Therapy Approach
Dialectical Behavior Therapy (DBT) Skills
DBT skills are practical ways to handle strong emotions, get through hard moments without making them worse, and ask for what you need. Vanessa Gross, LMFT, teaches them one-on-one as part of individual therapy, using situations from your own week.
What DBT Skills Are
Dialectical behavior therapy began as a full treatment program for people whose emotions are intense and hard to manage. Its skills are now taught much more widely, including within individual therapy.
The word dialectical refers to holding two ideas that seem to pull against each other. In plain terms, two things can be true at once. You are doing what you can with what you have, and some of your reactions still need to change.
Mindfulness: Noticing What Is Happening Right Now
Mindfulness is the base the other DBT skills are built on. It means noticing what is going on inside and around you, then describing it in plain terms without piling judgment on top.
Saying to yourself "my jaw is tight and I'm thinking he doesn't care" leaves room to choose a response. Saying "I'm overreacting again, what is wrong with me" adds shame to a feeling that was already hard.
Practice can be as ordinary as giving full attention to washing the dishes, or naming three sounds you can hear when your thoughts start racing.
Distress Tolerance: Getting Through a Hard Moment
Distress tolerance skills are for moments when a feeling is so strong you cannot think straight, and the situation cannot change right away. What matters in that moment is getting through the next hour without doing something that makes tomorrow harder.
Picture the urge to send a long, angry message right after an argument. Instead, you might splash cold water on your face, walk fast around the block, or breathe out more slowly than you breathe in. Once your body settles, you can decide what you actually want to say, and whether tonight is the time to say it.
Distress tolerance also covers accepting facts you cannot change today, like a decision that has already been made. That frees up energy for the parts you can still affect.
Emotion Regulation: Understanding and Shifting Your Emotions
Emotion regulation skills help you understand what a feeling is telling you, and change the ones that no longer fit the facts. You learn to name emotions precisely and notice what sets them off. You also see how poor sleep, skipped meals and ongoing stress leave you more reactive.
One of these skills is called opposite action. Say fear tells you to cancel plans with a new friend, though nothing about the plans is risky. Opposite action means going anyway, on purpose, and paying attention to what actually happens.
Interpersonal Effectiveness: Asking, Saying No and Keeping Relationships
These skills cover the conversations many people put off: asking for help, turning down a request, or raising something that has bothered you for months. Before the conversation, you decide what matters most this time: the outcome, the relationship itself or your self-respect.
Then you plan your words. You might be asking a partner to take over school pickups, or telling a family member you will not host the holidays this year. Either conversation tends to go better when you describe the situation plainly, say what you need, and stay steady if the other person pushes back.
When a Full DBT Program Is the Better Fit
Vanessa teaches DBT skills within individual therapy. She chooses the skills that match what you are dealing with, and you practice them on real situations from your life. She does not run a full DBT program: there is no skills group and no phone coaching between sessions.
Some people need that fuller structure, for example when strong emotions regularly lead to actions that put their safety at risk. If that describes you, or if it becomes clear as therapy goes on, Vanessa will say so and refer you to a comprehensive DBT program.
Between sessions, if you are in crisis or thinking about suicide, call or text 988, or call 911 if you are in immediate danger.
Questions
Frequently Asked Questions
They often help people who feel emotions quickly and intensely, then regret what they said or did in the moment. They also suit people who shut down during conflict, find it hard to say no, or spiral after a small setback. Adults with ADHD sometimes find the emotion regulation skills useful when frustration flares over something minor.
Part of the work in session is preparing for those moments. You might write a short plan together that lists the early signs of an emotion building and the first skill to try. It can also name two or three people you can contact. At the next session, you look at what happened and what helped, then adjust the plan.
DBT grew out of cognitive behavioral therapy and shares its practical, skills-first style. It adds a strong focus on acceptance and mindfulness, along with skills for moments when emotions run too high for reasoning to help. Vanessa may use the two together, for example CBT to examine a recurring thought and DBT skills to get through the moment it shows up.
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