DBT (dialectical behavior therapy) helps people with complex trauma, personality disorders, and other mental health conditions get stabilized, reduce crises and self-harm by teaching four core skills (mindfulness, distress tolerance, emotional regulation, and interpersonal effectiveness).
For trauma or PTSD specific treatment, it is often combined with the trauma-focused therapies such as TF-CBT or EMDR for improved treatment outcomes [1][2]. Read on to learn more about DBT, its effectiveness, and how it’s used with other treatments to improve successful recovery outcomes.
Key Takeaways:
- Stabilize before processing: DBT lowers immediate risk and builds coping, so trauma work is safer and more effective.
- Skills you can use today: Mindfulness, distress tolerance (e.g., TIP, STOP), emotion regulation, and interpersonal skills generalize to daily life.
- Plan the sequence: Many people do DBT first, then add trauma-focused CBT, prolonged exposure, or EMDR when stable enough.
What is DBT for Trauma and How Does it Help?
DBT is a structured, skills-based therapy that blends acceptance and change strategies. For trauma, it prioritizes safety and stabilization, then helps patients move into trauma-processing when appropriate [3] [4].
DBT helps lower nervous system arousal, helps clients with emotional labeling, and can reduce the risk of crises related to self-harm or suicidal ideation. It can make the long-term trauma processing and cognitive work more tolerable.
What Are The Core Modules of DBT and How Do I Use Them?
DBT emphasizes four core skillsets to support emotional regulation, trauma processing, and strengthen relationships. These include [5]:
Mindfulness: Notice how you are feeling → name the emotion → gently return attention (anchor to breath/ the five senses).
Distress Tolerance: Manage intense feelings or emotions with crisis interventions/self-soothing practices such as TIPP and STOP to ride out waves without adding harm.
Emotion Regulation: Understand the function of feelings, learn triggers, coping skills for reducing emotional intensity.
Interpersonal Effectiveness: Focus on expressing needs, setting limits/boundaries, and preserving self-respect.
What Does Effective DBT Look Like?
DBT is most effective when it’s part of a comprehensive treatment routine. Clients should attend individual DBT sessions weekly to learn skill sets and work through emotional distress. These, combined with DBT skills groups, provide a space to practice and implement the DBT skills learned in therapy.
High-quality care should be outcomes-based, emphasizing long-term recovery and ensuring hospitalization or relapse rates are reduced. During DBT, especially as part of a larger treatment program, crisis planning is also emphasized to prevent future hospitalizations.
How Long Does DBT Usually Take?
Many comprehensive DBT programs run 6 to 12 months (cycling between the four modules). Brief/targeted formats do exist to help with stabilization or as part of relapse prevention plans. The duration and frequency of sessions may look different for everyone. Duration should align with treatment goals, risk, and, if co-occurring conditions are present.
A willingness to practice skills in and outside of therapy sessions, agreement on a safety plan, and open communication with your therapist can greatly improve successful treatment outcomes. Skipping sessions, avoiding triggers entirely, or stopping care as soon as symptoms subside can reduce the effectiveness of care and successful outcomes.
Where Might Medications or Ketamine-Assisted Therapy Fit?
Medications may help with depression or anxiety symptoms while you build skills, especially related to sleep, mood, or appetite. If your prescriber believes you could benefit from medication, they can coordinate this with a psychiatrist or your clinical treatment team.
Ketamine-assisted therapy is also a growing approach paired with DBT to help those with treatment-resistant depression and complex trauma more easily process underlying distress. This is for carefully selected, treatment-resistant cases under medical oversight. It is not a first-line treatment or replacement for DBT.
At Harper Clinic, our functional medicine team designs personalized treatment plans based on your mental health needs. For some, this might include integrating DBT with other forms of care such as medication, ketamine therapy, or TMS. To ensure you meet the criteria for treatment, our consultation team will provide a comprehensive assessment.
Dialectical Behavioral Therapy in Utah
Harper Clinic understands the difficulty in treating complex trauma and mental health conditions. We offer a range of therapies, such as DBT and CBT, to process emotional distress, reduce trauma symptoms, and improve one’s overall health.
Get in touch with us through text, phone call, or our direct Vagaro booking. We will verify insurance, schedule your first consultation, and design a treatment plan tailored to your specific health needs.
FAQs
DBT vs. CBT: which should I start with?
If crises, urges, or emotional volatility lead, begin with DBT. When stable but stuck in trauma memories, add trauma-focused CBT, prolonged exposure, or EMDR (often sequenced).
Does DBT help depression linked to trauma?
Yes. DBT skills reduce avoidance and improve functioning. Some people pair DBT with antidepressants or CBT-for-depression elements under a clinician’s care.
What should I expect between sessions?
Homework and skills coaching: brief daily practice, crisis-survival drills, and progress tracking
Sources
- Cleveland Clinic. (2023). Dialectical behavior therapy (DBT). https://my.clevelandclinic.org/health/treatments/22838-dialectical-behavior-therapy-dbt
- Harvard Health Publishing. (2024). DBT: What is it and who can it help? https://www.health.harvard.edu/blog/dialectical-behavior-therapy-what-is-it-and-who-can-it-help-202401223009
- Verywell Mind. (2024). Dialectical behavior therapy (DBT). https://www.verywellmind.com/dialectical-behavior-therapy-1067402
- NCBI Bookshelf (SAMHSA TIP 57). (2015). Trauma-informed care in behavioral health services. https://www.ncbi.nlm.nih.gov/books/NBK207191/
- Harned, M. S., et al. (2010). Treating PTSD in suicidal/self-injuring women with BPD: DBT target hierarchy. Am J Psychiatry (review summary). https://pmc.ncbi.nlm.nih.gov/articles/PMC2963469/
- American Psychological Association (APA). (2024). PTSD guideline: Cognitive-behavioral treatments. https://www.apa.org/ptsd-guideline/patients-and-families/cognitive-behavioral