Dialectical Behavior Therapy (DBT) in Michigan | Counseling & Psychology

Dialectical Behavior Therapy (DBT) is a skills-based type of talk therapy that helps people manage big emotions, reduce self-harm urges, and improve relationships. If you feel “stuck” in the same painful patterns—like intense anger, panic, or feeling empty—DBT can give you clear tools you can practice in real life. Our Dialectical Behavior Therapy (DBT) in Michigan services are designed to help you feel safer, steadier, and more in control. DBT is often a strong fit for people who have frequent mood swings, high stress, trauma symptoms, or thoughts of hurting themselves.

Signs You Might Benefit from DBT

DBT may help if you struggle with strong feelings that rise quickly and feel hard to calm down. Many people come to DBT after trying other therapy types and still feeling overwhelmed or “too sensitive.” DBT does not blame you. It teaches skills so your brain and body can handle stress in a healthier way.

• Big emotions that feel out of control (anger, shame, anxiety, sadness)
• Self-harm, suicidal thoughts, or feeling unsafe with yourself
• Impulsive choices you later regret (spending, substance use, risky sex, binge eating)
• Fast relationship shifts (feeling close, then suddenly wanting to cut people off)
• Frequent conflict at home, school, or work
• Feeling numb, empty, or disconnected
• Trauma-related reactions like panic, intense triggers, or emotional flooding
• Hard time coping with change, rejection, or criticism

Benefits people often notice

• Fewer crisis moments and better safety planning
• More calm during conflict and fewer blowups
• Less shame and stronger self-respect
• Better boundaries and healthier communication
• Improved ability to stay present and make wise choices

Evidence-Based Approach

DBT is an evidence-based therapy developed by psychologist Marsha Linehan. It combines acceptance (“you are doing the best you can”) with change (“you can learn new skills”). DBT is supported by strong research, including studies showing it can reduce self-harm and suicidal behaviors and improve emotional regulation. Major medical and research sources such as the National Institutes of Health (NIH) discuss psychotherapy as an effective treatment for many mental health conditions, and DBT is widely recognized as a structured, skills-focused approach for high-emotion and high-risk concerns.

Core DBT skill areas

• Mindfulness: learning to notice thoughts and feelings without getting pulled under by them
• Distress Tolerance: getting through a crisis without making it worse
• Emotion Regulation: understanding emotions and reducing emotional “fires” before they spread
• Interpersonal Effectiveness: asking for what you need, saying no, and keeping self-respect

Clinical reasoning: why DBT works for many people

When emotions spike, the brain can move into “survival mode.” In that state, it is harder to think clearly, pause, and choose helpful actions. DBT teaches skills that support both the mind and body—so you can slow down, name what is happening, and respond in a safer way. DBT also uses practice and repetition, because coping skills get stronger over time, like building a muscle.

How DBT can be delivered

DBT can look different depending on your needs, age, and level of risk. A standard DBT model often includes skills training plus individual therapy. Some clinics also offer phone coaching for between-session support when appropriate. Your therapist will recommend a plan that fits your goals and safety needs.

• Individual DBT therapy: weekly sessions focused on your goals, safety, and skill use
• DBT skills training: structured learning and practice of DBT skills (often in a group setting)
• Homework/practice: simple skill practice between sessions to build real-world change

Clinical standards in Michigan: In Michigan, mental health therapy is provided by licensed professionals (such as Licensed Professional Counselors, Psychologists, Licensed Clinical Social Workers, and Marriage & Family Therapists) who must meet state education, training, supervision, ethics, and continuing education requirements. You can ask your therapist about their credentials, DBT training, and how they follow safety protocols for higher-risk concerns.

Research note (APA): The American Psychological Association (APA) describes DBT as a cognitive-behavioral treatment that helps people learn skills to manage intense emotions and reduce self-destructive behaviors. Your therapist should be able to explain how DBT fits your diagnosis, goals, and treatment plan.

What to Expect

Starting therapy can feel scary, especially if you have been carrying pain for a long time. We aim to make the process clear and predictable. You will never be forced to share details before you are ready. DBT is often structured, which many people find reassuring.

Step 1: First contact and scheduling

We will ask a few basic questions to match you with the right level of care. If you are in immediate danger, we will help you find urgent support right away.

Step 2: Intake assessment

In your intake session, your therapist will learn about your symptoms, history, strengths, and goals. You may also complete screening tools for depression, anxiety, trauma symptoms, or suicide risk. If DBT is a fit, you will talk about how DBT works, what commitment is needed, and what support you want in place.

Step 3: Treatment plan and safety plan

If there is any risk of self-harm or suicide, we will create a clear safety plan. This may include coping steps, crisis resources, and support people you can contact. Safety planning is meant to protect you, not punish you.

Ongoing sessions: what happens week to week

• Check-in: what went well, what was hard, and what skills you tried
• Skill teaching: learning 1–2 skills in a simple, step-by-step way
• Practice planning: choosing where you will use the skill in real life
• Review and adjust: noticing what helped and updating the plan

DBT is not about being perfect. It is about learning how to return to balance when life feels too big.

Insurance, Copays, Deductibles, and Mental Health Parity

Paying for therapy can be stressful. We help you understand your benefits before you begin when possible. Costs depend on your insurance plan and the type of DBT services you receive (individual therapy, group skills training, or both).

Common insurance terms

• Copay: a set amount you pay per visit (for example, $20–$60)
• Deductible: the amount you pay before insurance starts paying more
• Coinsurance: a percentage you pay after meeting your deductible
• Out-of-pocket maximum: the most you pay in a plan year before insurance covers more

Mental health parity

Many health plans must follow mental health parity rules, meaning mental health benefits should be covered in a way that is similar to medical benefits. Coverage still varies by plan, and some services may need prior authorization. We can provide documentation such as a diagnosis and treatment plan if your insurer requests it.

If you do not have insurance

Ask about self-pay rates and any available sliding scale or payment plans. If you need a higher level of care (like intensive outpatient or inpatient services), we can help with referrals.

FAQ

Is DBT only for borderline personality disorder (BPD)?

No. DBT was first created for people with high-risk suicidal behaviors and BPD, but it is now used for many concerns. DBT skills can help with anxiety, depression, trauma symptoms, substance use concerns, and strong emotional sensitivity. Your therapist will help you decide if DBT fits your needs.

How long does DBT take?

It depends on your goals and how intense your symptoms are. Some people start feeling changes in a few weeks, especially when they practice skills between sessions. A full DBT skills cycle is often several months. Many people continue longer to strengthen skills and prevent relapse.

What if I’m in crisis or having suicidal thoughts?

If you are in immediate danger, call 911 or go to the nearest emergency room. You can also call or text the 988 Suicide & Crisis Lifeline (U.S.). DBT can be part of a strong safety-focused treatment plan, but urgent crisis care may be needed right away.

Can DBT be done through telehealth in Michigan?

Often, yes. Many Michigan-licensed therapists provide secure telehealth sessions when clinically appropriate. Your therapist will review privacy, safety planning, and whether telehealth is a safe fit based on your needs and location.