Dialectical Behavior TherapyDBT
For when emotions move faster than your judgment. I'll help you set a clear goal, then use proven skills to get you there.
- Free10-minute consultation
- 24–48 HrsTypical time to a first session
- 11 StatesCA, CO, GA, FL, IL, NJ, NV, NY, MA, TX, VT
- In-NetworkUnited Healthcare, or private pay
What Is Dialectical Behavior Therapy?
Dialectical behavior therapy, or DBT, is a skills-based approach built for the moments when emotions take over. A tense meeting turns into a sharp reply you regret. A comment from your partner sends you from calm to furious in seconds. You know how you want to act, but in the moment the feeling wins.
None of this means something is wrong with you. Some people feel things faster and harder, and most were never taught what to do with that. DBT with me gives you specific skills to bring emotions down, get through tough moments and stay effective with people, and to leave with a plan.
The word dialectical refers to holding two things at once: accepting where you are right now while working to change it. Sessions, which are generally more structured and didactic, start with where you are and what you want to change.
When DBT Skills Tend to Help
Most people don't book a first session because they have decided they want DBT. They book because the same heated moments keep costing them at work or at home.
DBT skills tend to suit people who already know what they should do and struggle to do it when emotions run high. If a few of these sound like the last several months, it's worth a conversation.
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What DBT Skills Help With
Intense emotions rarely stay in one corner of life. Frustration from work follows you home, and tension at home follows you to work. Choose an area to see how it can look and what I focus on in sessions.
When anger takes the wheel
Anger moves fast. Your heart rate jumps, your jaw tightens and the words come out before you've decided to say them. Afterward you can see what you should have done, but in the moment that clarity isn't there.
DBT skills are built for that window. I help you notice the physical signs early and use specific techniques to bring the intensity down before it turns into something you have to clean up later.
What I help with
- Spotting the physical warning signs early
- Cooling down fast when you're heated
- Stepping away without storming off
- Rebuilding trust after an outburst
When important conversations keep going sideways
Many people know what they want to say to a partner, a parent or a coworker. The problem is saying it while upset. It comes out too sharp, or it doesn't come out at all, and the real issue never gets addressed.
DBT's interpersonal skills give you a clear structure for asking for what you need, saying no and holding a boundary while keeping the relationship intact.
Want to work on this with your partner? See Couples & Marriage Counseling.
What I help with
- Asking for what you need clearly
- Saying no without guilt or a fight
- Holding a boundary under pressure
- Staying calm when the other person isn't
When you need relief right now
When stress spikes, most people reach for something that brings fast relief: a drink, a few hours on a screen, a late night at the office or pulling away from everyone. It works for a little while, and then the original problem is still there with a new one on top.
DBT's distress tolerance skills give you other ways to get through the worst of a moment. They're practical, quick to use and don't come with a cost later.
What I help with
- Financial stress and money worries
- Overworking to avoid other problems
- Checking out through screens, gaming or scrolling
- Pulling away from friends and family
- Drinking or other substances to unwind
When pressure at work turns into reactions you regret
High-stakes jobs come with tight deadlines, difficult people and decisions that can't wait. When stress runs high, it's easy to snap at a colleague, fire off an email too fast or shut down in a meeting.
DBT skills help you stay effective under pressure. You learn to pause long enough to choose your response, so your reputation reflects your judgment and not your worst moment.
What I help with
- Staying composed in tense meetings
- Pausing before you answer a frustrating email
- Handling criticism without getting defensive
- Managing pressure before it turns into burnout
When you act first and think later
Strong emotions push for immediate action. Quitting on the spot, a big purchase, sending the text or walking out of the room can all feel right in the moment and wrong by the next morning.
In sessions I help you build a gap between the urge and the action. Even a few minutes is often enough to make a choice you'll still stand behind tomorrow.
What I help with
- Recognizing urges before you act on them
- Riding out an urge without giving in
- Spending or decisions made while upset
- Weighing short-term relief against long-term cost
When everything hits at once
Some days the pile-up is real: a hard conversation, a missed deadline, a sick kid and no sleep. When everything hits at once, it's hard to think clearly about any of it.
DBT mindfulness skills help you slow down and focus on one thing at a time. That doesn't make the pile smaller, but it makes it possible to work through it instead of freezing or exploding.
What I help with
- Grounding yourself when your mind is racing
- Focusing on one problem at a time
- Getting through a hard day without shutting down
- Building daily habits that lower your baseline stress
When your mood sets the tone for the whole day
Anxiety and low mood often travel with emotional intensity. A rough morning colors the whole day, and small setbacks feel bigger than they are.
DBT's emotion regulation skills help you understand what drives your mood and build habits that make you less vulnerable to big swings. Many clients pair them with CBT for a fuller set of tools.
Looking for more on this? See Anxiety Therapy or Depression Therapy.
