Skills for the days that feel unmanageable.

Written and clinically reviewed by Stephanie Hartfield, RCC, CCC, Registered Clinical Counsellor and Canadian Certified Counsellor, MA Counselling Psychology and Art Therapy. Last reviewed 28 October 2026

Dialectical Behavior Therapy (DBT) is a type of cognitive-behavioural therapy focused on teaching concrete skills: how to manage emotions, handle stress, improve relationships and live mindfully. It works equally well online, by phone or in person.

If you have had therapy before and come away thinking “that was useful, but I still do not know what to actually do at 11pm when it all lands on me” — this is the answer to that. DBT is unusually practical. You leave with tools, not only insight.

What DBT is for

DBT is used for a wide range of mental health and everyday living issues. It helps by building emotional regulation, distress tolerance and interpersonal effectiveness, making it easier to cope with challenges and improve overall well-being.

It tends to be a particularly good fit if you recognize yourself in any of these:

• Emotions arrive at full volume and take a long time to come back down
• You act in the moment in ways you regret once the wave passes
• You swing between feeling too much and feeling nothing
• Conflict either gets avoided entirely or goes nuclear
• You know what you “should” do and cannot access it when it counts
• Stress shows up in your body before you have consciously noticed it

The four skill areas

Mindfulness

Not meditation for its own sake — the practical ability to notice what is happening while it is happening, which is what makes every other skill possible. Noticing “I am starting to spiral” thirty seconds earlier changes what you can do about it.

Distress tolerance

What to do when a feeling is unbearable and you cannot fix the cause right now. Getting through the moment without doing something that makes tomorrow worse. These are the skills people find most immediately useful.

Emotion regulation

Understanding what your emotions are doing, reducing how often you get ambushed, and building a life with fewer unnecessary triggers in it. This is the slower, structural work.

Interpersonal effectiveness

Asking for what you need, saying no, and holding your position without wrecking the relationship or abandoning yourself. Scripts and structure for the conversations you have been avoiding.

How I use DBT

I am DBT-trained and I draw on these skills within individual counselling — this is DBT-informed therapy rather than a full standardized DBT programme with group sessions and phone coaching. For most people that is exactly what they want: the practical tools, taught individually, applied to their actual life.

In practice, a session often has two halves: what happened this week and how it landed, then a skill to take into next week. I will ask you to try things between sessions, because that is where the change happens — but I am not going to shame you about homework. If a skill did not work, that is useful information and we adjust.

DBT also pairs well with the other work I do. Grief regularly produces emotions that feel unmanageable, so these skills come up constantly in grief and loss work too.