It was first developed for people with very intense emotions and has since been adapted for a range of related difficulties.
    • Borderline personality disorder: DBT was originally developed for borderline personality disorder and remains the most established therapy for it. Expect structured work on emotion regulation, distress tolerance, and reducing self-destructive patterns, usually combining individual sessions with skills training.
    • Anger: DBT gives you tools to notice anger building and respond before it escalates, using distress tolerance and interpersonal skills. Expect practical work on managing the moment and communicating without damaging relationships.
    • Addictions: DBT helps you tolerate cravings and difficult feelings without acting on them, and build a life that competes with the pull of the addiction. It is often used alongside other addiction support rather than on its own.
    • Anorexia: DBT can support the emotion regulation side of an eating difficulty, helping you sit with distress without using restriction to cope. It works alongside specialist eating disorder treatment and medical oversight, not as a standalone treatment.
    • Avoidant personality disorder: DBT's interpersonal effectiveness and distress tolerance skills can help you approach social situations you would otherwise avoid. Expect gradual, skills-based work on tolerating discomfort in relationships.
    If you are not sure whether DBT is the right fit, our matching service can help. You complete a short survey, and our psychologists combine data-driven insights with human judgement to suggest therapists suited to your situation.

    It's Complicated is a therapist-founded mental health platform connecting clients with verified practitioners across Europe and globally, in over 60 languages. We work with over 2,500 vetted therapists, with in-person availability in Berlin, Amsterdam, Barcelona, Lisbon, Vienna, and other major cities, alongside online sessions worldwide. It's Complicated is free to use, and you pay your chosen therapist directly at rates they set. DBT is a demanding, multi-part therapy, and finding a practitioner genuinely trained in it can be harder than finding general talking therapy. Our matching service is built to remove that friction. You complete a short survey, our psychologists combine data-driven insights with human judgement to identify the right therapists for your situation, and you choose from a shortlist of strong candidates. You can also browse our directory directly if you'd prefer to choose yourself. Get matched with a therapist who uses Dialectical Behaviour Therapy, or browse the directory.
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    Related approaches

    There's no one-size-fits-all in therapy. If you're exploring DBT: Dialectical behaviour therapy, these approaches might also be worth a look.
    CBT: Cognitive behavioural therapy
    CBT: Cognitive behavioural therapy
    ACT: Acceptance and commitment therapy
    ACT: Acceptance and commitment therapy
    Schema therapy
    Schema therapy
    CFT: Compassion-focused therapy
    CFT: Compassion-focused therapy
    Mindfulness
    Mindfulness

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    FAQs about DBT: Dialectical behaviour therapy

    Dialectical Behaviour Therapy (DBT) is a structured talking therapy that teaches skills for managing intense emotions, tolerating distress, and improving relationships. It combines individual sessions with skills training and balances accepting yourself as you are with changing patterns that cause difficulty. It grew out of cognitive behavioural therapy.

    DBT covers mindfulness, distress tolerance, emotion regulation, and interpersonal effectiveness. Mindfulness anchors the others by building present-moment awareness. Distress tolerance helps you get through crises, emotion regulation makes strong feelings less overwhelming, and interpersonal effectiveness supports communication and boundaries in relationships.

    Cognitive Behavioural Therapy (CBT) focuses on identifying and changing unhelpful thoughts. Dialectical Behaviour Therapy (DBT) developed from CBT but adds a strong focus on accepting difficult emotions, tolerating distress, and relationship skills. DBT is usually more structured and skills-based, often combining individual sessions with group training.

    It's Complicated matches you with practitioners trained in Dialectical Behaviour Therapy (DBT) for online or in-person sessions. You complete a short survey, our psychologists suggest suitable therapists based on your needs, and you choose from a shortlist. Because DBT training varies, matching helps you reach a genuinely qualified practitioner. It's free to use.

    DBT was developed for people with very intense, hard-to-regulate emotions and is used for difficulties including anger, impulsive behaviour, self-destructive patterns, eating difficulties, and some personality disorders. It suits situations where emotional overwhelm drives distress or conflict, and where practical coping skills are the priority.
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    Caroline Rosa

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