Dialectical Behaviour Therapy (DBT)

What it is

Dialectical behaviour therapy, or DBT, is a structured, skills-based talking therapy. Its name comes from "dialectical", meaning the holding-together of two things that seem opposite: accepting yourself and your experience as they are, while also working to change what is causing suffering. DBT was developed specifically for people who experience emotions very intensely and who may struggle with self-harm and unstable relationships, and it has the strongest evidence of any treatment for borderline personality disorder.

It is more involved than many therapies, typically combining weekly individual sessions with a group that teaches practical skills, and sometimes phone coaching for difficult moments. This structure reflects how much it focuses on building concrete, usable skills.

Why it helps, and the evidence

DBT has good evidence, particularly for borderline personality disorder, where trials show it reduces self-harm, suicidal behaviour and hospital admissions and improves functioning. It is also used for other difficulties marked by overwhelming emotion and impulsive or self-harming behaviour. It helps by directly teaching the skills that emotional intensity tends to overwhelm: ways to ride out distress without making things worse, to understand and manage emotions, to stay steady in relationships, and to be present rather than swept away.

What to expect

DBT teaches skills in four areas: mindfulness (noticing the present without being overwhelmed), distress tolerance (getting through crises without harmful actions), emotion regulation (understanding and shifting intense feelings), and interpersonal effectiveness (asking for what you need and setting boundaries). Individual sessions help apply these to your own life, while the group focuses on learning the skills themselves. It is usually a longer commitment than a brief therapy, reflecting the depth of what it addresses.

Is it right for me

DBT is especially helpful for people whose main difficulty is intense, hard-to-manage emotions, impulsive actions, self-harm, or stormy relationships. It asks for real commitment, including the group component, which suits some people more than others. A qualified professional can advise whether DBT, or a different approach, fits your situation. Full DBT programmes are not yet widely available everywhere in Kenya, though skills-based elements are increasingly offered; our Get Support page can help you explore options.

When to seek help

If you struggle with overwhelming emotions, self-harm, or relationships that feel impossible to keep steady, ask a mental health professional about DBT or DBT-informed approaches. If you are having thoughts of harming yourself, please reach out today; these are exactly the difficulties DBT is built to help with, and support is available now.