Dialectical Behavioural Therapy (DBT)
Some feelings arrive like a wave you didn't see coming. DBT is where you learn to surf.
about approach
What is DBT?
Dialectical Behaviour Therapy (DBT) was developed in the late 1980s by psychologist Dr. Marsha Linehan, originally as a treatment for individuals experiencing chronic suicidality and borderline personality disorder. Drawing from cognitive behavioural therapy, Buddhist philosophy, and dialectical thinking - the idea that two seemingly opposite things can both be true at once - DBT is built on one central and deeply compassionate premise: you are doing the best you can, and you can do better. This balance between radical acceptance and commitment to change is the dialectic at the heart of everything the model does.
DBT is organized around four core skill sets: mindfulness - the foundation of all DBT work, developing the capacity to observe experience without judgment; distress tolerance - skills for surviving crisis moments without making them worse; emotion regulation - tools for understanding, managing, and reducing the intensity of overwhelming emotional experiences; and interpersonal effectiveness - skills for communicating needs, setting limits, and maintaining relationships without losing yourself in the process. At Providence, we draw meaningfully from DBT's rich skills framework, integrating it into our broader clinical approach in the ways that most genuinely serve each individual client.
Why you might be here
Your Emotions Move Fast - and Sometimes They're Running the Show
Maybe you know this experience: an emotion arrives - suddenly, intensely, seemingly out of nowhere - and before you've had a chance to think, you've said something you regret, withdrawn entirely, or found yourself in a spiral that took days to climb out of. Perhaps you live with the exhausting reality of feeling things more deeply and more immediately than the people around you seem to, and have spent a great deal of energy trying to manage, hide, or outrun that intensity. Or maybe the challenge is less about big emotional eruptions and more about a persistent undercurrent of distress - anxiety, emptiness, or a sense of being perpetually overwhelmed - that makes daily life feel far harder than it looks from the outside.
DBT was specifically designed for exactly this territory; the intersection of high emotional sensitivity, intense reactivity, and the painful relational and behavioural consequences that can follow. It is worth knowing that emotional intensity is not a character flaw. Research suggests that people who struggle with emotion dysregulation often have a biological sensitivity to emotional stimuli combined with environments that didn't always provide the right tools for managing it. DBT takes that seriously, meeting you where you are, with genuine compassion, while also offering a very concrete, learnable set of skills for changing the patterns that are getting in your way.
Unconventional by Choice, Exceptional by Design
Our clinicians combine specialized expertise with intentionally unconventional, innovative methods to craft care that is deeply personal and never one-size-fits-all.We don't just talk about it
Our experiential, integrative treatment models address trauma and a wide range of concerns at their root.Trusted by Over 3,500 Clients and Counting
Our track record reflects thousands of individuals, couples, and families who have found meaningful healing with our team.Rooted in Values, Driven by Relationship
We believe values-based leadership creates values-based care. That relational philosophy shapes every interaction you have with our team, and you'll feel it.
Concrete, practical skills for tolerating distress without making it worse - a toolkit for the hard moments
Greater capacity to understand, name, and regulate the intensity of your emotional experience
Reduced reactivity - more space between the trigger and the response
Meaningful improvements in your relationships - clearer communication, healthier limits, less loss of self under pressure
A more grounded and non-judgmental relationship with your own emotional life
Relief from the shame spiral that often follows intense emotional episodes - replaced by self-understanding and skill
Greater ability to stay within the window of tolerance during and between deeper trauma processing work
A sense of genuine agency over your internal experience - not control, but choice
Skills you can use independently, for life - long after formal therapy has ended
Why choose Providence Therapy
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DBT Skills at Providence: Practical, Purposeful, and Part of Something Bigger
DBT has one of the strongest evidence bases of any structured therapeutic approach - with robust randomized controlled trials demonstrating its effectiveness for emotional dysregulation, self-harm, suicidal ideation, mood disorders, eating disorders, and substance use, as well as meaningful gains in interpersonal functioning and quality of life. The skills it teaches are genuinely practical - concrete, learnable, and applicable far beyond the therapy room. Many clients describe the DBT skills they acquire as among the most immediately useful things they have ever encountered in a therapeutic context. They are tools you actually use - on hard days, in difficult conversations, and in the moments when feelings arrive faster than thoughts.
