Dialectical Behavioural Therapy (DBT)
In person in Toronto & online across Ontario.
Horizon Therapy Toronto offers a wide range of therapy options, including Dialectical Behavioural Therapy (DBT). Our therapists and counsellors are here to support your unique mental health needs and provide you with tools to meet the challenges you are facing in your life. DBT is a form of cognitive behavioural therapy that helps people shift unhelpful thought patterns while also building practical life skills. The word “dialectical” reflects DBT’s core idea of holding two truths at once. You can accept yourself and your experiences as valid, while also working toward meaningful change and growth. DBT helps with many issues including depression, anger management, borderline personality disorder, self harm, trauma, and anxiety.
What is DBT?
DBT was originally developed by Dr. Marsha Linehan and is an effective therapy for people who experience intense or overwhelming emotions. It helps you learn when and how to change emotional patterns that are causing distress, while also learning how to accept emotions when fighting them is not helpful. At its heart, DBT focuses on creating a balanced approach to acceptance and change, with the goal of building what is often called “a life worth living.”
DBT draws from two main approaches. One is cognitive behavioural therapy, which focuses on changing unhelpful thoughts, emotions, and behaviours. The other is mindfulness, which emphasizes acceptance of the present moment and learning to calm and focus the mind.
How Does DBT Work?
DBT is a structured therapy that focuses on teaching four core skills. Along with change focused tools from CBT, DBT brings in mindfulness, acceptance, distress tolerance, and relationship skills to help you navigate intense or overwhelming moments. DBT is traditionally designed to include: weekly individual therapy, weekly group skills training, phone coaching, and a therapist consultation team. At Horizon Therapy, we do not currently offer a standalone DBT skills group. However, our therapists thoughtfully integrate DBT skills training into individual therapy sessions. For clients who are interested in or would benefit from a full group-based DBT program, we are also happy to provide referrals to trusted programs in the community.
DBT Core Skills:
Mindfulness
The practice of being in the present and acknowledging thoughts, feelings and behaviours as they happen, without trying to control them. This may include exploring body scan, negative judgments, wise mind, mindful breathing, or thought defusion.
Distress Tolerance
The process of learning how to cope during a crisis, especially when it is impossible to change, and accepting a distressing situation as it is, without judgment. Skills used at this stage may include: cost benefit analysis, recognizing emotional crisis, distraction, TIPP, and self soothing.
Emotion Regulation
The ability to manage emotions so that they do not control thoughts and behaviours. This is the third core skill of DBT and includes teachings such as : recognizing emotions, self validation, emotion exposure & window of tolerance, myths about emotions, mastery and problem solving abilities.
Interpersonal Effectiveness
Learning to manage your relationships, including
asking for what you want, saying no, creating friendships, and managing conflict. In this stage, you’ll learn many skills such as communication, boundary setting, assertiveness, listening, validation, and trust to support you in strengthening your connections and maintain respect for yourself and also others.
dialectical behavioural therapy (DBT) in Toronto & across Ontario
What Does DBT Help With?
DBT has been a widely studied form of therapy with fifteen trials of DBT to date. DBT is specifically known to be helpful with:
- Depression
- Anger Management
- Borderline Personality Disorder
-
Post-Traumatic Stress
Disorder (PTSD) - Relationship issuses
- ADHD
- Eating Disorders
- Substance Abuse
- Anxiety
- Chronic feelings of emptiness
DBT in Toronto & Across Ontario
FAQ DBT
How does DBT differ from CBT?
Both DBT and CBT are evidence-based forms of talk therapy where individuals work with a mental health professional to understand their difficulties and build coping skills. CBT tends to focus mainly on identifying and changing unhelpful thinking patterns and behaviours. DBT, on the other hand, places equal importance on accepting thoughts, feelings, and behaviours while also learning practical strategies to shift them when needed. In addition to personal coping skills, DBT strongly emphasizes skills for navigating relationships and managing interpersonal challenges.
While DBT is rooted in CBT principles, it expands on them by paying closer attention to emotional intensity and social experiences. It was specifically developed to support people who struggle with strong emotions and need tools to regulate them more effectively.
Are there any limitations of DBT?
While DBT is highly effective for many people, it is not a one size fits all approach. DBT is skills focused, which means it emphasizes learning and practicing tools for managing emotions and relationships. Some people may want or need deeper exploration of past experiences, trauma, or attachment patterns, which may require additional or different therapeutic approaches. DBT also requires regular practice of skills outside of sessions, and it can feel structured or demanding for those who prefer a more open-ended style of therapy. A skilled therapist will often integrate DBT with other modalities to better meet an individual’s needs.
How long does DBT take to work?
The timeline varies from person to person. Some people notice improvements in emotional awareness and coping skills within a few months, while deeper changes often take longer and develop with consistent practice. DBT is most effective when skills are regularly used in everyday life, not just discussed in sessions.
Can DBT be combined with other therapy approaches?
Yes. DBT is often integrated with other therapeutic approaches such as psychodynamic therapy, attachment-based therapy, or trauma-informed care. Many therapists use DBT skills alongside other modalities to create a more personalized and flexible treatment plan based on a client’s goals and needs.
Why do small problems sometimes trigger huge emotional reactions?
In DBT, we understand that intense emotional reactions often occur because the nervous system is highly sensitive to perceived threats. Small stressors can feel overwhelming if your brain interprets them as urgent or unsafe. DBT teaches skills like mindfulness, distress tolerance, and emotion regulation to help you notice triggers, pause before reacting, and respond more effectively to everyday challenges.
Why do I regret things I say when I’m angry?
Saying things you regret during anger is often a result of intense emotions overriding rational thinking. When your brain is in “fight or flight” mode, it can be hard to pause or think through the impact of your words. DBT provides strategies to observe emotions, pause, and communicate needs safely without escalating conflict, reducing post-anger regret.
Why do my emotions change so quickly?
Rapid shifts in emotion are common in people with heightened emotional sensitivity. Your nervous system may respond strongly to small triggers, causing moods to fluctuate quickly. DBT helps you recognize emotional patterns, develop grounding techniques, and respond to emotional changes with awareness and balance, making daily life feel more manageable.
Resources
Meta-Analysis on DBT Efficacy for Borderline Personality Disorder – Panos PT, Jackson JW, Hasan O, Panos A. Meta‑analysis and systematic review assessing the efficacy of DBT. (2013)
Systematic Review of DBT for Borderline Personality Disorder –“Efficacy of Dialectical Behavior Therapy in the Treatment of Borderline Personality Disorder: A Systematic Review.”
Effectiveness Study in Routine Mental Health Settings – Effectiveness of DBT in a community mental health centre.
Systematic Review of DBT Across Mental Health Conditions “Effectiveness of DBT as a transdiagnostic treatment for various conditions.”
DBT Adaptations and Evidence Overview –Dialectical behaviour therapy developments and empirical evidence review.
Horizon Therapy | Toronto, ON
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