Dialectical Behavior Therapy (DBT)

Dialectical Behavior Therapy (DBT) was developed by psychologist Marsha Linehan in the 1980s as a treatment for individuals with borderline personality disorder (BPD) who experienced intense, rapidly shifting emotions and self-destructive behaviors. The word "dialectical" refers to the core tension DBT holds in balance: accepting yourself as you are in this moment while simultaneously working toward meaningful change. This balance — acceptance and change — is the philosophical foundation of the approach.

DBT is organized around four skill modules, each targeting a different area of functioning. Mindfulness teaches nonjudgmental present-moment awareness and is the foundation on which all other DBT skills rest. Distress Tolerance equips you with strategies to survive a crisis without making it worse — grounding techniques, self-soothing, and the TIPP skill for rapidly reducing physiological arousal. Emotion Regulation addresses the underlying causes of emotional dysregulation by helping you identify emotions, reduce vulnerability to mood episodes, and build positive experiences. Interpersonal Effectiveness gives you structured scripts and strategies for asking for what you need, maintaining self-respect, and preserving important relationships even in conflict.

DBT skills are taught by licensed therapists in individual or group psychotherapy. Hometown NP does not provide DBT psychotherapy; Hometown NP PMHNPs focus on psychiatric evaluation and medication management, and patients may seek a separately licensed therapist for DBT when clinically appropriate. DBT's structured skill set makes it well-suited to telehealth because skills can be practiced in the real-life environment where you need them most.