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What to Expect in Dialectical Behavior Therapy

Northpoint Specialist- -

Dialectical behavior therapy (DBT) is a valuable option for many people in substance abuse rehab. It can support your drug or alcohol recovery while also addressing other mental health issues. Compared to other forms of therapy, DBT is relatively unique. Instead of focusing only on talking through emotions, it provides clear, structured skills to help you manage distress, regulate emotions, and improve relationships.

If you’re starting DBT, knowing what to expect can make the process feel less overwhelming. The structured nature of DBT means each session follows a specific format, balancing skill-building with real-life application.

Understanding how sessions are structured, what types of skills you’ll learn, and how therapy is designed to help can give you a sense of direction and make it easier to stay engaged in the process. The more you understand the purpose behind each part of DBT, the more confident you’ll feel in applying what you learn to your recovery

What to Expect in Dialectical Behavior Therapy Sessions

Instead of relying on willpower alone, DBT gives you specific techniques to change patterns that have been holding you back. Through a combination of skill-building, real-life practice, and ongoing support, you’ll develop a more balanced and intentional way of responding to challenges. Here’s what you can expect:

Learning Skills to Gain Emotional Stability

DBT provides specific techniques to help you regulate emotions, reduce impulsive reactions, and develop a stronger sense of control. These skills target different aspects of emotional regulation, so you can approach situations with more balance and clarity.

Each skill builds on the others, creating a toolkit that helps you manage emotions, communicate effectively, and stay grounded in stressful moments:

  • Mindfulness trains you to slow down, notice what’s happening in the moment, and respond intentionally rather than reacting on autopilot.
  • Distress tolerance helps you get through overwhelming situations without resorting to avoidance, anger, or self-destructive behaviors.
  • Emotion regulation gives you strategies to identify emotional triggers, shift intense feelings, and prevent mood swings from taking over.
  • Interpersonal effectiveness teaches you how to express your needs clearly, set firm boundaries, and navigate difficult conversations without guilt or resentment.

Practicing Skills in Everyday Situations

DBT isn’t limited to therapy sessions. A core part of the process is applying these skills in real life, so they become second nature. Between sessions, you’ll be asked to track your experiences and reflect on how different strategies work for you.

By using these techniques in everyday moments, you’ll build confidence in your ability to handle challenges without feeling overwhelmed or out of control:

  • Daily exercises strengthen your ability to manage emotions and reactions in real time.
  • Behavior tracking helps you recognize patterns in your thoughts, feelings, and actions so you can make targeted changes.
  • Crisis plans give you step-by-step strategies for handling distressing situations in a way that prevents regret or harm.

Combining Group and Individual Therapy for Stronger Support

DBT blends different types of therapy to ensure you’re getting both structured learning and personalized guidance. This combination helps reinforce what you’re learning and provides multiple layers of support.

This approach ensures that you’re not only learning strategies but also receiving feedback and real-time support as you work through challenges:

  • Group skills training introduces DBT techniques in a structured environment where you can practice and refine them with others.
  • Individual therapy focuses on applying these skills to your personal struggles, helping you troubleshoot challenges and strengthen weak spots.
  • Coaching between sessions allows you to reach out for support when facing real-world situations where DBT skills are needed.

A Nonjudgmental Approach That Encourages Growth

Many people enter DBT feeling stuck, either overwhelmed by emotions or disconnected from them. The therapy process acknowledges where you are while also guiding you toward change. Rather than labeling emotions as good or bad, DBT helps you work with them in a way that feels more manageable.

This balanced approach allows you to make meaningful changes without feeling pressured to “fix” yourself overnight:

  • Validation techniques help you feel heard and understood rather than criticized for how you feel.
  • Acceptance strategies teach you how to sit with emotions instead of suppressing or avoiding them.
  • Growth mindset principles encourage you to see progress as a step-by-step process rather than an all-or-nothing goal.

Ongoing Reflection and Adjustment for Lasting Change

Progress in DBT happens over time, and part of the process is continuously refining how you apply these skills. The goal isn’t perfection but steady improvement, with adjustments based on what works best for you.

By engaging in ongoing reflection, you’ll develop a deeper understanding of yourself and create lasting change that helps you navigate life with more stability and confidence:

  • Journaling prompts help you reflect on emotional shifts, track successes, and identify areas for improvement.
  • Feedback loops allow you to tweak coping strategies based on real-life experiences rather than relying on trial and error.
  • Long-term skill-building ensures that techniques become habits, making it easier to manage emotions and relationships over time.

How Dialectical Behavior Therapy Works

In dialectical behavior therapy, you do two main things. First, you learn how to accept the reality of your current substance and mental health issues. From this state of acceptance, you move on to a process of actively making positive changes.

Pre-Assessment

Not everyone is a good candidate for dialectical behavior therapy. For this reason, a pre-assessment is often the first step in DBT. This step helps your therapist determine if you’ll benefit from the treatment. It also enables you to decide whether you want to participate. During a pre-assessment, you will:

  • Answer specific questions about your current condition and background
  • Ask any questions you may have about dialectical behavior therapy
  • Collaborate with the therapist to create a personalized treatment plan
  • Get an overview of what DBT involves, including its goals and techniques

All therapy participants must complete an entire course of DBT. This explains why you must also confirm your commitment to it.

Individual Sessions

Part of the therapy takes place in individual sessions with your therapist. What should you expect from DBT’s one-on-one sessions? Common goals of your private time with your therapist include:

  • Determining the specific issues standing in the way of your mental wellness
  • Identifying and changing behaviors that interfere with your recovery
  • Learning the skills needed to make effective changes
  • Protecting you by helping you limit any suicidal thoughts or behaviors

DBT therapists often ask participants to record their everyday thoughts, emotions, and behaviors in a diary. You then review your diary entries with your therapist during your sessions.

Group Sessions

Some DBT skills are best taught in a group setting. Here, the focus isn’t on discussing your problems as you would in typical group therapy. Instead, you go through targeted skills training with other people also receiving DBT.

What should you expect from DBT’s skills training? Two of the primary skills you work on are improved mindfulness and the ability to handle highly stressful emotions. In addition, you learn how to gain better emotional control and interact with others more effectively.

Other Services Provided in DBT

The details of what to expect in dialectical behavior therapy aren’t always the same for everyone. That’s true, in part, because your program may also include other dialectical therapy services. One such service is crisis coaching over the telephone.

You may need this coaching between sessions for any of several reasons. For example, some people go through emergencies where they could harm themselves or others. Phone coaching can help safely navigate such situations. You may also need timely advice on the best ways to make use of the skills you learn in DBT.

Engage in Dialectical Behavior Therapy at Northpoint Recovery

Knowing what to expect in advance is a major plus for anyone enrolling in DBT. Need more guidance or advice? Get it today at Northpoint Recovery. We make regular use of DBT in our inpatient recovery programs. With our help, you can get a complete understanding of the therapy, its uses, and your likely experiences in treatment. Just call us today at 888.296.8976 for further details. You can also reach us by filling out our brief online message form.

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