At Providence, we work with DBT-informed skills as an integrated component of our broader trauma-focused and experiential framework. While a comprehensive DBT program is a highly specialized offering best suited to specific clinical presentations, the skills themselves are widely applicable and woven through our work with many clients. Distress tolerance skills offer genuine relief for clients in the middle of trauma processing who need tools for riding out activation between sessions. Emotion regulation strategies complement somatic work by building the client's capacity to stay in the window of tolerance. Interpersonal effectiveness skills support the relational healing that attachment-based and parts-based approaches are deepening. At Providence, DBT skills are never delivered in isolation; they are one meaningful thread in a carefully integrated treatment experience, chosen because they fit, and held within the relational warmth and clinical depth that characterizes everything we do.
Have questions before taking the leap?
If you have any questions for us prior to booking an appointment or being matched with a therapist, please fill out this contact form and our clinic concierge will get back to you during business hours (Monday- Friday 9:00am to 5:00pm PST).
We look forward to supporting you
604-332-5279
info@providencetherapybc.com
Our Team
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Elizabeth Anderson
Daniel Prince
Dorsa Sobhani
Emily Macdonell
For Your Clarity
Dialectical Behavioural Therapy (DBT) Frequently Asked Questions
DBT was developed by Dr. Marsha Linehan in the late 1980s, originally for individuals experiencing chronic suicidality and borderline personality disorder. It has since been adapted and applied to a much broader range of presentations including mood disorders, eating disorders, substance use, PTSD, and any presentation involving significant emotional dysregulation. Its four core skill modules - mindfulness, distress tolerance, emotion regulation, and interpersonal effectiveness - are applicable to virtually anyone whose emotions move fast, feel intense, or sometimes seem to take the wheel.
At Providence, we draw from DBT's skills framework, integrating it into our individual clinical work in ways tailored to each client's needs. A comprehensive DBT program, with structured group skills training, phone coaching, and the full treatment protocol as Linehan designed it, is a highly specialized and intensive offering suited to specific clinical presentations. If a full DBT program is what a client needs, we will be honest about that and support them in finding the right fit. For many of our clients, DBT-informed skills integrated within a broader experiential and trauma-focused framework is exactly the right approach.
No, while BPD remains the presentation with the strongest evidence base for full DBT, its skills are broadly applicable. Anyone who experiences intense or overwhelming emotions, reactive relational patterns, difficulty tolerating distress, or the sense of being emotionally flooded can benefit meaningfully from DBT-informed work. At Providence, we use DBT skills across a wide range of clients and presentations, always in service of the individual's broader treatment goals.
Very naturally. DBT skills complement our trauma-focused and experiential work in meaningful ways - distress tolerance tools support clients navigating the activation that can come with EMDR or somatic processing; emotion regulation strategies build the nervous system capacity that polyvagal-informed work is developing; interpersonal skills deepen the relational healing happening through attachment-based and parts-based approaches. DBT skills are practical, learnable, and transferable - and within the broader Providence framework, they become part of a whole-person treatment experience rather than a standalone skills program.
Mindfulness is the foundation - developing the capacity to observe your experience without judgment or reactivity. Distress tolerance offers tools for surviving crisis moments and intense emotions without making things worse. Emotion regulation builds skills for understanding, modulating, and reducing the intensity of overwhelming emotional states. Interpersonal effectiveness provides practical tools for communicating needs, maintaining healthy relationships, and holding your own in difficult interactions - without sacrificing yourself or the relationship.
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