Dialectical Behavior Therapy for Anxiety: Practical Skills for Emotional Balance 

dialectical behavior therapy for anxiety

Dialectical behavior therapy for anxiety can help when your emotions seem to go from zero to one hundred with no warning. One minute you’re fine; the next your heart is racing, your thoughts won’t stop, and even simple things feel impossible. You might shake, feel sick, or just freeze. Sometimes your body reacts before your brain can catch up. 

DBT teaches skills you can actually use. It helps you deal with stress, stay in the moment, and handle your emotions without hurting yourself or anyone else. It’s not a quick fix, but it works if you practice it. 

At Embrace Now, we work with each person to create a DBT program that fits their needs. We focus on more than just easing anxiety. We help you build tools to face life’s emotional ups and downs with more control and less self-blame. If you want to see how dialectical behavioral therapy techniques can help, we are ready to support you along the way. 

What is Dialectical Behavior Therapy? 

Dialectical Behavior Therapy, or DBT, is a form of talk therapy that helps individuals to regulate intense emotions by teaching to balance acceptance and change. As a form of Cognitive Behavior Therapy (CBT), DBT blends the traditional CBT strategy of challenging unhealthy thoughts and behaviors with its own key skills of mindfulness, acceptance, distress tolerance, and interpersonal relationships. 

What is DBT Used For? 

Originally, DBT was designed to help individuals with borderline personality disorder regulate their emotions. However, it has shown to be effective in treating a wide range of mental health disorders, especially in individuals who experience strong emotions.  

Conditions frequently treated using DBT include: 

  • Anxiety  
  • Depression  
  • Post-traumatic stress disorder (PTSD)  
  • Substance abuse  
  • Eating disorders  

DBT has also been effective in treating individuals who suffer from suicidal tendencies and self-harm. 

The Core Four DBT Areas 

DBT focuses on implementing four key skills in treatment. These skills are identified as: 

  1. Mindfulness 

Mindfulness teaches individuals to be more cognizant of their emotions and thoughts. It is intended to help ground patients in the present and filter out negativity from past events or fear of future events.  

  1. Distress tolerance 

Many of the mental health conditions treated with DBT can become overwhelming at times due to how intense and persistent the related thoughts and emotions become. Distress tolerance teaches individuals to deal with their emotions without worsening them, in turn building strength and confidence. 

  1. Emotional regulation 

Emotional regulation teaches patients to acknowledge their negative emotions without dwelling on them or letting them take over. It also teaches individuals to change these emotions to positive and foster positive emotions as a whole. 

  1. Interpersonal effectiveness 

Interpersonal effectiveness teaches individuals to maintain healthy relationships, without letting your mental health issues take control. For example, people with anxiety may have trouble telling others no, but when building interpersonal effectiveness, you will learn to prepare for these situations and how to say no. This skill helps to build confidence and healthy boundaries in relationships. 

What Does DBT Look Like? 

Despite DBT being a talk-therapy, DBT sessions typically do not involve therapists talking patients through their struggles. Instead, DBT focuses on teaching patients to accept and change their behaviors for a healthier lifestyle. 

DBT can look different depending on the mental health condition it is targeting and simply on a person-to-person basis. Therapists will work with their patients to come up with the best strategy for their case, and this might be altered as the patient begins to progress through DBT.  

However, DBT will typically be composed of four session types: 

  1. Pre-assessment  

In DBT pre-assessment, therapists work with their patients to confirm that DBT is the best treatment option for their case. During this time, the therapist will explain how DBT works, what their plan may look like, and how long it will take. Therapists will also try to collect more information on the patient’s case during this time. 

  1. Individual Therapy  

Individual therapy is typically done through weekly sessions. In these sessions, patients begin to learn the core four DBT skills: mindfulness, distress tolerance, emotional regulation, and interpersonal effectiveness. They will also learn to directly implement these skills into their everyday lives to create more positive emotions.  

  1. Skills Training  

Skills training is typically done in group sessions, where patients are taught to “master” the core four skills taught in individual therapy. It is important that these group sessions are not confused with group therapy, as these sessions are typically done in classroom style.  

  1. Telephone Crisis Coaching  

Telephone crisis coaching is used on an as-needed basis during DBT. It acts as a lifeline when patients are thinking of taking extreme actions or feeling extremely overwhelmed by their emotion in between sessions. Telephone crisis coaching allows patients to receive emergency help during real-life situations. Embrace Now does not offer phone coaching. 

At Embrace Now, we incorporate components of DBT skills into individual therapy. We do not offer fully adherent DBT treatment, but we believe DBT skills can be transformative in coping with anxiety.  

Cognitive Behavioral Therapy vs Dialectical Behavior Therapy for Anxiety 

CBT is often thought of as the best form of treatment for conditions like anxiety; however, for some people, CBT is not effective due to the strength of emotions. DBT is particularly successful in situations where individuals experience extreme or even debilitating emotions. 

