What Is Dialectical Behavior Therapy (DBT)?
The therapy pairs acceptance with change. You learn to accept where you are right now while building a new way to respond. A psychologist developed the therapy in the late 1980s to treat chronic suicidal thoughts, self-harm, and borderline personality disorder (BPD).
It has since grown into one of the most researched therapies for emotion regulation. In our program, DBT blends individual sessions with skills practice, so you build skills before you need them. The next hard moment gets a different response than the old one.
The Four DBT Skills You Will Learn
These skills fall into four groups. Each skill has a job. Mindfulness helps you notice a thought or urge without acting on it right away. Distress tolerance gives you a way to get through a crisis without making it worse. A craving or a flood of anger both count.
Emotion regulation teaches you to name what you feel and lower its intensity before it drives a decision you regret. Interpersonal effectiveness helps you ask for what you need and say no without the relationship falling apart. Your therapist teaches these skills in session. Then you practice between sessions, using real situations from your week. You report which skills worked and which didn’t, and the plan adjusts from there.
How We Use DBT for Addiction and Mental Health
DBT for addiction looks different from DBT for a mood disorder alone, though the skills overlap. When substance use drives the pattern, distress tolerance work often targets cravings directly. It gives you something to do with an urge besides acting on it. When a mental health condition drives the pattern instead, emotion regulation gets more attention. A feeling gets somewhere to go besides drinking, using, or shutting down.
Many people need both, and your therapist builds the mix of skills around whichever is present for you. Progress often shows up as small changes. An urge passed without acting on it counts. So does a hard conversation finished without walking away.
Who DBT Helps Most
Dialectical behavior therapy in Minnesota helps people manage intense emotions, repeated crises, or patterns that keep pulling them back to a substance. It remains one of the strongest treatments available for BPD, chronic suicidal thoughts, and self-harm. Awareness lags behind need. About 1.4 percent of U.S. adults live with borderline personality disorder in a given year, according to the National Institute of Mental Health.
Most never receive a diagnosis. Many are managing PTSD, bipolar disorder, depression, or anxiety alongside a substance use condition. DBT gives them one set of tools for both. The skills apply whether the hardest moment involves a craving, a panic spiral, or a fight with someone you love.
Other Therapies That Work Alongside DBT
DBT rarely works alone in our program. Three other therapies support it at Blue River, each doing a different job. None replaces DBT here. Together, they give your treatment plan several angles on the same problem. Your therapist decides which combination fits your history, your goals, and what has helped before.
- Cognitive Behavioral Therapy (CBT): Targets the thought patterns that feed anxiety, depression, or substance use. You test whether those thoughts hold up.
- Individual Therapy: One-on-one time with your therapist to work through what is happening in your life right now.
- Group Therapy: A room of people working on similar goals, where you practice interpersonal effectiveness skills in real time.
These three therapies run alongside DBT, never in place of it. Your treatment plan draws from whichever mix fits the week you are having. It changes as you do. A hard week might call for more individual time. A calmer one might lean on group support to practice a skill out loud. The shift happens without you starting over with a new provider or repeating your history to someone new.
Which Programs Include DBT
Every level of care at Blue River includes DBT in some form. In our partial hospitalization program (PHP), DBT groups run alongside individual and medical support and fill several hours of your day. In our intensive outpatient program (IOP), DBT fits into the group and individual therapy you attend several days a week.
Outpatient (OP) builds DBT into weekly or biweekly sessions for people managing fewer symptoms. Virtual IOP delivers the same training online. It fits people who want privacy or live too far away to attend in person. Wherever you start, the skills carry over if your level of care changes later.
What Starting DBT Looks Like
Your path into DBT starts the same way every plan we build does. It begins with a needs assessment and a biopsychosocial assessment. The conversation covers your history, current symptoms, and what has and hasn’t worked before. The plan starts with you.
From there, your therapist builds DBT into an individualized treatment plan, alongside any other therapy that fits your situation. If medication could help, you also meet with a psychiatric provider for an evaluation. Nothing starts until the picture is built. Your therapist checks in on how the plan is working and adjusts the mix of therapies as your needs change. You will know which therapies, which program, and which schedule fit before your first full session begins.