DBT Skills in Individual Therapy

My Approach

What DBT skills are

Dialectical Behavior Therapy, or DBT, was developed as a comprehensive treatment that combines individual therapy, skills training and other supports. Over time, many of its skills have become widely used on their own because they are practical and teachable.

The skills are usually grouped into a few areas: mindfulness, which helps you notice what is happening without judging it; emotion regulation, which helps you understand and influence your emotional reactions; distress tolerance, which helps you get through a crisis moment without acting in ways you regret; and interpersonal effectiveness, which helps you ask for what you need while protecting relationships and self-respect.

The word dialectical points to holding two things at once, such as accepting yourself as you are while also working to change. That balance runs through the whole approach.

• Mindfulness
• Emotion regulation
• Distress tolerance
• Interpersonal effectiveness

Acceptance and change together

One of the most useful ideas in DBT is that acceptance and change are not opposites. You can acknowledge that a situation is painful, that your reaction makes sense given your history, and still decide to respond differently.

Many people swing between harsh self-criticism and giving up. Neither tends to help. DBT skills offer a middle path: seeing clearly what is happening, treating yourself with some respect and choosing an action that moves you toward what you value.

This balance is especially helpful in relationships. Interpersonal effectiveness skills can help you prepare for a difficult conversation, say no without guilt or ask for something important while keeping both your goal and your self-respect in view. I work with individuals only, so this work focuses on your part of the relationship and the choices within your control.

What it looks like in session

We often start by mapping a recent moment when emotion took over. What set it off? What did you notice in your body? What urge showed up, and what did you do? Understanding the sequence makes it easier to step in earlier next time.

Then we talk through which skills might help at different points in that sequence. Some are about reducing vulnerability, such as sleep, routine and physical health. Some are about pausing before reacting. Some are about asking for what you need clearly and calmly.

I do not hand out scripts to memorize. We adapt the skills to your life, and I explain how each one connects to what we are working on. Over time, the goal is for the skills to feel less like techniques and more like your own way of responding.

Who DBT skills can help

DBT skills can be useful for adults who feel overwhelmed by emotion, who react quickly and regret it later, or who shut down when things get hard. They also pair well with work on anxiety, depression, relationship challenges, substance use, and stress and burnout.

I often combine DBT skills with CBT to examine the thoughts involved, with Motivational Interviewing when change feels uncertain, and with solution-focused questions that highlight what is already helping.

If you are in crisis or thinking about harming yourself, please call or text 988, or call 911 in an emergency. This site is not monitored for emergencies.

Getting started

You do not need to be in crisis to benefit from these skills. Many people come to therapy because the same kind of moment keeps going badly, and they want a steadier way through it.

Sessions are by secure video for adults physically located in Connecticut, New York or Massachusetts. A free consultation is a chance to talk about what you are facing and whether a skills-informed approach fits. You can request a time through the secure client portal on the Work With Me page.