The key differences between CBT and DBT are: 

  • CBT focuses on identifying negative behaviors and challenging them. DBT teaches patients to accept their behaviors and emotions and learn to redirect them as positive behaviors.  
  • CBT is done as an individual talk therapy and is often flexible on how each session can be completed depending on what the patient is experiencing. DBT is completed as a multifaceted therapy that includes individual sessions, group sessions, and even phone sessions. 

When deciding between cognitive behavioral therapy vs dialectical behavior therapy, it really comes down to what fits your needs. CBT works well for many people because it focuses on spotting negative behaviors and challenging them. But if your emotions feel intense or overwhelming, DBT can be more helpful. Understanding the differences between DBT vs CBT therapy can help you pick the approach that’s right for you. 

Finding the Right Therapist or Psychologist for Anxiety at Embrace Now 

If learning real, practical dialectical behavioral therapy techniques to handle emotional storms sounds like what you’ve been missing, the next step is about connection. Finding the right therapist or psychologist for anxiety is the most important part. It’s about someone who understands your unique anxiety, speaks plainly, and makes you feel heard, not analyzed. 

That’s what we focus on at Embrace Now. Our team works with anxiety, panic, OCD, and phobias every day. When you reach out, you’re connecting with a real person who can tailor dialectical behavior therapy for anxiety to your life, whether you meet in our Conshohocken or Paoli office or through telehealth from anywhere in the country. 

At Embrace Now, we incorporate components of DBT skills into individual therapy. We do not offer fully adherent DBT treatment, but we believe DBT skills can be transformative in coping with anxiety. 

You don’t have to keep white-knuckling your way through anxiety. The skills taught in dialectical behavior therapy for anxiety are learnable, and the right therapist or psychologist for anxiety can guide you through them. Let’s build that toolkit together. 

Ready to stop just managing anxiety and start moving through it? Contact Embrace Now today, and let’s talk about how we can help. 

Reviewed by Dr. Sandra, Licensed Psychologist


Frequently Asked Questions 

Q1. What is dialectical behavioral therapy? 

A1. Dialectical behavior therapy helps people who feel emotions very intensely. It teaches practical skills for handling crises and difficult relationships. You learn to accept yourself while also working on change. It’s like a class for managing tough feelings more effectively. 

Q2. What are the six main points of dialectical behavior therapy? 

A2. The main points teach you that your emotions have a real cause. You practice staying focused in the present moment. You learn ways to survive painful times without making things worse. It also gives you skills to manage feelings and ask for what you need from others. 

Q3. CBT vs DBT – What’s the difference?  

A3. CBT focuses on changing your thoughts to change how you feel. DBT focuses more on accepting your feelings while you learn to cope with them. DBT includes more training, like groups and between-session support. It’s often better for when emotions feel too strong to control. 

Q4. Does therapy help with anxiety? 

A4. For many people, therapy helps anxiety feel more manageable. It teaches you how to deal with anxious thoughts instead of spiraling. Over time, anxiety tends to lose some of its grip. The skills you learn can help long after therapy ends. 

Q5. Can therapist help with anxiety? 

A5. A therapist helps you understand what sets your anxiety off. They work with you on tools you can use when anxiety shows up in real life. Therapy is not about fixing you; it is about giving you better ways to cope. With time, anxiety usually feels less intense and easier to handle. 

Free Consultation for Anxiety: Dialectical Behavior Therapy (DBT)

Schedule a free 10 minute consultation call with therapist, Dr. Sandra Ostroff.

Dr. Sandra Ostroff specializes in evidence-based therapies for anxiety disorders, phobias, panic disorder, and OCD.

This recorded pop-up workshop by Dr. Sandra on panic features 26 minutes of video content and covers:

What panic attacks are

What panic disorder is

Difference between panic and anxiety attacks

Several coping skills for panic

This recorded pop-up workshop by Dr. Sandra on Rumination features 32 minutes of video content and covers:

What rumination is

When rumination happens

How it occurs commonly in OCD, Generalized Anxiety Disorder, and Depression

Steps to cope with rumination when it is not helpful

Exercise to cope with rumination when our focus on something is needed, but the rumination about that thing is taking over/becoming unhelpful.

“Embrace Discomfort” Workshop, is designed to help you understand and overcome avoidance behaviors through the practice of exposure. This workshop consists of four lessons, totaling approximately 39 minutes of video content, complemented by four associated resources with practical strategies to help you embrace discomfort and lead a more fulfilling life.

By the end of this workshop, participants will:

Understand Why Avoidance is Problematic: gain a foundational understanding of avoidance and exposure, feeling more confident in the necessity and benefits of facing discomfort.

