Dialectical Behavior Therapy (DBT)

DBT combines acceptance and change to build skills in emotional regulation, distress tolerance, mindfulness, and interpersonal effectiveness.

Dialectical Behavior Therapy (DBT) was developed by psychologist Marsha Linehan in the 1980s, originally for people with borderline personality disorder who were struggling with severe emotional dysregulation and suicidal behavior. Since then, DBT has evolved into one of the most widely applicable therapeutic frameworks available — particularly for anyone who experiences intense emotions that feel difficult to manage, who struggles with impulsivity, or who has been told they are "too sensitive." DBT is built on a fundamental dialectic: the simultaneous acceptance of who you are right now and commitment to change.

The Four DBT Skill Modules

Mindfulness: the foundational skill: learning to observe your experience without judgment
Distress Tolerance: surviving crises without making things worse; radical acceptance
Emotional Regulation: understanding and modulating the intensity of your emotions
Interpersonal Effectiveness: communicating your needs, maintaining relationships, preserving self-respect

Who Benefits from DBT

DBT was originally developed for borderline personality disorder, but its applications have expanded considerably. It is now an evidence-based treatment for eating disorders, PTSD, ADHD, depression, bipolar disorder, and substance use disorders — as well as for anyone who wants to build skills in managing difficult emotional states. The skills DBT teaches are genuinely useful for almost anyone; many people find them to be life-changing regardless of whether they meet criteria for any specific diagnosis.

DBT at NEST

NEST clinicians trained in DBT integrate its skills-based framework into individual therapy. Rather than requiring the full standard DBT program (which typically includes both individual therapy and skills groups), we adapt DBT principles and skills to meet the needs of the individual client. DBT at NEST is not rigid or clinical in feel — it's delivered with warmth and flexibility, recognizing that skills are most likely to be used when they've been genuinely understood and internalized rather than mechanically applied.