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Understanding Dialectical Behaviour Therapy (DBT): Building a Life Worth Living

Updated: Sep 14

Imagine life as a wild rollercoaster, with emotions that shoot up to the sky one moment and plummet to the ground the next. For many people, this ride can be overwhelming, leading to intense emotions, impulsive actions, and strained relationships. If you’re struggling with these challenges, there’s a type of therapy designed to help you regain control and build a life that feels worth living—Dialectical behaviour Therapy, or DBT.



Image of Frank Pew, founder and clinical director of True North Psychotherapy, sitting on a chair writing in a book.

What Is DBT?

Dialectical behaviour Therapy (DBT) is a specialized form of talk therapy originally developed to treat people with Borderline Personality Disorder (BPD), a condition marked by intense emotional instability. However, DBT has since proven to be effective for a wide range of other mental health issues, including depression, anxiety, eating disorders, and PTSD (Post-Traumatic Stress Disorder).

The term “dialectical” refers to balancing two opposing ideas—acceptance and change. DBT teaches people to accept themselves and their current situation while also working on making positive changes. This balance is key to helping individuals manage their emotions, improve relationships, and make decisions that align with their long-term goals.


Who Is DBT For?

DBT is particularly helpful for individuals who:

  • Experience intense, overwhelming emotions.

  • Struggle with impulsive behaviours like self-harm or substance abuse.

  • Have difficulties maintaining stable relationships.

  • Often feel hopeless, empty, or out of control.

  • Deal with chronic suicidal thoughts or behaviours.

While DBT was initially designed for people with BPD, it can benefit anyone who wants to develop better emotional regulation, coping strategies, and relationship skills.


The Four Components of DBT

DBT is a comprehensive therapy that includes four key components: Individual Therapy, Skills Training, Phone Coaching, and Team Consultation. Each component plays a crucial role in helping individuals build a life worth living. Let’s break down each of these components.


1. Individual Therapy: Personalized Support and Guidance

In DBT, individual therapy is like having a personal coach who guides you through your emotional challenges. You meet one-on-one with a therapist who is trained in DBT. During these sessions, you’ll work on understanding your specific struggles, set goals, and develop strategies to manage your emotions and behaviours.


What Happens in Individual Therapy?

  • Targeting Problem behaviours: Your therapist will help you identify the behaviours that are causing the most problems in your life, such as self-harm, substance abuse, or relationship conflicts. Together, you’ll work on strategies to reduce these behaviours and replace them with healthier ones.

  • Developing a Life Worth Living: You’ll also focus on long-term goals that align with your values and desires. This could include improving relationships, pursuing a career, or finding activities that bring you joy and fulfillment.

  • Processing Emotional Challenges: Individual therapy is a safe space to explore your emotions, past experiences, and any trauma that might be contributing to your current struggles. Your therapist will help you find ways to cope with these challenges without resorting to harmful behaviours.


2. Skills Training: Learning the Tools for Emotional Mastery

Skills training is the educational part of DBT. It usually takes place in a group setting, where you learn and practice skills that help you manage emotions, cope with stress, and improve relationships. The skills training component is structured into four main modules:


  • Mindfulness: Learning to stay present and fully experience the moment, without judgment.

  • Distress Tolerance: Developing techniques to survive crises without making things worse.

  • Emotion Regulation: Understanding and managing intense emotions.

  • Interpersonal Effectiveness: Building and maintaining healthy relationships.


How Does Skills Training Work?

  • Group Sessions: You’ll attend regular group sessions where a trained DBT therapist teaches you these skills. Each session focuses on a specific module, and you’ll practice the skills both in and outside of the group.

  • Homework Assignments: To reinforce what you’ve learned, you’ll be given homework assignments. These might include practicing mindfulness exercises, using distress tolerance skills during a tough moment, or applying interpersonal effectiveness techniques in your relationships.

  • Support and Feedback: The group setting provides a supportive environment where you can share your experiences, learn from others, and receive feedback on your progress.


3. Phone Coaching: On-the-Spot Help When You Need It

Life doesn’t always go according to plan, and sometimes you might find yourself in a crisis outside of therapy sessions. That’s where phone coaching comes in. Phone coaching is a key component of DBT, offering you immediate support from your therapist when you’re struggling to use your skills in real life.


How Does Phone Coaching Work?

  • Crisis Support: If you find yourself in a difficult situation and aren’t sure how to handle it, you can reach out to your therapist for guidance. They’ll help you figure out which DBT skills to use and how to apply them effectively.

  • Brief and Focused: Phone coaching isn’t a full therapy session. It’s a brief check-in to help you navigate a specific challenge. The goal is to give you the support you need to avoid impulsive behaviours and stay on track with your therapy goals.

  • Building Independence: Over time, phone coaching helps you become more confident in using DBT skills on your own, so you can handle crises without needing immediate support.


4. Team Consultation: Supporting the Therapists Behind the Scenes

DBT is a challenging therapy, not just for the clients, but also for the therapists who provide it. That’s why the fourth component of DBT is team consultation. This is a meeting where DBT therapists come together to support each other, share insights, and discuss difficult cases.


Why Is Team Consultation Important?

  • Preventing Burnout: Working with clients who have intense emotional and behavioural challenges can be stressful for therapists. Team consultation provides a space for therapists to discuss their experiences, get support from their peers, and prevent burnout.

  • Ensuring Consistency: DBT is a highly structured therapy, and team consultation helps ensure that all therapists are providing consistent, effective treatment to their clients.

  • Continuous Improvement: Therapists use team consultation to stay up-to-date with the latest DBT practices and to brainstorm new strategies for helping their clients succeed.


How DBT Helps You Build a Life Worth Living

The ultimate goal of DBT is to help you build a life that feels meaningful and fulfilling—a life worth living. Here’s how the four components of DBT work together to make that happen:

  • Personalized Support: Through individual therapy, you receive personalized guidance that helps you understand and manage your unique challenges. This one-on-one support ensures that you’re making progress toward your specific goals.

  • Practical Skills: In skills training, you learn practical tools for managing your emotions, coping with stress, and improving your relationships. These skills are the building blocks for a stable, satisfying life.

  • Real-Time Help: Phone coaching offers you immediate support when life throws you a curveball, helping you stay on track and avoid setbacks.

  • A Strong Support System: Behind the scenes, your therapist is supported by a team of professionals who are dedicated to providing you with the best possible care.


Is DBT Right for You?

DBT is a powerful therapy that has helped countless people gain control over their emotions, make healthier choices, and build lives they’re proud of. Whether you’re dealing with intense emotions, impulsive behaviours, or relationship difficulties, DBT offers a comprehensive, supportive approach to making positive changes.


If you’re looking for a way to build a life worth living—one where you feel more balanced, in control, and connected—DBT could be the right path for you. With the guidance of a trained therapist and a commitment to practicing the skills, you can learn to navigate life’s challenges and create a future that feels truly worth living.

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