Types of Therapy
Dialectical Behavior Therapy (DBT): What to Expect
What Is DBT Therapy, and What Should You Expect From It?
DBT therapy (dialectical behavior therapy) is a structured talk therapy that teaches skills to manage intense emotions, reduce self-destructive behavior and improve relationships. NIMH says it was developed specifically for people with borderline personality disorder, and it usually combines individual therapy with a weekly skills group. SAMHSA lists 8,628 mental health facilities that offer DBT (October 2026); the care finder shows which take Medicaid, Medicare or a sliding fee.
DBT therapy is one of the most structured forms of talk therapy you can get. Instead of one weekly conversation, it usually pairs individual sessions with a skills group, and the therapists meet as a team to keep treatment on track. This guide explains what DBT is, how it compares with CBT, who it’s built for, and how to find a program you can afford.
People in DBT often live with intense emotions, and some have thoughts of self-harm or suicide. If that’s you right now, call or text 988, or chat at 988lifeline.org, any time. Veterans can dial 988 and press 1. Call 911 if someone is in immediate danger. The crisis guide explains what happens when you reach out.
What DBT Therapy Is
DBT stands for dialectical behavior therapy. NIMH says it was developed specifically for people with borderline personality disorder, a condition that makes it hard to regulate emotions and can lead to impulsive behavior, an unstable sense of self and troubled relationships.
DBT uses mindfulness, meaning awareness of your present situation and emotional state, and teaches skills to help you control intense emotions, reduce self-destructive behaviors and improve your relationships. A review on the NIH’s NCBI Bookshelf describes DBT as a highly structured therapy that combines mindfulness practices with concrete interpersonal and emotion-regulation skills rooted in cognitive behavioral therapy. Its aim is to change behavior and help you tolerate distressing feelings without making things worse.
How a DBT Program Is Set Up
DBT is a package rather than a single session type. The NCBI Bookshelf review describes three parts.
| Part of DBT | What it is | Who attends |
|---|---|---|
| Individual therapy | One-on-one sessions with your DBT therapist | You and your therapist |
| Group skills training | A class-style group where skills are taught and practiced | You and other people in the program |
| Therapist consultation team | A weekly team meeting where DBT therapists support each other and review care | Your therapists, not you |
NIMH notes that group sessions can help people with borderline personality disorder learn to interact more constructively with others and express themselves more effectively. When you call a program, ask whether it offers all of these parts or only a skills group. Knowing what is included helps you compare programs and costs.
The Skills DBT Teaches
DBT skills fall into four areas, drawn from the NIMH and NCBI Bookshelf descriptions:
- Mindfulness: noticing what you feel and what is happening right now, without judging it.
- Tolerating distress: getting through a painful moment without doing something that makes it worse.
- Regulating emotions: learning to control intense emotions.
- Interpersonal skills: improving how you relate to others and express yourself.
The skills are taught in the group and applied to your own life in individual sessions. Ask a program how it expects you to practice between sessions, so you know the time commitment before you start.
Where to Find It: DBT by State
SAMHSA's FindTreatment.gov lists 8,628 mental health facilities with this service (dbt) across 55 states and territories, checked October 2026. Pick a state for its facilities, cities and treatment agency.
DBT vs CBT: How They Differ
DBT grew out of cognitive behavioral therapy, so the two share a lot. Here is how they compare.
| CBT | DBT | |
|---|---|---|
| Core idea | Notice and question inaccurate or harmful thoughts, then change self-defeating behavior | Change behavior and learn to tolerate distressing feelings |
| Main tools | Questioning thoughts, exposure, problem solving | Mindfulness plus skills for emotions, distress and relationships |
| Usual format | Individual sessions | Individual sessions plus a skills group, with a therapist team |
| Built for | Many conditions, including anxiety disorders | People with borderline personality disorder |
NIMH describes CBT as helping you become aware of automatic ways of thinking that are inaccurate or harmful, question those thoughts, and change self-defeating patterns. DBT adds mindfulness and concrete skills for moments when emotions run very high. Neither is “better” in general. The right choice depends on what you’re dealing with, and a clinician can help you decide. The CBT guide covers CBT in depth, and the EMDR guide explains a therapy aimed at trauma.
Who DBT Is for
NIMH says psychotherapy is the primary treatment for borderline personality disorder and that people with the condition should get treatment from a licensed mental health professional. It is usually diagnosed in late adolescence or early adulthood. NIMH also notes that people with borderline personality disorder have a significantly higher rate of self-harm and suicidal thoughts than the general population, which is one reason DBT puts so much weight on safety skills.
Borderline personality disorder often occurs alongside other conditions, including depression, PTSD, bipolar disorder, anxiety disorders, substance use and eating disorders. If you’re dealing with one of those too, the guides to therapy for depression, bipolar disorder treatment and eating disorder treatment explain how care for each fits in.
Only a licensed professional can diagnose borderline personality disorder or say whether DBT fits you. If you’re not sure where to start, NIMH suggests talking to a primary care provider, who can refer you to a psychologist, psychiatrist or clinical social worker.
