Dialectical Behavior Therapy (DBT) in Chicago & Northbrook IL

What Is Dialectical Behavior Therapy (DBT)?

Dialectical Behavior Therapy (DBT) is a comprehensive, skills-based form of psychotherapy developed by Dr. Marsha Linehan that targets emotional dysregulation, self-destructive behavior, and the interpersonal difficulties that often accompany intense emotional experience.

Originally developed for people experiencing chronic suicidality, DBT has since become one of the most widely used and well-researched therapies for a broad range of presentations where emotional intensity and impulsivity are central. Its defining feature is the balance it holds between two seemingly opposite ideas: you are doing the best you can given your history and circumstances, and change is necessary for your life to improve. That tension, rather than being a contradiction, is the engine of the work.

The Four Core DBT Skill Areas

DBT is organized around four interconnected skill modules, each targeting a different part of the cycle that keeps people stuck:

Mindfulness: The foundation of all other DBT skills. Mindfulness in DBT is not about achieving calm. It is about developing the capacity to observe your own experience without automatically reacting to it, creating enough space to choose a response rather than just having one.
Distress Tolerance: Skills for surviving painful moments without making things worse. When a situation cannot be fixed right now, distress tolerance offers tools for getting through it without resorting to impulsive or self-destructive behavior.
Emotion Regulation: Understanding emotions, naming them accurately, reducing vulnerability to emotional flooding, and building a life that generates more positive emotional experiences over time.
Interpersonal Effectiveness: How to ask for what you need, say no when you mean it, and navigate close relationships in ways that protect both your self-respect and your connections with others.

“DBT is a concrete set of skills that actually smuggles in a different worldview. A worldview where we can be more present in our lives as we’re actually living them. DBT helps build our capacity to tolerate (and even embrace!) the unwanted and unexpected, while helping us move more deliberately toward what we genuinely value. We focus on staying present when our mind wants to go a thousand different directions, getting through difficult moments without making them worse, understanding our emotions and the importance of the full range (yes, even the uncomfortable ones), and improving how we relate and communicate with the people in our lives.”
– Rose Metivier, LCPC, NCC, Midwest Counseling & Diagnostics

What Does DBT Help With?

DBT has a particularly strong evidence base for:

Borderline Personality Disorder (BPD)
Chronic suicidal ideation or self-harm
Intense, rapidly shifting emotions
Eating disorders, particularly binge-purge patterns
Substance use and addiction
Post-traumatic stress
Treatment-resistant depression
Relationship instability and chronic conflict

DBT has also been adapted for adolescents, where a family skills component is typically integrated into the treatment.

How Is DBT Delivered?

Comprehensive DBT typically involves two parallel components: individual therapy sessions and a skills training group. Individual sessions help you apply skills to your specific circumstances and life, while the group provides structured teaching and practice in a community setting. Research consistently shows that the combination is more effective than either component alone.

At Midwest Counseling, we offer DBT skills groups as well as individual therapy with DBT-trained clinicians. During a consultation, we can help you determine which format is the best fit for what you are dealing with and what is currently available.

DBT Therapy in Chicago, Northbrook, and via Telehealth

Our Chicago and Northbrook offices include clinicians with specialized DBT training working with adults and adolescents. We also offer DBT-informed individual therapy via telehealth across Illinois and many other states. Call telephone or book a consultation online.

Frequently Asked Questions About DBT

What is dialectical behavior therapy used for?
DBT was originally developed to treat borderline personality disorder and chronic suicidality, but its applications have expanded significantly. It is now used for eating disorders, substance use, post-traumatic stress, treatment-resistant depression, self-harm, and any presentation where intense emotional dysregulation and impulsive behavior are central features.

What does dialectical mean in DBT?
Dialectical refers to the synthesis of opposing ideas. In DBT, the central dialectic is between acceptance and change: the simultaneous validation that a person is doing their best, and the recognition that change is necessary. This balance distinguishes DBT from approaches that emphasize one side without the other.

What are the four modules of DBT?
The four core DBT skill modules are mindfulness, distress tolerance, emotion regulation, and interpersonal effectiveness. Each module targets a different component of the emotional and behavioral difficulties DBT is designed to treat.

How is DBT different from CBT?
CBT focuses primarily on identifying and changing unhelpful thought patterns and behaviors. DBT builds on a CBT foundation but adds a strong emphasis on acceptance, validation, emotion regulation, and interpersonal skills. DBT also typically involves a skills training group component in addition to individual therapy, and it was specifically designed for people with more severe emotional dysregulation.

Is DBT available via telehealth?
Yes. Individual DBT therapy is widely available via telehealth and research supports its effectiveness in that format. DBT skills groups may also be offered via telehealth depending on availability. Midwest Counseling offers both individual DBT therapy and skills groups in Chicago and Northbrook, as well as telehealth options across Illinois and many other states.

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