Adherent DBT Therapy at EBT Collaborative

What Adherent DBT Means

Not all DBT is the same. Many therapists describe themselves as trained in DBT or offer DBT-informed therapy, but most do not provide the complete program that was tested in clinical research. That distinction matters for outcomes.

Adherent DBT, also called comprehensive DBT, follows the model developed by Dr. Marsha Linehan at the University of Washington. It consists of four required components delivered together:

• Individual therapy: Weekly individual sessions addressing treatment targets in a structured hierarchy, starting with behaviors that threaten the client's life or the treatment itself.

• DBT skills training group: A separate weekly group where clients learn and practice the four skill modules. This is not a support group. It is a structured class.

• Phone coaching: Clients can contact their individual therapist between sessions for in-the-moment coaching when they face difficult situations or urges.

• Therapist consultation team: Clinicians meet regularly to review cases, maintain treatment fidelity, and support each other. This component is invisible to clients but critical to quality of care.

Skills-only programs, which offer the group component without the individual therapy and coaching, are not adherent DBT and do not have the same evidence base.

The Four DBT Skill Modules

Mindfulness

Mindfulness is the foundation of DBT. It involves learning to observe thoughts, emotions, and urges without immediately reacting to them. In DBT, mindfulness is a practical skill practiced daily, not a spiritual practice.

Distress Tolerance

Distress tolerance skills help clients survive crisis moments without making things worse. These skills are not intended to solve problems. They are designed to get clients through intense emotional moments until the intensity naturally decreases.

Emotion Regulation

Emotion regulation skills address how emotions are understood, experienced, and changed. Clients learn to identify and name emotions, reduce vulnerability to emotional reactivity, and change unwanted emotional states through behavioral strategies.

Interpersonal Effectiveness

Interpersonal effectiveness skills address how to ask for what you need, say no, and maintain relationships while staying true to your values. They are particularly helpful for clients whose relationships are chaotic or who sacrifice their own needs to avoid conflict.

Who DBT Is Designed to Help

DBT was originally developed for individuals with Borderline Personality Disorder and chronic suicidality, and it remains the most evidence-supported treatment for BPD. It is also well-supported for:

• Self-harm and non-suicidal self-injury

• Eating disorders including anorexia, bulimia, and binge eating

• PTSD and complex trauma, in combination with DBT Prolonged Exposure

• Substance use disorders

• Treatment-resistant depression and anxiety

Comprehensive DBT Programs at EBT Collaborative

Our DBT program for adults provides the full adherent model for clients 18 and older. Our multi-family DBT program for adolescents (DBT-A) adapts the DBT model for teens ages 12 to 18 with parents as active participants in treatment. DBT-C is our developmentally adapted version of DBT for children ages 7 to 12, with parents playing a central co-therapist role.

DBT in Franklin, TN and Palm Beach Gardens, FL

We offer adherent DBT at our Franklin, Tennessee location and our Palm Beach Gardens, Florida location. Telehealth is available to clients throughout Tennessee and Florida.

Frequently Asked Questions

How long does DBT take? Standard DBT runs for approximately one year, though clients with more complex presentations sometimes benefit from extended treatment. Skills groups typically cycle through all four modules in about six months.

Do I need a referral to start DBT? No referral is required. You can contact us directly to schedule a consultation.

Is DBT covered by insurance? Coverage varies by plan. Visit our billing page for more information on insurance and fees.

What if I cannot attend a skills group? For clients who are not appropriate for group or who prefer an individual format, we can discuss modified options during your consultation.

Ready to Start Comprehensive DBT?

If you are looking for a real DBT program, not a simplified or abbreviated version, we are here. Contact EBT Collaborative to schedule a consultation and talk through which program is the right fit for you.