Got DBT? Dialectical Behavior Therapy 101

Recently, I observed one of our residents in the hallway when she was supposed to be in the weekly DBT skills group. “Why do we have to learn DBT? It’s just common sense!” she shouted in protest. I was quick to validate her experience.

When we look at the skills taught in DBT, it is understandable why someone would label them as common sense. It is also true that they are not always commonly used, even by those with good sense.

What is DBT?

Dialectical Behavior Therapy (DBT) is a research-supported cognitive behavioral psychotherapy that is found to be effective in treating symptoms and behaviors related to emotional dysregulation.

In other words: DBT is a therapy designed to help people change patterns of behavior that are not helpful, such as self-harm, suicidal thoughts, and substance use. It works by teaching cognitive and behavioral strategies to help people develop more adaptive ways of thinking and more effective behaviors, particularly in times of distress.

The creator of DBT, psychologist Marsha Linehan, Ph.D., was once struggling with emotional dysregulation herself. It took years of recovery and prolonged stays in psychiatric hospitals before she was able to piece together what she had found most helpful in her own recovery to form DBT. She wrote a wonderful piece in the New York Times that shares her experience with mental illness and how she came to develop the therapy.

Many of the programs at Sheppard Pratt are DBT-informed, and we offer a comprehensive DBT program at The Berkeley & Eleanor Mann Residential Treatment Center (Mann RTC).

Why DBT?

The skills taught in DBT cover a wide variety of beneficial life skills. And for those who struggle with chronic suicidal thoughts and non-suicidal, self-injurious behaviors, these skills are often life-saving.

The seemingly simple tasks taught in DBT are often taken for granted, but when implemented together, they equal a healthier and more balanced life. Some of these skills for example, might include:

  • Eating a balanced diet
  • Being nonjudgmental of others
  • Distracting oneself from distressful situations
  • Engaging in pleasant activities
  • Effectively getting our needs met
  • Getting a good night’s sleep

I empathize with the youth entering our program; it’s a new environment with different rules and expectations. It’s a lot to take in. Not to mention, it takes a lot of practice and many mistakes before someone becomes truly skillful in DBT and is ready to implement in the community.

To master DBT skills, it’s important to know that all of us (yes, even we, the staff!) benefit from actively using the skills taught in DBT. At Mann RTC, we aspire to practice the skills we teach our residents in our everyday lives, too (view staff implementation DBT skills on our Instagram: @MannDBTResources).

Which families need DBT?

The short answer: every parent and guardian can benefit from DBT. As a parent, my nine and 11 year olds know all about DBT, especially the importance of using their distress tolerance skills when they become upset, and their PLEASE skills to prevent the grumpies from coming to town.

In our DBT family groups at Mann RTC, we not only teach skills, we also discuss ways parents can assist in decreasing unwanted behaviors in their children, such as cutting, aggression, and truancy, and how to support an increase in more skillful behaviors, such as school attendance and following expectations in the home.

Our DBT family groups also offer families an opportunity to talk with one another, which provides validation around past and current struggles and motivation to make needed changes.

When we teach DBT to our residents and their families, we emphasize that DBT is not just something for the youth and families to use while in treatment; we hope that they continue to use DBT skills upon discharge. An important aspect of DBT is to generalize its application into the real world; to be able to carry on skillful use of Mindfulness, Distress Tolerance, Interpersonal Effectiveness, Emotion Regulation, and Walking the Middle Path skills.

Last week, one of our staff took two youth on a community outing. One of the youth, who has been patiently waiting to receive news of when he is being discharged, asked, “Can we do a mindfulness exercise before we go?” This youth wanted to center himself before they left campus to be more present in the moment as they embarked on a fun activity. To see and hear such real time examples provides me the proof that DBT is offering our residents and families an opportunity to, as DBT would say, “create lives worth living.”

In upcoming posts, I look forward to sharing the skills that are being taught in our program. In the meantime, check out the Sheppard Pratt DBT Resource page at for additional information and videos on DBT.

If you are experiencing distress, call Mann RTC’s Life Worth Living Line for DBT skills coaching at 410-938-5060.

Tess Carpenter, Psy.D., is the clinical director of The Berkeley & Eleanor Mann Residential Treatment Center at Sheppard Pratt, which provides comprehensive Dialectical Behavior Therapy (DBT) in a residential setting to adolescent youth experiencing emotional and behavioral dysregulation. Dr. Carpenter is intensively trained in DBT and oversees the residential and clinical areas of the program, as well as DBT implementation and program development.