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For people who are seeking support for resolving a mental health disorder, Dialectical Behavior Therapy is an excellent option to consider.
Dialectical Behavior Therapy (DBT) is a modified version of Cognitive Behavioral Therapy (CBT). However, DBT incorporates principles of mindfulness. Through utilizing mindful techniques individuals can accept the circumstances of their lives while also learning to make useful changes.
The essential emphasis in DBT is on teaching clients how to both tolerate and regulate strong emotions. This goes hand-in-hand with learning effective ways of reducing stress and cultivating more healthy relationships.
DBT was designed specifically to be especially effective for people with difficult psychiatric conditions. This method of therapy has been proven to achieve results in these individuals. Today it is also used to treat a wide range of mental health disorders. These disorders may include mood disorders, impulse control disorders, and eating disorders.
DBT was developed in the 1980s by psychologist Marsha Linehan.
When professionals observed that Cognitive Behavioral Therapy wasn’t working as well as they expected with certain patients, they revised their approach. The revisions were aimed at helping those who were chronically suicidal and diagnosed with Borderline Personality Disorder. The result of these revisions was Dialectical Behavior Therapy.
DBT is now used to treat a wide range of mental health disorders effectively.
The term “dialectical” means balancing opposites through a back-and-forth process. In the case of Dialectical Behavior Therapy, the opposites that are being brought into balance are:
In DBT, the therapist welcomes the totality of the client’s circumstances and experience. The therapist helps them to reach a similar level of acceptance. At the same time, the therapist works with the client to transform dysfunctional behavior and improve their life.
Change and acceptance would seem to be opposing ideas. However, in DBT they are brought together to achieve positive results.
In DBT, the therapist validates the client’s current experience, while also encouraging and supporting skillful transformation.
However dysfunctional certain behavior may seem, such actions “made sense” in the context of the client’s lived experience. This can be acknowledged, while also offering more skillful approaches to solving the problem. And this is what a DBT therapist does.
Because change is constant and inevitable, healing is possible. And the gateway to this healing process is acceptance through mindfulness. In this way, the tension between acceptance and change is resolved favorably.
The therapeutic process has been described by professionals as being something like a dance. The therapist seeks to balance strategies based on acceptance and change, in response to the client’s resistance or cooperation. It’s a beautifully delicate process that can initiate profound transformation.
Dialectical Behavior Therapy cultivates four essential skills: mindfulness, distress tolerance, emotional regulation, and social effectiveness.
Mindfulness and distress tolerance are skills based on acceptance. Emotional regulation and social effectiveness are skills based on change.
In combination, these four skill-sets support the DBT dialectic between acceptance and change.
Mindfulness is the foundation of all DBT processes. With techniques drawn from both eastern and western meditative traditions, the DBT therapist supports the client’s capacity to:
The distress tolerance techniques in DBT help prepare the client to relate more skillfully to intense emotions and difficult situations.
The therapist offers tools for responding more effectively to stressors, and viewing difficult situations in less overwhelming ways. With these new skills, the individual can cultivate a more optimistic mindset. They will be able to cope with whatever circumstances may arise.
Empowering distress tolerance tools used in DBT include:
So, rather than avoiding distress, the DBT client increases their tolerance and acceptance of difficult feelings or situations.
The emotional regulation skill of Dialectical Behavior Therapy has to do with the nature and function of emotions. DBT patients learn how to relate skillfully to their emotions and feelings. The client learns to fully experience and accept emotions without being consumed or overwhelmed by them.
In this process, the client learns that:
With these new emotional regulation skills, the client is able to acknowledge and have greater tolerance for difficult situations. And they are able to regulate emotions that would otherwise be overwhelming.
The interpersonal effectiveness skills cultivated via Dialectical Behavior Therapy support the client in cultivating mutually satisfying relationships and healthy emotional intimacy.
In this aspect of the therapeutic process, the client learns:
Dialectical Behavior Therapy has been used to treat a wide variety of mental health disorders, including:
In DBT, the therapist validates the client’s current experience, while also encouraging and supporting skillful transformation.
However dysfunctional certain behavior may seem, such actions “made sense” in the context of the client’s lived experience. This can be acknowledged, while also offering more skillful approaches to solving the problem. And this is what a DBT therapist does.
Because change is constant and inevitable, healing is possible. And the gateway to this healing process is acceptance through mindfulness. In this way, the tension between acceptance and change is resolved favorably.
The therapeutic process has been described by professionals as being something like a dance. The therapist seeks to balance strategies based on acceptance and change, in response to the client’s resistance or cooperation. It’s a beautifully delicate process that can initiate profound transformation.
Dialectical Behavior Therapy in Orange County generally includes a combination of:
Group therapy sessions—where each client has the opportunity to share their experience. Individuals participate in role-playing and other group practice sessions to prepare for real-world situations; and complete homework assignments.
