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DBT THERAPY - IN PERSON AND ONLINE ACROSS ONTARIO

Dialectical Behaviour Therapy (DBT)

Develop skills to manage stress and thrive with DBT Therapy
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Dialectical behaviour therapy (DBT) is a skills-based therapy that helps you manage intense emotions, cope with crises, and build steadier relationships. It balances accepting your emotions with changing the patterns that keep you stuck, and it teaches four skill sets: mindfulness, distress tolerance, emotion regulation, and interpersonal effectiveness. At Trillium Counselling, Registered Social Workers and Registered Psychotherapists offer DBT-informed individual therapy in Kitchener-Waterloo and online across Ontario.

Last updated: October 2026

What is Dialectic Behaviour Therapy?

Before we talk about what DBT can do, let's dig into what it is. DBT was originally created to address the needs of patients with borderline personality disorder (BPD), especially women who had demonstrated suicidal behaviours. BPD is notoriously difficult to treat.

This evidence-based approach has not only been shown to help people in that specific population, but its use has also been expanded to support people with other conditions too. It's been demonstrated to be effective in patients with substance-use disorders, binge-eating disorders, depression, and PTSD.

Man looking over horizon deep in thought

Dialectical Behaviour Therapy was founded by Dr. Marsha Linehan in the late 1980s, as a professor of psychology at the University of Washington.  with its original intent to treat those with Borderline personality disorder and suicidal ideation.  Marsha Linehan also founded Behavioural Tech which is an institute developed specifically to train therapists to work with complex disorders using scientifically valid treatments, such as DBT. 

DBT is based on cognitive behavioural therapy (CBT), but it puts more weight on accepting yourself, your feelings and thoughts, and the world as it is in the moment, alongside learning to change what isn't working (CAMH). For a side-by-side comparison, read our article on the difference between CBT and DBT.

The goal of DBT Therapy is to teach clients to regulate and understand their emotions, deal with stress, and form healthier relationships.

DBT Therapy Techniques

DBT is grounded in helping individuals navigate and regulate overwhelming emotions. At Trillium Counselling, our therapists support you in developing mindfulness skills—fostering a compassionate, non-judgmental awareness of your experiences and emotional state. This intentional presence empowers you to manage strong feelings and respond thoughtfully, rather than feeling trapped by automatic reactions.

Our team guides you in building resilience when facing distress, introducing healthy strategies that move away from old patterns. We also focus on strengthening communication and relationship skills, equipping you to connect respectfully, listen deeply, and handle challenging interactions with greater confidence and care.

DBT Therapy Skills

DBT-Therapy-Techniques-Breathing-Exercise

1. Strengthen Mindfulness

In order to strengthen mindfulness skills, a therapist could walk a patient through breathing exercises that they can turn to in difficult moments. Practicing these skills during calm times helps people remember how to use them when they're feeling difficult emotions.

DBT-Therapy-Technique-Walking-Around

2. Distress Tolerance

To help a patient boost their distress tolerance, a therapist might coach them in non-harmful ways they can distract themselves when painful feelings are high. For example, they could simply get up and walk around to give their emotions time to subside and become more manageable.

DBT-Therapy-Skill

3. Emotional Regulation

Emotional regulation teaches us skills to help manage and mitigate intense emotions. DBT helps clients develop strategies to regulate their emotional states (anger, depressed, anxious, intensely frustrated etc.). Developing this skillset includes
- Identify and label emotions (increase mindfulness to current emotions)
- Reduce vulnerability to the emotional mind
- Identify obstacles to changing emotions

DBT-Therapy-Technique-GIVE

4. Interpersonal Effectiveness

Interpersonal effectiveness can improve by learning different ways to interact. A therapist might offer the acronym GIVE to remind a patient to be Gentle, show Interest in others, Validate others' feelings, and have an Easy attitude.

These are some pretty big concepts, but how does it work in practice? DBT can be used in individual therapy or group therapy settings, but in either setting, it includes activities to help patients learn how to apply them to their lives. Here are a few examples of techniques therapists may use to help patients develop these skills.

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Right Therapist, Right Plan, Real Support

Working with a therapist can help you master core DBT skills to manage emotions, handle stress, and build a more balanced life

How Does DBT Therapy Work?

Whatever specific techniques are used, there are five basic functions that DBT seeks to fulfill.

DBT infographic showing the 5 functions of DBT therapy

DBT Therapy Steps - The Five Components of Treatment

 

1. Enhancing capabilities

Therapists approach DBT from the standpoint that patients lack certain life skills, such as emotional regulation. Rather than exploring the historical reasons for these gaps in their understanding, they focus on learning and using these skills.

 

2. Generalizing capabilities

It's great to understand a different approach--such as choosing not to react in a way that will make a difficult moment worse--but if you forget that new approach the moment you start arguing with your partner, it's not very helpful. One of the goals of therapy is to learn to use these new skills in real-life situations. 

