Online Dialectical Behavior Therapy (DBT): Navigating Life's Challenges with Skill and Resilience

Everyone experiences intense emotions from time to time. But for some people, this may happen much more often. These emotions may affect relationships and other parts of daily life, and could be debilitating in severe cases. 

If you deal with frequent, strong emotions, you might find dialectical behavior therapy (DBT) helpful, as it’s designed to help people who struggle with intense emotions. 

DBT usually occurs in person. However, the growing interest in online therapy means that online DBT may be an option for you.

Learning more about DBT and how it works in an online setting may help you understand this form of talk therapy better. In the following sections, we’ll explore the different components of DBT and what to expect from online DBT sessions. 

What is dialectical behavior therapy (DBT)?

DBT is a type of psychotherapy or talk therapy that involves learning to accept what you experience and feel, but also making changes to improve your life. It’s a modified form of cognitive behavioral therapy (CBT) that helps you learn to be present and regulate your emotions. 

This type of therapy may be helpful for those who have strong emotions that handle them with maladaptive coping mechanisms. DBT can help you recognize and accept these intense thoughts and feelings, but helps you develop adaptive ways to handle them. 

What does DBT help with?

Marsha Linehan developed this type of therapy in the 1970s to help individuals with borderline personality disorder (BPD). It’s still the preferred treatment for BPD, but is now also used to help with many other conditions:

• Anxiety
• Depression
• Eating disorders like bulimia and binge eating disorder
• Post-traumatic stress disorder (PTSD)
• Self-harm
• Substance use disorders 
• Suicidal behavior

Essential components of DBT

DBT’s focus on handling emotions in adaptive ways has made it an effective treatment for BPD and other mental health conditions. How does DBT help you achieve this? Below, we’ll go over the main modules or components of this type of therapy.

Mindfulness 

Living in the moment, being present, focusing on your current environment — these are all part of being mindful. Mindfulness forms the cornerstone of DBT. It involves learning to be fully present and aware. Focusing on this practice helps give your emotions and thoughts less power to affect your behavior.

In DBT, you learn mindfulness in order to observe and accept your thoughts and feelings. Instead of engaging with them, you work on allowing them to pass through your mind, which may help ease your symptoms. Mindfulness may also help reduce the risk of self-destructive behaviors you might use as coping mechanisms, like substance use. 

Emotional regulation 

Struggling with intense emotions, like anxiety, may make you emotionally vulnerable. Learning to regulate these emotions may help improve your emotional well-being. This component of DBT involves helping you learn strategies to manage and alter strong emotions, leading to improved emotional stability. 

During DBT, you’ll learn to identify and name your emotions. Then, your therapist will work closely with you to recommend some ways to change how you deal with them.

For example, intense anger might make you want to yell at someone or break something. Emotional regulation helps you recognize your anger and redirect your focus to calming yourself versus being destructive. 

Interpersonal effectiveness

Strong emotions may sometimes make it hard to have healthy relationships with other people. You might get into heated arguments when conflicts occur. Or you might have a tough time saying no when people ask you to do something. These challenges may affect your sense of self-respect or your respect for others. 

Interpersonal effectiveness teaches you how to develop skills to improve your relationships. You’ll learn how to communicate assertively and handle conflicts in adaptive ways. DBT helps you practice asking for what you want or need and learning to say no to others. These skills boost your self-respect while also helping you respect others. 

Distress tolerance 

Emotions are a natural part of life. However, experiencing them on an intense level can understandably be distressing. These emotions may lead to self-destructive behaviors like self-harm or substance use. Distress tolerance in DBT helps you learn to cope with strong emotions in safe and adaptive ways.

Instead of resorting to maladaptive coping behaviors or trying to block these emotions, you learn to endure them. Through DBT, you learn different distress tolerance skills that give you multiple tools you can use to deal with intense emotions.

For example, you might learn self-soothing skills that involve your senses, like focusing on what you see, hear, feel, smell, and taste. Or you might use distraction or radical acceptance to tolerate distressing emotions. 

How does online dialectical behavior therapy work?

Online DBT uses the same principles and techniques discussed above — but through a digital platform. 

This type of teletherapy offers a more accessible way to get treatment, especially if you don’t have transportation available. It’s also helpful if you don’t have any mental health professionals near you who offer DBT. Online DBT might also be more convenient, as you can attend therapy sessions from the comfort of your home. 

While online DBT does adhere to the standard DBT principles, there are a few subtle differences to be aware of, which we’ll examine below. 

1. Virtual sessions 

These virtual sessions adapt traditional DBT to a digital environment. Meeting with a therapist online for DBT is a lot like meeting with one in person. Virtual sessions allow you to interact with your therapist in a real time, face-to-face setting. You might not be in the same room, but you can still interact with your therapist through your screen. 

2. Group skills training 

Group therapy sessions are an important part of traditional DBT. They’re just as important in online DBT. These group sessions involve meeting with others in a virtual setting and working on developing DBT skills under the guidance of a therapist. 

Group skills training helps you learn and practice DBT techniques, like emotion regulation skills, in a supportive virtual community. Being part of DBT skills group sessions may motivate you to keep up with therapy.

3. Homework and practice 

DBT skills training doesn’t just happen during individual and group sessions. “Homework” assignments are another important part of DBT. These assignments give you a chance to practice what you’ve learned independently, which helps reinforce DBT skills outside of your therapy sessions. These assignments might include activities like keeping a journal or practicing mindfulness meditation.

4. Phone coaching 

DBT is a learning process that takes time. There might be occasions when you really struggle with your emotions before mastering DBT skills. If you’re experiencing a crisis or need help right away, phone coaching is available with online DBT. Phone coaching offers immediate support in times of crisis and guides you in applying DBT skills during these challenging situations. 

5. Privacy and security measures 

Online DBT sessions involve sharing a lot of confidential or sensitive information with your therapist. As such, you might have concerns about security and privacy. Your DBT therapist can go over the specific measures taken to protect your privacy and ensure confidentiality and safety. For example, all communication between you and your therapist may be encrypted. Keep in mind that therapists are required to follow strict laws and regulations on confidentiality when working with clients in person or online. However, know that if you feel uncomfortable at any time for any reason, you can voice your concerns.

Connect with a therapist for your needs with SonderMind 

DBT therapy offers an effective way to handle intense emotions, which can pave the way to a better quality of life. 

At SonderMind, we can connect you with a therapist who offers DBT, or other types of therapy modalities, to help you learn adaptive coping skills for handling difficult emotions. Simply tell us about your therapeutic needs and preferences, and we’ll connect you with providers who can meet your unique needs.

Start with SonderMind to connect with a supportive therapist today.