Dialectical Behaviour Therapy (DBT)
Teaches skills for managing intense emotions, improving relationships, tolerating distress, and building a life worth living through mindfulness and practical strategies.
What Is DBT?
Dialectical Behaviour Therapy (DBT) was originally developed for borderline personality disorder but is now widely used for anyone who struggles with emotional regulation, self-harm, suicidal thoughts, or intense emotional experiences.
DBT teaches four core skill sets: mindfulness (present-moment awareness), distress tolerance (surviving crisis without making things worse), emotion regulation (understanding and managing emotions), and interpersonal effectiveness (communicating needs and maintaining relationships).
Comprehensive DBT includes individual therapy, group skills training, phone coaching for crises, and a therapist consultation team. Modified DBT programs may offer group skills training alone or a combination of individual and group.
Who Benefits from DBT?
mental health
Highly effective for emotional dysregulation, self-harm, suicidal ideation, eating disorders, and borderline personality disorder. Teaches practical, learnable skills.
autism
Modified DBT helps manage intense emotions and meltdowns, improves distress tolerance, and teaches concrete social interaction skills through the interpersonal effectiveness module.
brain injury
Addresses emotional dysregulation and impulsivity that commonly follow brain injury. Skills are concrete and can be adapted for cognitive differences.
intellectual disability
Adapted DBT programs simplify skills using visual supports and repetition, making emotion regulation strategies accessible for people with cognitive differences.
What to Expect in a Session
First Session
A comprehensive assessment evaluates emotional regulation difficulties, self-harm risk, treatment history, and suitability for DBT. The therapist explains the DBT framework and makes a commitment agreement.
Ongoing Sessions
Individual sessions focus on problem behaviours from the past week using a 'diary card' that tracks emotions and skill use. Group skills sessions teach and practise the four DBT skill modules in a structured curriculum.
Your Child's Role
You or your teen actively learns and practises DBT skills during sessions and between sessions using worksheets, diary cards, and real-life practice assignments.
Caregiver's Role
For adolescents, parents attend skills groups alongside their teen (in DBT-A). Parents learn the same skills, improving family communication and modelling emotion regulation.
When to Start
School Age (6-17)
DBT for adolescents (DBT-A) is typically used from age 12+. It is particularly effective for teens with self-harm, intense emotions, or relationship difficulties.
Adults (18+)
DBT is effective at any adult age for emotional regulation difficulties, self-harm, and chronic suicidality.
General guidance: If self-harm, suicidal thoughts, or severe emotional dysregulation are present, DBT should be considered as a first-line treatment. It is one of the most effective therapies for these issues.
| Item | Range | Details |
|---|---|---|
| Initial Assessment | $200–$500 | DBT suitability assessment |
| Per Session | $180–$275 | 60 minutes individual; 90-120 minutes group skills |
| Insurance | Individual DBT covered under psychology benefits; group skills training may or may not be covered separately | |
| Tax Credit | Eligible for Medical Expense Tax Credit (METC) when provided by a registered psychologist or psychotherapist | |
Money-Saving Tips
- Hospital-based DBT programs (e.g., CAMH, BC Mental Health) are often publicly funded with no cost
- DBT group skills classes are significantly cheaper than individual sessions and are a core component of treatment
- Some community mental health agencies offer modified DBT programs at reduced or no cost
| Province | Status | Program | Details |
|---|---|---|---|
| BC | Limited | Hospital Programs / MSP | Available through hospital-based programs; some health authorities offer DBT skills groups at no cost. |
| AB | Limited | Alberta Health Services | AHS offers some DBT programs through hospital mental health services; community availability is limited. |
| SK | No data | — | — |
| MB | No data | — | — |
| ON | Limited | Hospital Programs / OHIP | DBT programs available at CAMH and hospital mental health programs; community-based DBT is primarily private-pay. |
| QC | No data | — | — |
| NB | No data | — | — |
| NS | No data | — | — |
| PE | No data | — | — |
| NL | No data | — | — |
| NT | No data | — | — |
| NU | No data | — | — |
| YT | No data | — | — |
Evidence & Research
DBT has strong evidence for reducing self-harm, suicidal behaviour, and emotional dysregulation. Multiple randomized controlled trials support its effectiveness. Adapted DBT programs for people with intellectual disabilities and autism are showing promising results in emerging research.
Red Flags to Watch For
Be cautious of any provider who:
- The therapist claims to 'do DBT' but does not offer the core components (individual therapy, skills group, phone coaching)
- Skills training is not structured around the four core DBT modules
- The therapist is punitive about self-harm or makes you feel shamed rather than supported
- There is no diary card or tracking of target behaviours and skill use between sessions
- The therapist has no specific DBT training or certification
How to Find a Provider
- 1
Contact your local hospital's mental health program — many offer DBT programs (e.g., CAMH, BC Mental Health & Substance Use)
- 2
Search the DBT-Linehan Board of Certification directory for certified DBT clinicians
- 3
Ask your psychiatrist or family doctor for referrals to DBT programs in your area
- 4
Contact community mental health agencies that offer group DBT skills programs
- 5
Check if your children's hospital or youth mental health program offers DBT-A for adolescents
Conditions That Use DBT
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