 

3. Improve motivation and reduce dysfunctional behaviours

Patients fill out self-monitoring forms to help them track their progress in their treatment goals. The therapist uses this information to guide the session focus, helping the patient understand their choices in different situations. They work on the skill that could help them in those situations. 

 

4. Enhancing and maintaining therapists' capabilities and motivation

This largely applies to therapists who work with patients with BPD. Professional support and guidance helps therapists maintain their focus and goals. 

 

5. Structuring the environment

The patient learns within a supportive therapeutic setting how to manage their own environment to support their goals. This can be as simple as learning not to engage in difficult discussions when they're tired, or as involved as disengaging from social circles that encourage self-destructive behaviour.

 

Support Starts Here

With DBT, you can reduce distress, build resilience, and live with greater stability. Reach out to schedule your first session.

A Few Things to Consider

Although DBT shows a lot of promise in helping patients live calmer, happier lives, there are a few things to think about before deciding if it's for you.

First of all, it isn't a quick fix. To benefit from DBT, you'll have to invest time and effort. It requires patients to do work outside of therapy sessions. These exercises help you develop the skills you're working on, and they're the best way to achieve the progress you're seeking.

It can also be difficult to confront painful emotions, but coping with these feelings is a central goal of DBT. An experienced therapist will help you navigate these challenges, but only you know if you're ready to take them on.

 

Is DBT used for trauma?

DBT was first developed for borderline personality disorder (BPD), and it's now used for many other concerns, including depression and trauma. In standard DBT, working directly on past trauma usually comes in a later stage, once you have skills to manage intense emotions, and it can include exposure techniques for PTSD (Reddy and Vijay, 2017). If trauma is your main focus, a trauma-focused approach such as EMDR therapy may be used alongside or after DBT skills, and your therapist may draw from several methods to fit what you need.

 

Is DBT the Right Approach for you?

Many people have turned to DBT to gain important skills that help them live happier, healthier lives. In the hands of a skilled therapist, it can help patients free themselves of being controlled by their emotions, so they can choose the life they want.

If you're interested in DBT or want more guidance to decide if it's the best choice for you, contact us for more information. Our therapists are happy to share their expertise and help you start your journey to find the mental wellness you're searching for.

DBT Therapy FAQs

What is DBT used for?

What is DBT used for?

DBT was developed for people with borderline personality disorder, and it can also help with suicidal behaviour, self-harm, substance use, PTSD, depression, and eating disorders (CAMH). Many people come to DBT because their emotions feel intense and hard to manage. A diagnosis can only come from a physician, psychiatrist, psychologist, or nurse practitioner, and our therapists work with these patterns whether or not you ever pursue one.

What can I expect in DBT therapy?

What can I expect in DBT therapy?

At Trillium Counselling, we offer DBT-informed individual therapy. You'll meet one-on-one with your therapist to learn DBT skills, practise them, and use them in your everyday life. Your sessions focus on four skill sets:

Mindfulness: techniques to stay present and connected with yourself.

Distress tolerance: strategies to get through overwhelming emotions and hard moments with more calm.

Emotion regulation: ways to notice your feelings and respond to them in healthier ways.

Interpersonal effectiveness: skills to communicate clearly, set boundaries, and build stronger relationships.

Rather than avoiding or pushing down difficult emotions, DBT helps you approach them with understanding, so they no longer control how you respond.

How long does DBT take?

How long does DBT take?

A full, standard DBT program usually asks for a one-year commitment (CAMH). At Trillium, we offer DBT-informed individual therapy, so there's no set program length. You and your therapist decide together how often to meet and how many sessions you need, based on your goals.

What is the difference between DBT and DBT-informed therapy?

What is the difference between DBT and DBT-informed therapy?

A full DBT program combines individual therapy, a weekly skills group, in-the-moment coaching such as by phone, and a consultation team that supports the therapists (CAMH). DBT-informed therapy uses DBT's skills and ideas without every part of the full program. At Trillium, that means one-on-one sessions where you learn and practise the four DBT skill sets. We don't offer DBT skills groups or between-session phone coaching. If you're looking for a full DBT program, mention it during your free consultation so we can talk through whether our approach is the right fit.

Is DBT covered by insurance or OHIP in Ontario?

Is DBT covered by insurance or OHIP in Ontario?

DBT-informed therapy with a Registered Social Worker or Registered Psychotherapist is not covered directly by OHIP, but many extended health plans cover it, as long as your plan includes your therapist's designation. Coverage varies by plan, so check your benefits before your first session. We direct bill most major insurers where your plan allows; otherwise, we email insurance-ready receipts after each session.

About the reviewer

Bradley Vasquez, RP, is a Registered Psychotherapist at Trillium Counselling with a post-graduate certificate in DBT and training in EMDR. This page was reviewed by Bradley for accuracy. Last reviewed August 2025.

Not sure yet? Let’s talk it through.

If you’d like to ask questions or explore your options first, book a free 20-minute matching consult or give us a call (226-752-8857) . One of our team members will help you find the right therapist and next steps that feel comfortable for you.