Identify Avoidance Patterns: Participants will recognize their avoidance patterns and understand the impact of these behaviors.

Understand How to Use Values to Embrace Discomfort: Participants will develop insight into the value of facing discomfort, realizing what they gain by overcoming avoidance and how it aligns with their core values.

Prepare Action Plan: Participants will leave with a clear plan and practical strategies to start embracing discomfort, using graded exposure techniques to gradually overcome avoidance.

“Embrace Connection: Social Anxiety Skills Workshop,” is designed to help you understand and manage social anxiety through evidence-based techniques and strategies. This workshop consists of five comprehensive lessons, totaling 43 minutes of video content, and includes four associated resources/activities to enhance your learning and application.

By the end of this workshop, participants will:

Understand Social Anxiety: Gain a clear understanding of social anxiety, its causes, and the difference between normal social anxiety and social anxiety disorder.

Manage Anxious Thoughts: Learn to catch, identify, and reframe socially anxious thoughts with evidence-based strategies.

Reduce Social Avoidance: Understand the ineffectiveness of avoidance, learn gradual steps to reduce it, and develop strategies to cope with the process.

Improve Communication Skills: Acquire practical conversation and communication skills to enhance confidence and effectiveness in social interactions.

Adopt a Values-Based Perspective: Learn to reframe social anxiety through a values-based perspective, improving their approach to social interactions and reducing anxiety.

Embrace Uncertainty – Coping with What If Thoughts Workshop”, is designed to help you understand and manage uncertainty and the ineffective “what if” thoughts that often accompany it. This workshop consists of five engaging lessons, totaling 34 minutes of video content.

By the end of this workshop, participants will:

Understand Uncertainty: Gain a clear understanding of what uncertainty is, why it’s common to feel uncomfortable with it, and the ineffectiveness of “what if” thoughts.

Learn the Five Laws of Uncertainty: Understand and accept the fundamental principles of uncertainty to cope more effectively.

Avoid Unreasonable Efforts to Reduce Uncertainty: Recognize why trying to eliminate uncertainty is ineffective and adopt healthier, more reasonable approaches.

Develop Coping Strategies: Acquire practical, evidence-based strategies for enduring and managing uncertainty.

Embrace Uncertainty: Learn to reframe uncertainty positively, find meaning in it, and embrace it as a part of life.

 

“Embrace Now: Mindfulness Skills Workshop” is designed to introduce you to the principles and practices of mindfulness, helping you cultivate a calmer, more centered mind. This workshop consists of five concise lessons, totaling 26 minutes of video content, complemented by four associated resources to support your mindfulness journey.

By the end of this workshop, participants will:

Understand Mindfulness: Gain a clear understanding of what mindfulness is, its benefits, and overcome common myths.

Enhance Present Moment Awareness: Learn and practice mindfulness activities that help stay grounded in the present.

Observe Thoughts Mindfully: Develop skills to observe thoughts without judgment and prevent them from taking over.

Regulate Emotions Mindfully: Learn techniques to notice and balance emotions, reducing impulsive behavior.

Cultivate Gratitude: Foster a positive mindset through regular gratitude exercises, enhancing overall mindfulness.

Embrace Your Values is designed to provide participants with a deep understanding of their values and practical strategies to live in accordance with them, fostering greater fulfillment and resilience in the face of anxiety and stress. This workshop consists of five engaging lessons, totaling 36 minutes of video content, and includes three guided activities to enhance your learning and application.

By the end of this workshop, participants will:

Understand the Importance of Values: Gain insight into what values are and how they influence behavior and well-being.

Explore Personal Values: openly explore their personal values, discovering what truly matters to them through reflective exercises.

Identify Core Values: Clearly identify and articulate their most important core values.

Assess Values-Based Actions: Evaluate current actions in relation to their values, identifying obstacles and areas for improvement.

Plan for Values-Based Action: Develop a practical plan to increase alignment between their actions and values, receiving a step by step guide on how to address obstacles and enhance engagement.

Embrace Calm – Anxiety Skills Workshop is designed to help you understand and manage anxiety effectively through evidence-based teachings provided by Dr. Sandra. This workshop consists of five concise lessons, totaling 41 minutes of video content, complemented by seven associated resources to deepen your understanding and practice.

By the end of this workshop, participants will:

Understand Anxiety: Grasp the “why” behind anxiety, feeling validated in their experiences.

Manage Anxious Thoughts: Utilize effective strategies to catch and cope with anxious thoughts.

Confront Avoidance: Recognize the pitfalls of avoidance and learn how to face anxiety-provoking situations.

Reduce Anxious Feelings: Apply mindfulness, self-compassion and distress tolerance techniques to alleviate emotional and physical sensations of anxiety.

Accept Anxiety: Develop acceptance strategies and cognitive reframes to live more comfortably with anxiety.