Individual therapy sessions—provide individualized support designed to meet the unique needs of a specific client.
Phone coaching—as support for clients who require additional support with a particularly challenging situation, between group or individual therapy sessions.
To learn more about Dialectical Behavior Therapy, or begin the healing journey, contact us today.
Frequently Asked Questions
Dialectical Behavior Therapy (DBT) is a cognitive-behavioral psychotherapy developed by Marsha Linehan in the late 1980s originally for borderline personality disorder, which has since been validated across a broad range of conditions including eating disorders, depression with emotional dysregulation, PTSD, suicidal ideation, and substance use. DBT is built around the core dialectic of acceptance and change, teaching patients to accept their current emotional reality while simultaneously working to change the thought patterns and behaviors that cause suffering. The therapy is structured around four skill modules: mindfulness, the foundational skill of non-judgmental awareness of present experience; distress tolerance, skills for managing acute crises without making things worse; emotion regulation, strategies for reducing emotional vulnerability and changing unwanted emotional states; and interpersonal effectiveness, skills for navigating relationships assertively while maintaining self-respect. DBT at Moment of Clarity is delivered in both individual therapy and DBT skills groups, providing both personalized application of skills and the peer practice environment that group work uniquely offers. Call 949-625-0564 to learn more about DBT programming.
CBT and DBT are both cognitive-behavioral therapies that address the relationship between thoughts, feelings, and behaviors, but they differ in emphasis, structure, and the specific populations and presentations for which each is most appropriate. CBT focuses primarily on identifying and changing distorted or unhelpful thought patterns and the behaviors that arise from them, using structured exercises to challenge cognitive distortions and practice new behavioral responses. DBT adds an explicit acceptance dimension to this change-oriented framework, recognizing that some patients, particularly those with intense emotional experiences, need to develop the capacity to tolerate and accept distress before cognitive restructuring and behavioral change are possible. DBT also has a more manualized, skills-training structure with its four modules and is designed for delivery across individual therapy and group skills training components simultaneously. CBT tends to be somewhat briefer and more focused on a specific problem, while DBT is designed as a more comprehensive, longer-term treatment for emotional dysregulation across multiple life domains. Both are offered at Moment of Clarity, and many patients benefit from both within their individualized treatment plan.
The four skill modules of DBT at Moment of Clarity are mindfulness, distress tolerance, emotion regulation, and interpersonal effectiveness, each addressing a distinct dimension of the emotional dysregulation and interpersonal difficulties that drive the conditions DBT treats. Mindfulness is the foundational module, teaching non-judgmental, intentional awareness of present experience, which provides the observational platform from which all other DBT skills are applied. Distress tolerance teaches skills for surviving acute emotional crises, including self-soothe techniques, TIPP skills (Temperature, Intense exercise, Paced breathing, Progressive relaxation), radical acceptance, and distraction strategies that allow patients to tolerate intense distress without acting destructively. Emotion regulation teaches strategies for reducing emotional vulnerability, identifying and naming emotions accurately, increasing positive emotional experiences, and acting opposite to problematic emotions. Interpersonal effectiveness teaches the DEAR MAN, GIVE, and FAST skills for communicating needs assertively, maintaining relationships, and preserving self-respect across difficult interpersonal situations. These four modules work together to build a comprehensive set of life skills for managing the full range of human emotional and relational challenges.
DBT as originally developed requires active, motivated engagement with structured skill-building exercises across individual therapy and skills group components, and patients in certain clinical states may not currently be in a position to benefit from the full DBT structure. Patients in acute psychosis or severe dissociative states, or those with active cognitive impairment that prevents reliable skill learning and practice, may need stabilization before DBT can be meaningfully engaged. Patients with extreme passive engagement who are not committed to the behavioral change component of DBT, or who are only willing to participate in the acceptance dimension without the change work, may find standard DBT less beneficial. Some patients with severe treatment-resistant depression may need biological treatment with TMS, ketamine, or medication optimization before they have the neurological capacity to engage productively in DBT skills learning, and the clinical team at Moment of Clarity coordinates these biological and behavioral components thoughtfully. Age-appropriate versions of DBT exist for adolescents and older adults, and the specific adaptation used depends on the individual patient's developmental level and cognitive needs. A thorough clinical evaluation determines the most appropriate DBT approach for your situation.
DBT is the gold-standard, most evidence-supported treatment for borderline personality disorder, and is a core component of Moment of Clarity's outpatient programs for adults with BPD. The structured, consistent, multi-session format of IOP and PHP mirrors the clinical contact that effective BPD treatment requires, making the Moment of Clarity program particularly well-suited for DBT delivery in BPD. Research on DBT for BPD consistently demonstrates significant reductions in suicidal and self-harm behaviors, reduced psychiatric hospitalizations, improved emotional regulation, and better interpersonal functioning in patients who complete a full DBT program. BPD treatment requires duration and clinical consistency, as the skill-building process across all four DBT modules develops over months rather than weeks, and the outpatient structure at Moment of Clarity supports this sustained engagement while patients maintain their daily lives and relationships. The team at Moment of Clarity provides DBT with the full structure, including individual therapy, skills groups, and phone coaching support as clinically appropriate, to deliver the complete evidence-based model.
