Dialectical Behavior Therapy (DBT) is a structured type of therapy that helps people better understand and manage intense emotions, change behaviors that are making life harder, and navigate relationships more effectively.

DBT was originally developed by psychologist Dr. Marsha Linehan for people experiencing chronic suicidal thoughts and behaviors and was later adapted to treat Borderline Personality Disorder (BPD). Today, DBT is also used with people who struggle with emotion regulation, impulsivity, self-harm, anxiety, depression, trauma, relationship difficulties, and other patterns that interfere with daily life.

At its core, DBT is about two things that can sound contradictory: acceptance and change. You can learn to understand and accept what you’re experiencing while also learning practical skills to respond differently when things get hard. The goal isn’t to stop having big feelings. It’s to have more choice in what you do next.

Comprehensive DBT is more than weekly therapy. It includes four parts that work together:

Individual therapy
Weekly sessions focus on your specific goals, patterns, and challenges, including figuring out what’s getting in the way and how to use DBT skills in your actual life.

DBT skills training
Weekly skills training teaches practical tools in four areas: Mindfulness, Distress Tolerance, Emotion Regulation, and Interpersonal Effectiveness. You learn the skills, practice them, and figure out how to use them outside the therapy room.

Phone coaching
Knowing a skill and remembering how to use it in the middle of a difficult moment are two different things. Brief coaching between sessions helps you identify and use DBT skills when you actually need them.

Therapist consultation team
This one happens behind the scenes. DBT therapists meet regularly with a consultation team to help them stay effective, supported, and consistent in providing DBT treatment.

Together, these four pieces make DBT much more than talking about what you want to change. You learn what to do differently, practice doing it, and build more choice in how you respond when life gets difficult.

You do not need to know before you reach out. We will figure that part out togther. The intake is a chance to look at what is happening, what you have already tried, and how much structure and support would actually be useful. Some people are well served by individual therapy; others need the additional pieces of comprehensive DBT. If your referring provider recommended that you "try DBT" they were likely referring to the comprehensive program.

You may have learned DBT skills without having participated in a comprehensive DBT program. Comprehensive DBT brings several parts together: weekly individual DBT therapy, skills training, between-session coaching, and an ongoing therapist consultation team. Skills are an important part of DBT, but they are not the whole treatment.

It is much more like a class than traditional group therapy. Sessions include mindfulness practice, reviewing homework, learning new DBT skills, and practicing them between meetings. You are not expected to process your past or share deeply personal information with the group.

Generally, the six-month DBT skills group is part of the comprehensive program rather than a standalone group you can simply enroll in. From time to time, I may offer additional groups with a DBT or skills-based focus, such as an Advanced Graduate Group for people who have completed a DBT program. These are separate offerings and are not a replacement for the standard skills training group within comprehensive DBT.

The group is structured carefully around safety and confidentiality. Participants are discouraged from describing high risk behaviors in the group setting. Those are discussed more generally as "target behaviors", which keep the focus on learning and practicing skills rather than comparing experiences. Target behaviors are best processed in individual sessions.

The DBT Collective is self-pay. A superbill can be provided for you to submit to your insurance company for possible out-of-network reimbursement, depending on your plan and benefits.

Individual psychotherapy may be offered in person in Miami or virtually to clients located in Florida, depending on availability. Leslie is licensed in Florida. DBT skills groups may be offered virtually or in person depending on the specific group and available space.

It can feel like a lot when you first hear “six months.” In my experience, once clients settle into the weekly rhythm, the time tends to move much faster than they expected. The length gives you time not only to learn the skills, but to practice using them in real life.