Dialectical Behavior Therapy

DBT was developed by Dr. Marsha Linehan at the University of Washington (Read her powerful personal story here).   All St Louis DBT therapists have post-graduate training in DBT.

DBT has four components. Their objectives are to learn and apply skills until they become nearly automatic in all (or most) areas of your life (e.g., home, school, work, social situations, friendships and intimate relationships).

Group skills classes

Group training is run like a class where the group leader teaches skills and assigns homework for you to practice using the skills at home, school, work and social situations.  A second group leader observes and reflects back how clients use (or don’t use) skills to interact, validates members and makes suggestions for increasing the effective use of skills.  Group skills training is NOT group therapy. You must be in individual therapy to participate in group skills classes.

Up to eight clients meet 1.5 hours weekly to learn and practice DBT skills. Classes are organized in four modules:  core mindfulness, distress tolerance, emotion regulation and interpersonal effectiveness. Two classes are currently offered:  one for young adults (age 17-25) and the other for adults (age 26+).  New DBT skills classes will be offered in the near future, including multi-family and adolescent/caregiver classes.

Individual therapy

In individual therapy, you will apply skills to current situations, track your progress and enhance your motivation.  Some things you can expect to do in DBT individual therapy:

  • Review Diary Cards – these are behavior and skills tracking devices.  These may be paper cards, an app on your phone, or an electronic/computerized version of the card
  • Behavior Chain Analysis – learn how to effectively and nonjudgmentally analyze your problem behaviors and come up with practical solutions
  • Talk about and practice applications of skills learned in DBT Skills Group.

Between session coaching

These are 10 minute calls, emails or texts to help you use your coping skills when you are overwhelmed by thoughts, emotions or destructive urges before the problem behavior occurs.  You call your individual therapist as needed or your therapist may ask you to check in at certain times when you are at particular risk.


Your therapist consults with a team of DBT therapists to ensure you get the best care possible and to address your therapist’s need for support and encouragement.  We consider this time “therapy for the therapist” and it keeps your therapist working according to the DBT model.