Dialectical Behavior Therapy (DBT)

A Skills-Based Therapy That Actually Teaches You How

What Is Dialectical Behavior Therapy?

Dialectical Behavior Therapy (DBT) is a structured, evidence-based form of psychotherapy developed by Dr. Marsha Linehan at the University of Washington in the 1980s. Originally designed for people with chronic suicidality and borderline personality disorder, DBT has since become one of the most effective treatments available for any condition involving intense, hard-to-manage emotions — including addiction, depression, PTSD, eating disorders, and severe emotion dysregulation.

The word dialectical comes from the central insight of the therapy: that two seemingly opposite things can both be true at the same time. You can accept yourself exactly as you are and work hard to change. You can be doing the best you can and need to do better. Holding both — instead of getting stuck in either — is where freedom begins.

At Golden State Rehab, our licensed DBT therapists in Los Angeles deliver comprehensive DBT — individual therapy, skills group, between-session coaching, and team consultation — within our PHP, IOP, and individual therapy programs.

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DBT skills training group at Golden State Rehab Los Angeles

The Four Modules

The Four Core Skills of DBT

DBT skills are organized into four modules. You'll learn all four in our skills group — and your individual therapist will help you apply them where they matter most.

1. Mindfulness

The foundation of every other skill. Learn to observe your thoughts and emotions without being controlled by them — and to access wise mind, the calm, clear-headed place between pure emotion and pure logic.

2. Distress Tolerance

Concrete crisis-survival skills (TIPP, ACCEPTS, IMPROVE, self-soothing) for getting through the moments when you'd otherwise self-harm, use, lash out, or do something you'd regret.

3. Emotion Regulation

Understand what emotions are for, why yours are so intense, and how to change them. PLEASE skills, opposite action, and the "check the facts" practice rebuild your emotional baseline.

4. Interpersonal Effectiveness

Get your needs met, set boundaries, and protect relationships without sacrificing yourself. DEAR MAN, GIVE, and FAST give you scripts and frameworks that work in real conversations.

Bonus: Radical Acceptance

One of DBT's most life-changing skills. Suffering = pain + non-acceptance. When you can radically accept what is — without approval, without resignation — pain becomes survivable.

Bonus: Wise Mind

The DBT name for the intersection of emotion mind and reasonable mind — the inner knowing where your best decisions come from. Mindfulness practice helps you access it on demand.

What DBT Treats

Conditions DBT Effectively Treats

DBT was originally developed for borderline personality disorder, but decades of research have established it as evidence-based for any condition where emotion dysregulation is the engine of the problem.

Borderline Personality Disorder

DBT is the gold-standard treatment for BPD — the only therapy with robust evidence for reducing self-harm, suicidality, and emotional volatility.

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Substance Use Disorders

DBT-SUD adapts the core model for alcohol, opioid, meth, and cocaine addiction — targeting the emotional dysregulation that drives relapse.

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Depression with Dysregulation

For depression that comes with self-harm, intense rage, or chronic suicidal thinking, DBT often succeeds where standard treatment plateaus.

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Complex PTSD & Trauma

DBT-PTSD and Prolonged Exposure within a DBT frame help trauma survivors build stabilization skills before processing trauma directly.

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Eating Disorders

DBT is evidence-based for binge eating disorder and bulimia nervosa — and adapts well for anorexia within a higher level of care.

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Self-Harm & Suicidality

DBT is the only treatment with strong evidence for reducing both — and remains a first-line recommendation in clinical practice guidelines worldwide.

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How It's Delivered

The Four Components of Comprehensive DBT

Real DBT isn't a single weekly session — it's a four-part system. Golden State Rehab is one of the few Los Angeles facilities that delivers all four components.

1. Individual Therapy

Weekly one-on-one sessions with your DBT therapist focused on what's most important to you that week, using your diary card to set the agenda and behavior chain analysis to understand patterns.

2. DBT Skills Group

A 2-hour weekly group that teaches the four skill modules in a structured curriculum. Think of it as classroom-style learning — practical, interactive, and focused on building real-world capacity.

3. Phone Coaching

Brief between-session check-ins with your therapist when you're in a crisis or skill-application moment. You don't have to white-knuckle through it alone.

4. Therapist Consultation Team

Our DBT therapists meet weekly as a team to consult on cases, sharpen each other's skills, and protect against burnout — ensuring you always get fresh, on-the-mark clinical thinking.

The Diary Card

A daily tracker of emotions, urges, behaviors, and skill use. Brings invisible patterns to light — and turns each individual session into focused, data-informed problem-solving.

Behavior Chain Analysis

The signature DBT tool: a step-by-step reconstruction of a problem behavior — vulnerability, prompting event, links, behavior, consequences — so you can intervene next time.

What to Expect

What a Course of DBT Actually Looks Like

Standard DBT is a 6–12 month commitment. It's not a quick fix — it's a curriculum that systematically rebuilds the skills nobody taught you. Here's what a typical week at Golden State Rehab looks like in our DBT track.

01

Individual Therapy

One 50-minute session per week with your primary DBT therapist — using your diary card to set the agenda.

02

Skills Group

One 2-hour group per week teaching one of the four DBT modules in a structured, classroom-style curriculum.

03

Daily Diary Card

Five minutes a day tracking emotions, urges, behaviors, and skill use — turning the invisible into something workable.