What I help with
- Understanding what drives your mood
- Protecting your mood with sleep, food and routine
- Acting opposite to an unhelpful urge
- Building more positive experiences into your week
What People Get Wrong About DBT
Most people who have heard of DBT picked it up secondhand from a friend, an article or a quick search. Some of what gets passed around is accurate. Some of it has turned into myths that make DBT sound narrower or more intense than it really is.
Hover over or tap a card to see what DBT actually looks like.
DBT was first developed for people with severe emotional struggles, and it's still used that way. Its skills have since proven useful for a much wider group, including people dealing with anger, stress, relationship conflict and impulsive habits. You don't need to be in crisis to benefit.
Acceptance in DBT isn't about approving of a situation or deciding nothing can change. It's about seeing what's actually happening so you stop spending energy fighting reality. That clarity is usually what makes real change possible.
DBT mindfulness is practical. It means noticing what you're feeling and thinking without reacting to it right away. You can practice it in a meeting, in traffic or in the middle of an argument, and it rarely involves sitting still for long.
Emotional control isn't a trait you're born with or without. It's a set of skills, and like any skill it improves with practice. Many clients notice they recover from hard moments faster once they've been using the skills for a while.
What DBT Sessions Look Like
Sessions are structured and built around a goal. I start by pinning down what you want to be different, then teach the DBT skills that fit the problem and the way you like to work. Most people end up with a blend.
Pick what matters most to you right now to see where I'd likely start.
Mindfulness
Mindfulness is the foundation of every other DBT skill. You'll practice noticing thoughts, feelings and urges without acting on them right away. That small pause is what gives you a choice in how you respond, whether you're in a meeting or in the middle of an argument.
Distress Tolerance
Distress tolerance skills are for the moments when you can't fix the problem right away and need to get through it without making it worse. You'll learn quick techniques to calm your body, ride out urges and buy yourself time to think.
Emotion Regulation
Emotion regulation skills help you understand what you're feeling, why it shows up and how to turn the intensity down. We also look at the basics that affect your mood more than most people expect, like sleep, exercise and daily routine.
Interpersonal Effectiveness
Interpersonal effectiveness skills give you a clear structure for asking for what you need, saying no and holding a boundary. The goal is to get what you want from a conversation while keeping both the relationship and your self-respect intact.
Every session is held online over secure video. I won't ask you to open up faster than you are ready to. Trust gets built over time, and the pace is something we agree on together.
What People Get Out of DBT
People who start DBT often say they wish they had started sooner. Progress looks different for everyone, and your goal shapes the work. These are some of the changes clients commonly work toward.
- Catching strong emotions before they take over
- Fewer regrets after heated moments
- Calmer, clearer conversations at home and at work
- Getting through stress without leaning on unhealthy habits
- Bouncing back faster after a bad day
- Saying no and asking for what you need
- Skills you can keep using after therapy ends
Common Questions
What is dialectical behavior therapy?
DBT is a skills-based form of therapy that helps people manage intense emotions, get through stressful moments without making them worse and handle relationships more effectively. It combines acceptance of where you are with practical skills for changing what isn't working.
Do you offer full DBT or DBT skills?
I teach DBT skills in individual sessions and blend them with other evidence-based approaches. Comprehensive DBT programs add weekly skills groups and other components designed for more intensive needs. If that level of support would serve you better, I'll tell you during the consultation and help you find it.
I've never been to therapy. What happens in the first session?
After a free 10-minute phone call, your intake appointment covers what's going on, relevant background and what you want to be different. Depending on need, that first session can often be scheduled within 24 to 48 hours of reaching out. By the end you'll have a defined goal and a rough plan. Follow-up sessions build toward that goal, and we'll check progress together along the way.
How long does DBT take?
It depends on the goal. Some clients come in to build a specific set of skills and finish within a few months. Others stay longer to practice skills across more areas of life. Because the work is organized around a defined goal, we'll review progress regularly and decide together when you've reached it.
Does DBT work online?
Yes. Research shows telehealth therapy produces outcomes comparable to in-person sessions for common concerns such as anxiety and depression. DBT skills translate well to video, and practicing them from your own space makes it easier to use them in daily life.
How much does it cost, and do you take insurance?
The 10-minute phone consultation is free. Intake and follow-up sessions are $195, and couples sessions are $205. I'm in-network with United Healthcare, though most clients choose private pay for the added privacy and flexibility. Payment is accepted by most major credit cards, Venmo, Cash App, FSA or HSA.
Which states can I book from?
Online sessions are available to clients located in California, Colorado, Georgia, Florida, Illinois, New Jersey, Nevada, New York, Massachusetts, Texas and Vermont.
Can DBT be combined with other approaches?
Yes. Most clients end up with a blend. I often pair DBT skills with CBT to work on the thoughts behind strong emotions, and with motivational interviewing when part of you isn't sure about making a change.
Get in Touch
10 minutes, no cost. Tell me a little about what's going on and I'll follow up to find a time that works.