Dialectical Behavioral Therapy (DBT) is one of the most common, and most researched, forms of treatment for mental health disorders. It’s a talk therapy that involves 1:1 conversations with a therapist and conversations as part of a group.
DBT is highly effective: it was initially created for Borderline Personality Disorder but is now integrated into treatment for depression, PTSD, suicidality, and eating disorders. Research shows that DBT can help stabilize and control self-destructive behaviors and improve the number of people who drop out prematurely from care programs [1].
The group therapy aspect of DBT is one of the qualities that sets it apart from other therapies, such as Cognitive Behavioral Therapy (CBT). Let’s take a look at what it is, how it works, and what to expect.
What Is DBT?
DBT was designed in the 1970s by psychologist Marsha Linehan. It primarily helps people who experience emotions very intensely, and it’s centered around teaching emotional regulation. In sessions, people come to understand that emotional distress is inevitable, but that they can manage their behaviors and reactions.
DBT blends the principles of acceptance and change, which is why it’s called ‘dialectical’, meaning to combine opposing ideas.
The structure of DBT includes individual sessions with a therapist and group sessions led by a therapist. The former supports personal processing, while the group dynamic supports skills integration.
DBT requires a lot of active input, and treatment typically takes between six months to a year. One study found that after six months, people receiving DBT reported significantly reduced symptoms of depression, emotional and behavioral dysregulation, and psychological inflexibility [2].
It’s been shown to reduce anger, impulsivity, and substance abuse [2], and to produce positive outcomes in treatment for eating disorders [3]. DBT has also contributed to lower use of crisis services [4].
What Does DBT Group Therapy Look Like?
DBT group therapy doesn’t work like a traditional support group, you don’t only share experiences and feelings, you also learn core skills. In these sessions, the therapist is an instructor and a facilitator who leads sessions to teach you tools and techniques that build emotional regulation.
Most DBT groups meet weekly for 1-2 hours, and include 6-12 people, although this can vary depending on the type of care program you’re in and the severity of your mental health disorder.
Homework is an important element of group therapy. The therapist will give you tasks that encourage you to integrate what you learn in the sessions into the real world. You’ll most likely share homework at the beginning of sessions and receive feedback from peers.
The format for each session is typically:
- Start with a mindfulness exercise to be grounded in the present and prepare for the session ahead.
- Share homework, specifically how you applied skills from DBT into your everyday interactions.
- The therapist leads a class on one of the core skills, and will guide discussions and answer questions.
- The session closes with a reflective talk about what’s been shared. Homework is assigned.
What Skills Do You Learn in DBT Group Therapy?
Group therapy in DBT concentrates on teaching four key skills to improve your quality of life and limit destructive behaviors. The skills are: distress tolerance, interpersonal effectiveness, emotion regulation, and mindfulness.
Distress tolerance teaches you how to deal with difficult feelings, and how to respond in a healthy way, including self-soothing and distraction techniques.
Interpersonal effectiveness teaches effective communication and how to set boundaries. With this skill, you’ll learn conflict management and how to cultivate healthy relationships.
Emotion regulation teaches you how to understand and manage intense emotions. You’ll be able to label emotions and develop strategies to change unhelpful emotional responses.
Mindfulness teaches you to be grounded in the present moment, rather than worrying about the past or future. Breathing exercises and body scans are part of this skill.
Why Is Group Therapy Part of DBT?
Because DBT is rooted in acceptance and change, it’s important that there’s a space for change to actually happen. Group therapy provides a safe space to slowly learn and enact change. By having other people present, you can practice with, and learn from, one another in real time.
Other benefits are:
- New skills: Group therapy extends beyond symptom relief. It fosters long-term emotion regulation, emotional intelligence, and resilience.
- Validation: Interacting with other people who struggle to regulate can be comforting and create group motivation to learn new skills.
- Feedback: You provide and receive constructive feedback, giving new perspectives on different scenarios and relationships.
- Confidence: You talk about experiences and practice new skills in a space that feels like a stepping stone between your 1:1 therapy sessions and the real world.
- Routine: Regular group therapy gives you consistency that can help maximize your treatment outcomes and set you up for healthier mental health habits.
- Support network: You have a group of people to stay in touch with after treatment to sustain your recovery.
Preparing for Group Therapy in DBT
It’s natural to feel anxious about going into group therapy if you’ve never done it before (or even if you have done it before). A few tips that can help you relax and get the most out of your sessions are:
Come with an open mind. Try to be curious and patient in sessions — learning any skill takes time and requires repeated effort.
Get involved. Participating in discussions and activities means that you’ll get more feedback and learning, and a greater sense of progress out of sessions.
Do homework. Both literally and figuratively. Take what you learn in sessions, outside of sessions to reinforce learning and real change.
Be kind. To yourself and to others. The more empathy you show, the faster you’ll learn emotion regulation.
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Sources
[1] Petruzzi, J. (January 2014). SCIENTIFIC EVIDENCE-BASE OF THE EFFECTIVENESS OF DBT. ResearchGate.
[2] Marshall, L. et al. (June 2026). Effectiveness of Dialectical Behavior Therapy (DBT) in a Forensic Psychiatric Hospital. The Journal of the American Academy of Psychiatry and the Law.
[3] Anderson, L. Wisniewski, L. (July 2023). Dialectical Behavior Therapy for Eating Disorders: Overview and Application. Springer Nature.
[4] Linehan, M. et al. (May 2015). Dialectical behavior therapy for high suicide risk in individuals with borderline personality disorder: a randomized clinical trial and component analysis. JAMA Psychiatry.
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