What is dialectical behavior therapy?
Dialectical behavior therapy (DBT) is a structured form of psychotherapy that emphasizes building skills to manage intense emotions and navigate relationships. It was first created to help people with chronic suicidal and self-destructive behavior. Today it is a leading treatment for borderline personality disorder and emotion dysregulation, and it is used for a growing range of mental health conditions.
Comprehensive DBT programs traditionally combine weekly skills instruction with individual therapy and often run from six months to a year.
What does "dialectical" mean?
A dialectic is the balancing of two things that seem opposed. DBT starts from the view that real life is complicated, and that health is an ongoing process refined through honest dialogue with yourself and others.
The central balance in DBT is between acceptance and change. You learn to accept your feelings as real and understandable, even when they are messy or contradictory, while also working to change the behaviors that make life harder. The aim is not to stop feeling strongly. It is to feel strongly without being swept away.
The four DBT skill areas
- Mindfulness: noticing thoughts and feelings in the moment without judging them or acting on them automatically.
- Distress tolerance: getting through a crisis moment without making it worse.
- Emotion regulation: understanding emotions, reducing vulnerability to them and shifting them when they are not helping you.
- Interpersonal effectiveness: asking for what you need, saying no and keeping self-respect in relationships.
Who can DBT help?
Dr. Audrey uses DBT with people whose emotions feel bigger and faster than they can manage. That often includes:
- Teens who are cutting or self-harming, or who swing quickly between anger and despair
- Young adults dealing with depression, anxiety or unstable relationships
- Adults with emotion dysregulation, borderline personality traits or complex PTSD
- Parents who want to coach their child through DBT skills at home
If you or someone in your family is in crisis, call or text 988 (Suicide & Crisis Lifeline) or 911. Dr. Audrey's practice is not a crisis service.
How Dr. Audrey uses DBT
Dr. Audrey is C-DBT certified through Evergreen Certifications and has more than 20 years of clinical experience. Her sessions blend DBT's structured techniques with compassionate understanding, and because her doctoral training is in family systems, she often brings parents into the work. A teen learning distress tolerance does much better when the adults at home know the same language.
DBT also fits naturally alongside her teen counseling and her couples therapy, where interpersonal effectiveness skills can change how partners argue.
All sessions happen by secure, HIPAA-compliant video. You need to be in Texas, New Jersey or New York during each session, since Dr. Audrey is licensed as a Texas LPC-S, a New Jersey LPC and a New York LMHC.
A typical session might start with a recent moment when emotions spiked. Together you map the chain of thoughts, feelings and events that led there, find the points where a different choice was possible, and pick one skill to practice before the next session. The practice between sessions is short and concrete, because the goal is to use the skills in real life, not just understand them.
Learn more about Dr. Audrey
Dr. Audrey is also a Certified Family Life Educator (CFLE) and a published author in the field of family dynamics. A Coppell police officer who watched her work with teens and parents wrote about it in The Gift, and families share their experiences on the testimonials and reviews page.
Her practice is LGBTQ+-friendly and LGBTQ+-owned. Clients of every identity are welcome and affirmed.
Getting started with DBT
Send the secure request form or text or call (917) 905-3183, and the office will reply within one business day. Existing clients can sign in to the client portal.