Dialectical behavior therapy (DBT) is an evidence-based form of psychotherapy that teaches practical skills for managing intense emotions, navigating difficult relationships, and tolerating distress without making things worse. Developed by Dr. Marsha Linehan in the late 1980s, DBT is built around one core idea: acceptance and change are not opposites — they work together. At Nevada Recovery Collective, DBT skills training is integrated into our virtual mental health IOP, serving adults throughout Nevada.
What Is DBT?
DBT was developed by Dr. Marsha Linehan at the University of Washington. She combined cognitive-behavioral techniques with mindfulness practices and organized them into teachable skills. The “dialectical” in DBT refers to the synthesis of two seemingly opposite positions — accepting yourself as you are right now, while simultaneously working to change the patterns that cause suffering.
Since Linehan’s original research, DBT has been studied extensively. A 2021 review found DBT effective for reducing emotional dysregulation, self-harm, and depression symptoms (Ritschel et al., 2021). Multiple meta-analyses have supported its use beyond the original BPD context — including for depression, anxiety, post-traumatic stress, and eating disorders.
The Four DBT Skill Modules
Mindfulness
Mindfulness is the foundation of DBT — the skill that makes all the other skills possible. In DBT, mindfulness is about learning to observe your own experience without immediately reacting. Participants learn to notice what’s happening in the moment with a nonjudgmental stance, which creates the space needed to choose a response rather than react automatically.
Distress Tolerance
Distress tolerance skills are for moments of crisis — when emotions are overwhelming and the risk of making things worse is highest. These skills help people survive the moment without adding new harm. Specific skills include TIPP, distraction techniques, and radical acceptance — fully acknowledging reality as it is.
Emotional Regulation
This module teaches people to understand what emotions are, what triggers them, and how to reduce their intensity over time. Skills include identifying emotions accurately, opposite action, and building a life that reduces vulnerability to emotional extremes through sleep, nutrition, activity, and connection.
Interpersonal Effectiveness
These skills focus on relationships — how to ask for what you need, set limits with others, and maintain self-respect. The DEAR MAN, GIVE, and FAST skill sets give people concrete language for navigating situations that previously felt impossible.
DBT in a Virtual IOP
DBT translates naturally into the IOP format. Skills groups — in which a clinician teaches DBT skills to a small group — are a core component of IOP structure. Participants learn skills together, discuss how they apply in real life, and build peer support through shared experience.
NRC uses a DBT-informed treatment approach, integrating DBT skills training into the virtual IOP alongside individual therapy and group sessions. The four DBT skill modules are taught and practiced in structured group sessions.
What Conditions Does DBT Address?
Depression — DBT’s emotional regulation and behavioral activation components address depressive patterns directly. See our depression page.
Anxiety — Distress tolerance and mindfulness skills address the avoidance and hyperarousal patterns that maintain anxiety. See our anxiety page.
Trauma — DBT skills provide stabilization and distress tolerance tools that are often recommended as a first phase of trauma treatment. See our trauma page.
Co-occurring conditions — DBT skills are cross-diagnostic by design and integrate well into treatment for complex clinical pictures. See our co-occurring conditions page.
DBT at Nevada Recovery Collective
At NRC, DBT-informed treatment is one of several evidence-based approaches in our virtual IOP. Jack Foley, LMFT, built the program around the principle that effective mental health treatment must be both clinically grounded and genuinely accessible. DBT skills are introduced and practiced in group therapy sessions. Individual therapy sessions allow clinicians to personalize skill application to each person’s specific situation.
To learn more about the program structure, visit our virtual IOP program page or our therapy modalities page.
Frequently Asked Questions About DBT
What is DBT?
Dialectical behavior therapy (DBT) is an evidence-based form of psychotherapy developed by Dr. Marsha Linehan. It combines cognitive-behavioral techniques with mindfulness and organizes them into four teachable modules: Mindfulness, Distress Tolerance, Emotional Regulation, and Interpersonal Effectiveness.
Is DBT effective for depression?
Research supports DBT skills training as effective for depression, particularly in people with treatment-resistant or recurrent depression. A 2021 review found meaningful reductions in depression symptoms in IOP settings (Ritschel et al., 2021).
How is DBT different from CBT?
Both DBT and CBT are evidence-based and address thoughts, emotions, and behavior. DBT places heavy emphasis on acceptance alongside change, incorporates mindfulness as a core component, and organizes treatment around a structured skills curriculum. CBT tends to focus more directly on restructuring unhelpful thought patterns.
Can I do DBT virtually?
Yes. DBT’s skills group format translates well to virtual delivery, and the between-session practice components — homework and diary cards — are home-based by design. NRC delivers DBT skills training to adults throughout Nevada via secure video platform.
Does insurance cover DBT?
Many insurance plans cover intensive outpatient programs that include evidence-based therapies like DBT. Visit our insurance page or contact us to verify your benefits.
What is the difference between full DBT and DBT skills training?
Full standard DBT includes four components: individual therapy, a weekly skills training group, between-session phone coaching, and a therapist consultation team. DBT skills training incorporates the skills curriculum without necessarily delivering all four structural components. NRC uses a DBT-informed approach, integrating DBT skills training into the virtual IOP structure.
Ready to Learn More About DBT and Virtual IOP at NRC?
If you’re an adult in Nevada dealing with depression, anxiety, trauma, emotional dysregulation, or a related condition, NRC’s virtual mental health IOP may be a fit.
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