DBT Skills

Sometimes insight isn't enough in the moment. When an urge is strong, a feeling is flooding, or a conversation is going sideways, it helps to have concrete tools you can actually use. That's where skills from dialectical behavior therapy, or DBT, come in.

I've received training in DBT, and I bring DBT-informed skills into individual therapy when they fit. To be clear about what that means: I don't run a comprehensive DBT program with a skills group and phone coaching. Instead, these skills become one part of an integrative, trauma-focused approach.

The core idea

Acceptance and change, together.

At the heart of DBT is a dialectic: two things that seem opposite can both be true. You can accept yourself as you are and also want to change. You can be doing the best you can and still benefit from new skills. Holding both can soften the all-or-nothing thinking that often comes with trauma and eating disorders.

This fits closely with how I see symptoms in general: as adaptive responses that made sense, even if they now cause pain. We don't have to fight who you are in order to grow.

Four skill areas

Practical tools for hard moments.

DBT skills are usually grouped into four areas:

• Mindfulness: noticing what's happening inside and around you without judgment.
• Distress tolerance: getting through intense moments without making things harder.
• Emotion regulation: understanding feelings and reducing how often they overwhelm you.
• Interpersonal effectiveness: asking for what you need and setting boundaries while caring for relationships.

In our work, we choose the skills that match what you're facing and practice them in session, so they're easier to reach for when you need them.

In practice

What it can look like in session.

Say you've noticed that conflict with someone close to you sends you into shutdown or panic. We might slow down and map what happens in your body, practice a distress tolerance skill for riding out the wave, and then use interpersonal effectiveness skills to plan how you want to show up in the next conversation.

Or, if urges around food feel strongest late in the evening, we might choose a few skills to try in that window and notice together what helps. The aim isn't to perform skills perfectly. It's to have more choices when old patterns pull at you.

Where skills help

Support alongside deeper work.

Skills can be especially useful when we're working with eating disorders, where urges to restrict, binge, or purge can feel overwhelming, and with complex trauma and PTSD, where strong emotions or shutdown can arrive quickly. They can help you stay steady enough for the deeper work to continue.

DBT-informed skills fit naturally with ideas like the window of tolerance, and with body-based approaches to nervous system dysregulation.

Between sessions

Skills grow with practice.

My Resources page includes DBT skills handouts and worksheets, along with a DBT coaching app, if you'd like something to explore between sessions.

Sessions happen in person in Doylestown and by secure telehealth for adults 21 and older. DBT-informed skills can be part of individual therapy whenever they're useful. To talk about whether this approach fits you, start with a free consultation.

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