DBT for Teens
Parents often look for DBT for a teenager. Start with your child’s pediatrician, who can refer you to a qualified clinician. If your child has Medicaid, the EPSDT benefit covers children under 21 and requires states to cover medically necessary services to treat or reduce illnesses. The guide to finding a therapist for a child or teen explains school-based options and what to ask.
How to Find a DBT Program
SAMHSA lists 8,628 mental health facilities that offer DBT and 10,595 that offer group therapy (October 2026). To narrow them down:
- Search by therapy type. Use the care finder and filter for DBT, then check your state page for local programs and coverage.
- Ask what the program includes. Ask whether it has individual therapy, a skills group and a consultation team, how long the program runs, and how often groups meet.
- Ask about training. Ask who leads the skills group and what DBT training the therapists have.
- Check licenses. DBT therapists are psychologists, licensed counselors, clinical social workers and marriage and family therapists. You can check a therapist’s license with your state board.
- Confirm cost. Ask whether the individual session and the group are billed separately, and what each costs you.
How to Support Someone in DBT
If someone you love is starting DBT, your support matters. NIMH offers practical steps for family and friends of a person with borderline personality disorder:
- Learn about the condition so you understand what your loved one is going through.
- Offer emotional support, validation, patience and encouragement. Change can feel hard and frightening, but things can improve with time.
- Learn about their treatment plan and find ways to support its goals, including the skills they’re practicing.
- Encourage structure, such as a daily schedule and healthy routines.
- Help them take any medication as prescribed, and encourage them to talk with their provider before stopping or changing it.
- Take any comment about self-harm or suicide seriously. Encourage prompt contact with a mental health professional, or with the 988 Lifeline by calling or texting 988.
- Get counseling for yourself, with a different therapist from the one your loved one sees.
NIMH adds that therapy for caregivers can help families build skills to understand and support the person, and work through the strain of caregiving. The couples therapy guide covers counseling for partners, and grief counseling can help when a relationship or loss weighs on you too.
Paying for DBT Therapy
Because DBT usually means two appointments a week, cost adds up faster than with standard therapy. These routes keep it lower.
- Medicaid. Medicaid is the single largest payer for mental health services in the U.S. SAMHSA lists 10,558 facilities that accept Medicaid. See Medicaid coverage of therapy.
- Medicare. Part B covers individual and group psychotherapy with licensed professionals, including clinical social workers, marriage and family therapists and mental health counselors. It also covers intensive outpatient and partial hospitalization programs. After the Part B deductible, you pay 20% of the Medicare-approved amount. See Medicare coverage of therapy.
- Sliding fees. SAMHSA lists 5,028 facilities with a sliding fee scale. NIMH also points to university training clinics, which often charge less. Start with sliding scale therapy or community mental health centers.
- Private insurance. Ask your plan whether the skills group counts as group psychotherapy. The insurance coverage guide explains parity rules.
The low-cost care checker matches your state, age and coverage to the routes that fit.
Frequently Asked Questions
How Long Does It Take for DBT to Help?
NIMH says many factors affect how long symptoms of borderline personality disorder take to improve once treatment begins. It stresses being patient, getting support during treatment, and sticking with treatment rather than stopping early. Ask a program how long it runs and how it tracks progress.
Is DBT Only for Borderline Personality Disorder?
NIMH says DBT was developed specifically for people with borderline personality disorder. If you have a different diagnosis, a clinician who knows your history can tell you whether DBT fits your needs or whether another therapy would serve you better.
Can a Family Member Join DBT?
DBT itself is built around the person in treatment, but NIMH says therapy for caregivers and family members is often helpful when a loved one has borderline personality disorder. It also suggests family members choose a different therapist from the one their loved one sees.
Is Medication Used Instead of DBT?
Not usually. NIMH says psychotherapy is the primary treatment for borderline personality disorder, and medication is not a first-line treatment. A provider may add medication for specific symptoms or for co-occurring conditions such as depression. Never stop or change a medication without talking to your prescriber.
Can DBT Be Done by Telehealth?
Ask each program whether it offers individual sessions or skills groups by video. Medicare covers individual and group psychotherapy through telehealth. See the telehealth therapy guide for how to check a provider's license across state lines.
More on Types of Therapy
- CBTWhat CBT is, what it treats and how to find it
- EMDREMDR for trauma and PTSD and how to find it
- Telehealth TherapyHow telehealth therapy works and what covers it
- Psychiatrist vs TherapistWho prescribes, who provides therapy, and which license to check
- AnxietyThe therapies NIMH describes for anxiety disorders and how to find one near you
- DepressionTherapy for depression, who provides it and how to pay for it
This guide explains mental health care in plain language from official sources. It isn't medical advice; a licensed clinician can assess what care fits your situation.
Sources
- NIMH: Borderline Personality Disorder
- NCBI Bookshelf (StatPearls): Borderline Personality Disorder
- NIMH: Psychotherapies
- Medicare.gov: Mental Health Care (Outpatient)
- Medicaid.gov: Behavioral Health Services
- Medicaid.gov: Early and Periodic Screening, Diagnostic and Treatment
- SAMHSA FindTreatment.gov listing data, checked October 2026