DBT Counseling

What Is DBT?

Lacamas Counseling Serves Vancouver, Camas, Washougal Washington and the surrounding areas

Dialectical Behavior Therapy (DBT) is an evidence-based psychotherapy developed by psychologist Dr. Marsha Linehan at the University of Washington to help individuals who experience intense emotions, self-destructive behaviors, and chronic relationship difficulties—especially those diagnosed with Borderline Personality Disorder (BPD).

Over time, DBT has proven effective for a variety of mental health concerns, including depression, anxiety, post-traumatic stress disorder (PTSD), substance use, and eating disorders.

DBT blends two essential therapeutic perspectives:

• Cognitive Behavioral Therapy (CBT) — changing unhelpful thoughts and behaviors.
• Mindfulness and Acceptance Strategies — cultivating awareness and acceptance in the present moment.

The term “dialectical” reflects the balance DBT seeks to achieve: acceptance and change. Clients learn to accept themselves as they are while working toward meaningful personal growth.

How Does DBT Work?

DBT provides a structured, skills-based approach to help individuals regulate emotions, manage crises, and build healthier relationships.

At Lacamas Counseling, DBT is typically taught through four core skill areas:

1. Mindfulness
   The foundation of DBT, mindfulness increases self-awareness and helps clients stay present instead of being overwhelmed by thoughts or emotions.
2. Distress Tolerance
   These skills help clients cope with painful emotions or stressful situations without resorting to impulsive behaviors or avoidance.
3. Emotion Regulation
   Clients learn to recognize, label, and manage emotions more effectively, reducing emotional intensity and vulnerability.
4. Interpersonal Effectiveness
   These skills teach clients how to communicate needs clearly, set healthy boundaries, and maintain self-respect in relationships.

DBT can be delivered through individual therapy, skills groups, or a comprehensive program that includes coaching and consultation. At Lacamas Counseling, we integrate DBT principles into both individual and group settings to meet clients where they are in their healing process.

What Are the Benefits of DBT Counseling?

DBT is one of the few therapies shown to create lasting, measurable improvements in emotional regulation and quality of life. Common benefits include:

• Improved emotional control – Learning how to manage intense emotions like anger, sadness, or anxiety.
• Reduced self-harm and suicidal thoughts – DBT has one of the strongest evidence bases for decreasing self-injurious behavior.
• Stronger relationships – DBT enhances communication and conflict-resolution skills.
• Greater resilience – Clients build skills to handle distressing situations calmly and effectively.
• Increased self-acceptance – DBT encourages compassion for oneself while pursuing meaningful change.

What Does the Research Say?

DBT is one of the most researched treatments for emotional dysregulation, with strong evidence supporting its effectiveness.

Strengths & Consensus

• Effective for Borderline Personality Disorder (BPD) – Numerous randomized controlled trials show DBT reduces self-harm, suicidal behavior, and hospitalizations in individuals with BPD.
• Useful for other disorders – DBT is also effective for PTSD, eating disorders, substance use, and mood disorders.
• Sustained outcomes – Clients who complete DBT often maintain symptom improvement over time, demonstrating lasting behavioral and emotional change.
• Comprehensive and skills-based – DBT provides clients with concrete tools they can use long after therapy ends.

Limitations & Considerations

• Requires commitment – DBT involves practicing skills daily and attending sessions regularly.
• Takes time – While progress can be steady, DBT typically requires several months for full integration.
• Works best with trained therapists – Effectiveness is highest when DBT is facilitated by clinicians trained through an accredited DBT program.

Is DBT Right for You?

DBT may be a great fit if you:

• Experience intense emotions that feel overwhelming.
• Struggle with impulsive or self-destructive behaviors.
• Have difficulties maintaining healthy relationships.
• Want to feel calmer, more balanced, and in control of your reactions.

At Lacamas Counseling, our DBT-informed therapists provide compassionate, structured support to help you build emotional strength and confidence. We’ll work collaboratively to help you develop the skills you need for a more stable, fulfilling life.