Dialectical Behavior Therapy (DBT): Transdiagnostic Treatment
Dialectical Behavior Therapy (DBT) has been around since the late 1980s, and while it was originally developed to help people who frequented Seattle inpatient hospitals, it became broadly applied. Over the years, DBT has grown into a flexible, skills-based approach that’s now used to help individuals manage everything from depression and anxiety to substance use and eating disorders. And that makes sense: most mental health issues aren’t neatly packaged into one diagnosis. They overlap, blur together, and often stem from the same root problems, like difficulty managing emotions, avoiding discomfort, or not knowing how to ask for what we need. DBT was built to address those problems head-on.
What Does Transdiagnostic Mean?
In academic-parlance, a transdiagnostic treatment targets common threads running through different mental health conditions, rather than just focusing on one specific disorder. The most common examples are emotional dysregulation, impulsivity, or experiential avoidance, which are patterns that show up across a wide range of diagnoses. DBT works by teaching practical, repeatable skills that help individuals better regulate their emotions and tolerate distress, which, in turn, reduces symptoms across a wide variety of mental health diagnoses.
The Evolution of DBT: From BPD to Broader Applications
When Dr. Marsha Linehan first developed DBT, it was aimed at treating individuals who were chronically suicidal and met criteria for BPD. Eventually, researchers and clinicians noticed that the skills DBT teaches were helpful for all sorts of people, not just those with BPD. In fact, hundreds of research studies confirmed that DBT wasn’t just for BPD–it was for a broad swath of patients.
Over time, DBT has been adapted for:
Depression: After a course of DBT, nearly all depressive symptoms tend to remit.
Anxiety: When anxiety and depression co-occur, DBT is particularly effective.
Substance Use Disorders: Specific DBT skills adapted for substance use made treating SUD very effective.
Eating Disorders: When disordered eating functions to regulate emotions, DBT is a particularly effective intervention.
PTSD: Particularly when paired with an exposure treatment for the trauma, DBT is exceptionally effective for individuals with complex trauma.
DBT’s Core Skills: Universal Tools for Emotional Well-Being
It’s not particularly magical or complicated; the secret sauce of DBT is doing it. The treatment is built around four concrete skill areas:
Mindfulness: Paying attention, on purpose, to the present moment, without judgment. This module is foundational to all the DBT skills and is associated with numerous health and wellness benefits.
Emotion Regulation: Understanding your emotions, naming them, and learning how to respond instead of react.
Distress Tolerance: Skills for surviving emotional storms without doing things that make them worse (E.G., impulsive texts, binge drinking, or meltdowns).
Interpersonal Effectiveness: Tools for saying what you mean, asking for what you need, and maintaining limits, without blowing up or shutting down.
These are life skills. In our current mental health landscape, where people often don’t get a clear diagnosis (or get six of them at once), having a single, skills-based framework to pull from can be a game-changer.
Why DBT is Especially Relevant in Today’s Mental Health Landscape
People are overwhelmed, disconnected, and burned out. Emotional pain doesn’t always fit neatly into a diagnostic category, and even when it does, treatment options can feel confusing, inaccessible, or out of touch. DBT skills offer practical, well-researched tools that people can actually use in their day-to-day lives.
This is especially important in digital mental health platforms like Tori Health, where DBT skills can be taught and reinforced in a scalable, accessible manner, helping to break down barriers to high-quality mental health care.
The Future of DBT as a Transdiagnostic Approach
The more we understand mental health, the more we realize that many mental health disorders share common emotional and behavioral struggles. Whether someone is dealing with trauma, depression, disordered eating, or just trying to survive their twenties, DBT offers a roadmap out of suffering. It’s not about pathologizing people, it’s about empowering them with the tools to build a life that feels worth living.
And in a world where stress is chronic, social support is fragmented, and people are craving more than just symptom reduction, that kind of approach is more relevant than ever.
Author:
Dr. Chelsey Wilks, Co-founder and Chief Clinical Officer at Tori Health.