DBT Skills and Mindfulness Therapy
What Is DBT - and How Do I Use It?
Dialectical Behavior Therapy is built on a deceptively simple insight: that two seemingly opposite things can both be true at the same time. You can love someone deeply and need to set limits with them. You can want to change and need to accept what is. You can feel overwhelmed and be okay.
This dialectical way of thinking — holding apparent contradictions without forcing a resolution — is one of the most genuinely useful frameworks I bring to my work with clients. It eases the rigidity of all-or-nothing thinking, creates space for complexity, and opens the way toward the kind of balanced, grounded perspective that makes real change possible.
DBT was developed by Dr. Marsha Linehan and originally designed for individuals with significant emotional dysregulation. Over time, its core skills have been widely adapted for a much broader population — and research consistently shows their value for adults managing anxiety, depression, and the stresses of everyday life.
My approach draws selectively on DBT's four core skill areas — mindfulness, emotional regulation, distress tolerance, and interpersonal effectiveness — integrating them with Cognitive Behavioral Therapy and neuroscience-informed practice into a cohesive, practical toolkit.
Please note: I do not offer comprehensive DBT treatment programs, which typically include structured skills groups, diary cards, and phone coaching. If you are seeking a full DBT program, I am happy to help you find an appropriate referral.
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The DBT Skills I Work With
Mindfulness is the foundation of everything else in DBT — and, increasingly, in all effective psychological treatment. Before you can change a thought, regulate an emotion, or navigate a difficult relationship, you have to first notice what is happening. Mindfulness develops that capacity: the ability to observe your own experience with clarity and without judgment, to be fully present rather than lost in the past or anxious about the future.
Emotional Regulation skills help you understand the relationship between thoughts, emotions, and behaviors — and develop practical strategies for managing strong emotional responses without being overwhelmed by them. Rather than suppressing or avoiding difficult emotions, you learn to observe them, name them, and respond with skill rather than react automatically.
Distress Tolerance skills are for the moments when the emotion is intense and the situation cannot immediately be changed. Rather than making things worse through impulsive reactions, these skills help you get through difficult moments with your self-respect and your relationships intact — building the resilience to tolerate what cannot yet be resolved.
Interpersonal Effectiveness skills help you navigate relationships with greater clarity and confidence — asserting your own needs effectively, maintaining important connections, and staying true to your own values even in difficult interactions.
How DBT and CBT Work Together
The most effective work I do with clients draws on both frameworks — and their integration is more powerful than either approach alone.
CBT works primarily through the mind: by identifying and challenging the automatic thought patterns that distort our perception and drive our emotional responses, it creates lasting change in how we think, feel, and behave. DBT works through a broader lens: it addresses the emotional intensity, the body's stress response, and the relational patterns that CBT alone may not fully reach.
Together they address both the content of suffering — the thoughts, the stories, the cognitive distortions — and the physiology of suffering — the nervous system arousal, the emotional overwhelm, the patterns that live in the body as much as the mind.
Many clients find that understanding why these skills work — the neuroscience behind mindfulness, the brain's capacity for change, the roots of anxiety — makes them more motivated to practice and more confident in their own ability to improve their mood. That understanding is woven into everything I do.
Is This Approach Right for You?
This integrated approach is particularly well suited for adults who are:
Struggling with anxiety, depression, or chronic stress
Feeling overwhelmed by emotions that seem disproportionate to the situation
Navigating difficult relationships or significant life transitions
Looking for practical, evidence-based skills — not just insight, but tools they can actually use
Ready to understand why they feel the way they do, and to do something about it
For most adults managing anxiety and depression, this targeted, integrated approach is both effective and more closely tailored to what you actually need.
Ready to Get Started?
If you're curious whether this approach is a good fit for you, I invite you to schedule a free 15-minute consultation. There's no pressure — just a conversation to see if we're the right match.
Dialectical Behavior Therapy Menlo Park
Beverly Leftwich Counseling, Santa Margarita Avenue
Menlo Park, CA 94025