Dialectical Behavior Therapy (DBT) was developed by Dr. Marsha Linehan specifically for borderline personality disorder, and is now recognized as effective for a wide range of conditions involving emotional dysregulation, self-harm, chronic suicidality, eating disorders, and substance use. Comprehensive DBT is a highly structured treatment requiring specific provider training.
Comprehensive DBT teaches skills across four modules: Mindfulness — the core of all DBT skills, learning to observe and describe experience without judgment; Distress Tolerance — surviving crises without making them worse, accepting reality as it is; Emotion Regulation — understanding emotions, reducing vulnerability, changing emotional states; Interpersonal Effectiveness — asking for what you need, saying no, maintaining self-respect in relationships.
Full DBT has four components: weekly individual therapy; weekly skills training group (2-2.5 hours, structured like a class); phone coaching (ability to call your therapist between sessions for skills coaching); and therapist consultation team (therapists meet weekly to support each other's work). Many therapists offer "DBT-informed" or skills-only groups — these are useful but not equivalent to comprehensive DBT for severe presentations.
Look for therapists who describe their practice as "comprehensive DBT" or who have completed intensive DBT training. The Linehan Institute and Behavioral Tech maintain directories of DBT-trained therapists. Ask specifically: "Do you provide comprehensive DBT with all four components, including phone coaching?" The answer tells you what you're getting.