04

Phone Coaching

Brief between-session check-ins with your therapist when you're in a crisis or skill-application moment.

05

Skill Practice

At home, on the freeway, at work, with your family — the real reps happen in your actual life, not just in session.

06

Team Consultation

Behind the scenes, our DBT therapists meet weekly as a team — so the clinical thinking you receive stays sharp.

Most clients cycle through the four skill modules twice over six months — once to learn, once to deepen. By the end, you have a full toolkit you can use for the rest of your life.

The Evidence

Why DBT Works: The Research

DBT is the most-validated treatment in existence for emotion dysregulation, self-harm, and chronic suicidality — with over four decades of research backing it.

40+ Years of Evidence

DBT has been studied since the 1980s in dozens of randomized controlled trials worldwide. It remains the only therapy with strong evidence for reducing self-harm and suicidality.

50% Reduction in Self-Harm

Across studies, DBT cuts self-injurious behaviors and emergency-room visits roughly in half compared to treatment-as-usual — within the first year.

First-Line Recommendation

DBT is recommended as a first-line treatment for BPD by the APA, NICE (UK), and clinical practice guidelines across most of the developed world.

Sources: National Institute of Mental Health, Behavioral Tech (founded by Dr. Linehan), American Psychological Association.

Is This You?

Signs DBT May Be Right for You

DBT is uniquely suited to anyone whose emotions feel "too big" — too fast, too intense, too long-lasting. You may be a strong fit for dialectical behavior therapy in Los Angeles if:

Your emotions go from 0 to 100 — and back down — much faster than other people's
You've been diagnosed with borderline personality disorder, or you've wondered if you might fit
You self-harm, have suicidal thoughts, or have a history of suicide attempts
You're using alcohol, substances, food, or sex to manage emotions you can't sit with
Your relationships swing between idealization and rupture — sometimes within the same week
You've tried CBT or talk therapy and want something more skills-focused and intensive
You've been called "too sensitive," "too much," or "unstable" — and want a treatment built for you

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DBT vs Other Therapies

How DBT Compares to Other Treatment Approaches

DBT vs CBT

CBT changes unhelpful thinking. DBT adds skills for surviving and regulating the emotions that come before the thinking. Many clients benefit from CBT for anxiety/depression and DBT for emotion regulation — we blend both.

DBT vs EMDR

EMDR reprocesses specific traumatic memories. DBT teaches the regulation skills you need to do trauma work safely. For complex PTSD, DBT often comes first — then EMDR, then integration.

DBT vs Schema Therapy

Schema therapy explores how early experiences shaped your "modes" or core patterns. DBT focuses on building the skills you need to act differently right now. Both can complement each other in long-term work.

Frequently Asked

DBT FAQs

How long does DBT take?

Standard comprehensive DBT runs 6–12 months — typically two full cycles through the four skill modules. Adapted DBT (DBT-SUD for addiction, DBT for eating disorders, or DBT skills group within a PHP or IOP) can be shorter. Most of our Los Angeles clients see meaningful change in distress tolerance and emotion regulation within 3 months, with deeper change accruing over the full year.

Is DBT only for borderline personality disorder?

No. DBT was originally developed for BPD and chronic suicidality, but the research base has expanded enormously. DBT is now evidence-based for substance use disorders, binge eating, bulimia, treatment-resistant depression, PTSD, ADHD with emotion dysregulation, and any presentation where emotional intensity is the engine of the problem.

Is DBT covered by insurance in Los Angeles?

Yes. DBT is covered by virtually all major insurance plans under the Mental Health Parity and Addiction Equity Act. At Golden State Rehab we accept Aetna, Anthem Blue Cross, Cigna, Blue Shield of California, United Healthcare, Magellan, and most others. Verify your DBT benefits in under two minutes — we'll tell you exactly what's covered before you commit to anything.

What's the difference between DBT and CBT?

Both are structured, evidence-based, skill-focused therapies. CBT targets unhelpful thinking patterns and behaviors — best for anxiety, depression, OCD, and most cases of addiction. DBT teaches concrete skills for tolerating intense emotions, regulating mood, and navigating relationships — best for BPD, self-harm, and emotion dysregulation. Many clients benefit from both, in sequence or blended together.

Can DBT help with addiction?

Yes — DBT-SUD (DBT for Substance Use Disorders) is one of the most effective treatments for clients who relapse around emotional triggers. DBT teaches you to ride out cravings using distress tolerance skills, repair relationships damaged by use, and build a life worth staying sober for. We use DBT alongside medication-assisted treatment, group therapy, and CBT for the strongest outcomes.

Do I have to do the skills group, or can I just do individual DBT?

Comprehensive DBT — the version with the strongest research support — includes both individual therapy and a skills group. The skills group is where you actually learn the skills; individual therapy is where you apply them. Some clients start with individual therapy alone, but we strongly encourage joining the skills group within a few weeks for the best results.

Is DBT done online or in person?

Both. At Golden State Rehab, we offer in-person DBT at our West Los Angeles facility and telehealth DBT for clients throughout California. Skills groups translate exceptionally well to video — most clients find the format works as effectively as in-person, with the added flexibility of doing therapy from home.

Do I need a referral to start DBT at Golden State Rehab?

No referral needed. Call our Los Angeles admissions team at (424) 208-3120 or submit our insurance verification form to get started. We'll assess your goals, match you with a DBT-trained clinician, and have you in skills group within the next available cycle.