Find a Dialectical Behavior Therapy (DBT) Therapist

What is Dialectical Behaviour Therapy (DBT)?

Dialectical Behaviour Therapy (DBT) grew from cognitive and behavioural traditions and was developed to help people manage intense emotions and improve day-to-day functioning. At its core is the idea of dialectics - balancing seemingly opposite needs such as acceptance and change. DBT integrates practical skills training with a focus on understanding patterns of behaviour, validating emotional experience and supporting steady progress towards meaningful goals.

The guiding principles behind DBT

DBT is built around a few central principles that shape how the work is carried out. Validation is important - recognising that your feelings and reactions make sense in context even as you learn new ways of responding. Skills development is central to the programme - you learn concrete techniques for managing distress, improving relationships and tolerating difficult emotions. There is also an emphasis on behavioural analysis - looking at what leads to certain actions and what maintains them - and on a collaborative, goal-oriented therapeutic relationship.

What kinds of problems is DBT commonly used for?

DBT is often recommended when emotional reactions feel overwhelming, when there is a history of self-harm or suicidal thinking, or when you find yourself caught in patterns of intense, unstable relationships. It is also used to support people experiencing difficulties with impulsivity, severe mood swings, compulsive behaviours, substance misuse and eating difficulties. Clinicians may recommend DBT when traditional talking therapies alone have not provided the practical tools you need to manage day-to-day crises.

What does a typical DBT session look like?

A DBT programme usually has several complementary parts, and what you experience may vary depending on the practitioner. Individual therapy sessions tend to focus on your personal goals, reviewing recent events and carrying out behavioural analyses to understand what led to difficult moments. Your therapist will help you set targets - for example reducing self-harm or improving attendance at work - and will guide you through strategies to achieve these targets. You will commonly be asked to use a diary card or similar tracking tool between sessions to record emotions, urges and use of skills.

Skills training is another key element and is often delivered in a group format. These sessions teach modules such as mindfulness - noticing and describing the present moment without judgement - emotion regulation - understanding and reducing intense feelings - distress tolerance - managing crises without making things worse - and interpersonal effectiveness - maintaining self-respect while getting needs met. Many practitioners also offer brief coaching by phone or message between sessions to help you apply a skill in a moment of need, though how this is provided can differ by clinician.

Sessions usually include homework. You will be encouraged to practise skills regularly so that they become part of your response repertoire. The overall programme is structured, but therapists will adapt pacing and focus to suit your circumstances and readiness to change.

How DBT differs from other therapy approaches

While DBT shares roots with cognitive behavioural therapy, it places a stronger emphasis on acceptance and the therapeutic relationship alongside behavioural change. Where some approaches focus mainly on changing thoughts, DBT combines that work with skills practice and a clear emphasis on tolerating emotional distress. Compared with psychodynamic approaches that explore historical origins of difficulties, DBT is more skills-orientated and focused on immediate, practical strategies to improve safety and functioning.

DBT also has a team-based aspect for clinicians. Therapists who practise DBT usually participate in consultation groups with colleagues to maintain fidelity to the model and to prevent burnout. This means your therapist will be part of an organised programme of support and ongoing learning, which can be helpful for maintaining a consistent approach to complex problems.

Who is a good candidate for DBT?

DBT can be a good fit if you experience frequent, intense emotional states that interfere with your life, or if you have used self-harm or impulsive behaviours to manage distress. It is suited to people who are willing to engage in a structured programme, complete short tasks between sessions and learn new coping strategies. DBT can also help if relationship difficulties or recurrent crises are a central concern.

That said, suitability depends on many factors. Your clinician will typically carry out an assessment to explore your needs, existing supports and any co-occurring difficulties such as substance misuse or severe depression. This assessment helps to tailor the programme to your situation or to recommend alternative or complementary supports when appropriate.

How to find the right DBT-trained therapist

When you begin looking for a DBT practitioner, consider a few practical points. Check whether the therapist is registered with an appropriate UK professional body and whether they have specific training or accreditation in DBT. Experience with the particular issues you are facing can be important - ask about the populations they work with and how long they have offered DBT-informed care. You can also ask whether they deliver individual therapy, group skills sessions or both, and whether short coaching contact between sessions is available.

It is reasonable to ask about the typical length of the programme, the frequency of sessions and how progress is reviewed. Inquire about practical matters such as fees, cancellation policy and whether they offer face-to-face appointments in your area or remote sessions. A good therapist will be able to explain their approach in plain terms, outline what you can expect in the first few sessions and be open about what DBT entails.

Preparing for your first DBT appointment

Before your first session, think about what you most want to change and any immediate concerns about safety. If you keep notes about recent emotional highs and lows or incidents that worry you, bringing these can help the therapist understand pressing patterns. Be ready to discuss your history, current supports and any previous therapies, as this information helps shape a personalised plan. Remember that initial sessions are as much about getting to know each other and assessing fit as they are about beginning skills work.

Making the most of DBT

DBT tends to be most helpful when you engage actively - practising skills, using diary tools and being open with your therapist about what works and what does not. Progress can be gradual and may involve setbacks. A collaborative attitude - where you and your therapist track goals together and adjust the plan as needed - often produces the most sustainable change. If you are unsure whether DBT is right for you, a conversation with a DBT-trained clinician can clarify how the model would apply in your circumstances.

Finding a practitioner who matches your needs and makes you feel understood is an important step. Use the therapist profiles above to compare training, experience and approach, and reach out to ask questions before booking your first session. With the right support, DBT can offer practical skills and a structured framework to help you navigate intense emotions and build a more manageable way of living.