How DBT Works

How DBT Works

Dialectical Behavior Therapy (DBT) is a research-supported cognitive-behavioral therapy developed by Dr. Marsha Linehan and her colleagues at the University of Washington. DBT addresses problems in regulating emotions, behavior, and thinking.

Dialectical Behavior Therapy is an effective program that is supported by numerous randomized control trials and is the subject of ongoing research and study. The treatment involves both weekly individual counseling and participation in fun, engaging DBT Skills Training Group in which clients will learn practical tools and strategies to help them become “emotionally skillful” as well as be more effective in managing life. Dialectical Behavior Therapy focuses on behavior change balanced with acceptance, compassion, and validation of the client.

The Biosocial theory behind DBT holds that individuals with emotion regulation disorders have emotional vulnerability and a deficit in their ability to regulate emotions. The emotion regulation deficit is maintained by an ongoing transaction in the environment, characterized by invalidating responses. Invalidating responses include the indiscriminate rejection of private emotional experiences, the punishment of emotional displays, but with intermittent reinforcement of escalation, and the consistent communication that emotional problems are easier to solve than they really are. What is Dialectical Behavior Therapy?


DBT  Therapy Options

WHAT IS DBT   San Jose DBT Program   DBT Skill Training   Full Fidelity DBT



DBT Targets:

• Heightened emotional sensitivity
• Quick and intense emotional reactions
• Slow return to normal mood
• Chronic problems with depression, anxiety, anger or anger expression

• Repeated suicide threats or attempts
• Self-harm behavior such as cutting and burning
• Relationship difficulties including hypersensitivity to criticism, disapproval, rejection or abandonment
• Impulsive and potentially self-damaging behavior in areas such as binge eating and purging, alcohol or drug abuse, sexual promiscuity, and gambling or spending sprees

• Extreme (black or white) thinking
• Difficulty with problem-solving and decision making
• Unstable self-image or sense of self
• “Detached” thinking, ranging from mild problems with inattention to episodes of complete dissociation

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Our San Jose DBT Program lasts approximately six months to one year and is organized into three stages. Each stage is designed to achieve a set of clearly defined treatment goals.

Stage One

  • Decreasing or eliminating life-threatening behaviors (suicide attempts, suicidal thinking, self-injury, homicidal and aggressive behaviors)
  • Decreasing or eliminating therapy-interfering behaviors (missing sessions, not doing homework, behaving in a way that burns others out)
  • Reducing or eliminating hospitalization as a way of handling crisis
  • Decreasing behaviors that interfere with the quality of life (eating disorders, not going to work or school, addiction, chronic unemployment)
  • Increasing behaviors that will enable the person to have a life worth living
  • Increasing behavioral skills that help to build relationships, manage emotions and deal effectively with various life problems

Stage Two

  • Continuing and building on Stage One skills
  • Targeting and decreasing symptoms of Post Traumatic Stress Disorder (PTSD) and other Anxiety or Depression related symptoms

Stage Three

  • Increasing love and respect for self and others
  • Affirming individual life goals
  • Solving ordinary life problems

Stage Four

  • Developing the capacity for freedom and joy
  • Creating a life worth living!

Click here to learn more about our standard DBT program

Visit our resources page for more information on Dialectical Behavior Therapy and DBT Skills Training.

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Distinctions About Dialectical Behavior Therapy

What We Believe:

One of the key assumptions of Dialectical Behavior Therapy is that while we may not have caused all of our problems, we are the only ones capable and responsible for fixing them.

This requires a continual willingness on the part of DBT participants to work hard and look at themselves honestly, so that they can make the changes necessary to build an emotionally resilient life.

DBT assumptions about participants:

  • You are doing the best you can.
  • You want to improve.
  • You will do better, work harder, and be motivated to change.
  • The lives of suicidal individuals are unbearable as they are currently being lived.
  • You will learn new behaviors in all areas of your life.
  • You cannot fail in DBT.

DBT assumptions about therapists:

  • All therapists, no matter how well trained, are fallible.
  • We make every reasonable effort to conduct competent and effective therapy.
  • We obey standard ethical and professional guidelines.
  • We are available for weekly therapy sessions and provide needed therapy back-up.
  • We respect the integrity and rights of the patient.
  • We maintain confidentiality.
  • We meet regularly for consultation and support.

DBT Therapist Distinctions:  DBT Therapists are active, engaged, compassionate and irreverent. We don’t wait to have a good relationship with clients before we do something. We DO SOMETHING in order to build a good relationship.

Our Standard DBT program in San Jose is modeled after the research model created by the treatment developer. It is important for consumers to know that If a program or therapist does not offer all these components in their DBT program then that program is not adherent and is not backed by the same research DBT is known for. Technically, a program that doesn’t offer all of these components cannot even make the claim that it offers Dialectical Behavior Therapy, though many do and this causes confusion to the consumer. For more information on the criteria for an adherent DBT program please visit

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