A man standing before two yellow lines with the word "start" written in white paint in the middle, indicating it's the starting line.

How to get started with dialectical behavior therapy?

Getting started can feel like a big step, but if you’re ready to commit to it, it can also be life-changing.

  1. Find a qualified DBT therapist or program
    • Look for someone trained specifically in DBT

Not every therapist who says they offer DBT provides it in its full, evidence-based format.

Ideally, they should have formal DBT training.

    • Search through reliable directories:
        • Local hospital outpatient programs or mental health clinics.
      • Ask questions when contacting therapists
        • Do you offer comprehensive DBT (individual therapy + skills group + phone coaching)?
        • Are you part of a DBT consultation team?
        • Have you been trained by a DBT-recognized organization?

True DBT programs usually have all four components: individual therapy, group skills training, phone coaching, and therapist consultation.

  1. Consider full DBT vs. DBT-informed therapy
    A couple going to relationship therapy and talking to a therapist while sitting on a couch.
    • Full DBT is the entire structured program (best for serious emotional or behavioral problems).
    • DBT-Informed Therapy uses DBT skills and principles but may not include all parts (better if you want to focus just on skill-building or if full DBT isn’t available near you).

Full DBT is strongly recommended if you’re dealing with life-threatening behaviors (like self-harm or suicidal thoughts).

  1. Assessment and commitment
    • Most DBT programs start with an assessment phase.

Therapists will evaluate your needs, emotional issues, and treatment goals.

    • You’ll usually be asked to sign a commitment agreement.

This says you agree to:

      • Attend sessions regularly.
      • Practice skills between sessions.
      • Work on dropping life-threatening behaviors.

Commitment is a key DBT principle. That’s not because they want to trap you, but because showing up for yourself is part of the rehab.

  1. Start learning the skills

Once you’re enrolled, you’ll likely begin with:

    • Mindfulness (foundational skill to stay present).
      A woman sitting in a yoga pose on the floor while keeping both hands together in front of her chest.
    • Distress tolerance (managing disasters without making things worse).
    • Emotion regulation (understanding and balancing emotions).
    • Interpersonal effectiveness (handling relationships and communication better).

Skills are usually taught one module at a time in group sessions, while your therapy centers itself on applying them to your challenges.

  1. Practice
    • Homework is a big part of DBT

You might be asked to fill out diary cards, track emotions, practice mindfulness exercises, or apply a new skill in your daily life.

    • Real change comes from using the skills outside therapy when life gets messy, rather than just talking about them.
  1. Stay patient and persistent
    Rocks stacked on top of each other.
    • DBT isn’t a quick fix. It usually takes 6 months to a year (sometimes longer) to work through a full DBT program.
    • Getting better happens slowly, through consistent small changes over time.
    • Many people report noticeable improvements in emotional stability, relationships, and self-respect after completing the program.

If you can’t access in-person DBT right now, there are some good online options too:

    • Online DBT skills groups.
    • Telehealth DBT therapy.
    • Self-help books like “The DBT Skills Training Handouts and Worksheets” by Marsha Linehan. (Good if you’re supplementing, not as a therapy replacement.)

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