DBT helps with PTSD at Moment of Clarity, particularly for patients with complex PTSD who also have significant emotional dysregulation, suicidal ideation, or self-destructive behaviors that require stabilization before trauma-focused processing can safely proceed. DBT's distress tolerance and emotion regulation modules build the self-regulation capacity needed to approach traumatic material without becoming overwhelmed, and the mindfulness skills developed in DBT support the present-focused awareness that trauma-focused therapies like EMDR require. DBT-PTSD is a specific evidence-based protocol that integrates DBT skills training with trauma reprocessing components for patients with complex PTSD, and some Moment of Clarity clinicians are trained in this integrated approach. For many patients with PTSD, DBT serves as a first phase of treatment that builds stabilization and skills before EMDR trauma processing begins in a subsequent phase, and the two modalities are sequenced within the individualized treatment plan at Moment of Clarity. The clinical team assesses each patient's PTSD presentation and emotional regulation needs to determine the optimal integration of DBT and trauma-focused work within the treatment plan.
DBT is an evidence-based treatment for eating disorders, particularly bulimia nervosa, binge eating disorder, and anorexia nervosa, and is used within Moment of Clarity's eating disorder programming alongside other evidence-based modalities. The connection between DBT and eating disorders lies in the recognition that eating behaviors including bingeing, purging, restriction, and compulsive exercise often function as attempts to regulate overwhelming emotions or escape intolerable internal states. DBT's emotion regulation and distress tolerance modules address the underlying emotional dysregulation that drives these behaviors, providing patients with effective and non-harmful alternative strategies for managing distress. Research supports DBT-informed treatment for binge eating disorder and bulimia in reducing binge-purge cycles, improving emotional regulation, and reducing the shame and secrecy that maintain eating disorder behaviors. At Moment of Clarity, eating disorder treatment is integrated within the broader DBT and trauma-informed clinical framework, with individualized plans addressing the specific emotional, behavioral, and relational dimensions of each patient's eating disorder presentation.
DBT at Moment of Clarity is structured within the IOP and PHP outpatient programs, providing both the individual therapy and group skills training components that constitute the evidence-based full model. Individual DBT therapy sessions allow the clinician to work with each patient on applying DBT skills to their specific situations, reviewing diary cards, problem-solving skills application failures, and processing the interpersonal and emotional challenges arising in daily life between sessions. DBT skills groups provide a structured curriculum covering all four modules in sequence, with group members learning each skill together and practicing application in a peer context that offers additional perspectives and social reinforcement of skill use. The clinical team at Moment of Clarity uses a DBT framework throughout the program, meaning DBT principles inform not just the formal skills groups but also the clinical culture, staff interactions with patients, and the overall program environment. This comprehensive implementation reflects the evidence that full-model DBT is significantly more effective than partial implementations that use only the skills training without individual therapy, or individual therapy without the skills curriculum.
The 24-hour rule is a specific DBT guideline that applies to phone coaching: if a patient engages in a self-harm behavior, they agree not to contact their therapist for coaching support in the 24 hours immediately following the behavior, unless there is a safety emergency. This rule is not punitive but reflects the DBT principle that contact immediately after self-harm can inadvertently reinforce the behavior by making crisis behaviors a pathway to increased therapist contact, and it encourages patients to use DBT distress tolerance skills before reaching self-harm as a coping strategy. The 24-hour rule is discussed transparently in the DBT program as part of the treatment agreement and is framed within the broader framework of skills-based crisis management. It applies to non-suicidal self-injury rather than to genuine suicidal crises, for which patients are always directed to call 911 or 988 immediately regardless of the 24-hour guideline. At Moment of Clarity, the application of DBT protocols including this rule is explained clearly at the start of treatment so patients understand the therapeutic rationale and can engage with the program structure knowledgeably.
Accessing DBT at Moment of Clarity begins with a free, confidential consultation by calling 949-625-0564, where the admissions team discusses your symptoms, history, and insurance coverage. DBT is available within both IOP and PHP levels of outpatient care, and free insurance verification confirms your plan's coverage for these programs. A comprehensive clinical assessment determines the appropriate level of care and identifies DBT as a component of your individualized treatment plan based on your specific diagnosis and clinical needs. Moment of Clarity is located in Tustin, CA, and Oceanside, CA, and telehealth options are available for hybrid participation. Same-day consultations are available.