Some feelings arrive faster than any plan you had for handling them. A comment lands wrong and the whole day tips over. You say the thing you swore you would not say, then spend the night replaying it. Dialectical Behaviour Therapy (DBT) was built for exactly this: not to talk you out of what you feel, but to give you usable skills for the moment the feeling hits. At 101 Psychotherapy in Vaughan, DBT is delivered by Registered Psychotherapists, in person at our Concord clinic or by secure video anywhere in Ontario, starting at $100 a session.
- Sessions from $100
- Free initial assessment
- No referral needed
- In person in Vaughan or online across Ontario
- Clinicians registered with the CRPO and the OAMHP
- English and Russian spoken
What Is DBT?
Dialectical Behaviour Therapy is a structured, skills-based talk therapy. It is based on cognitive behavioural therapy, but as CAMH’s guide to dialectical behaviour therapy puts it, DBT focuses more on the emotional and social aspects of living, and was created to help people manage their intense emotions.
The difference sits inside the word dialectical, which means the existence of opposites. In DBT you are taught two seemingly opposite strategies at once: acceptance, that your experiences and behaviours are valid, and change, that you can still make positive changes to manage emotions and move forward. Neither cancels the other out. Sessions move between the two rather than choosing a side. In practice that means less time spent analysing why you are the way you are, and more time building a concrete set of skills you can reach for when emotion runs ahead of judgement.
How DBT Works: The Four Skills
DBT skills training is organized into four modules. Each one answers a different question, and most people find they lean on one or two more heavily than the rest.
Mindfulness
The foundation the other three rest on. Mindfulness here is practical, not mystical: noticing what you are feeling while you are feeling it, and naming it accurately enough to make a choice. Most people discover they have been reacting to a story about the emotion rather than the emotion itself.
Distress Tolerance
What to do in the worst twenty minutes, when solving the problem is not yet possible and the goal is simply to get through it without adding a new one. These are short, physical, deliberately unglamorous techniques for riding out a crisis rather than acting on it.
Emotion Regulation
For emotional dysregulation, where feelings arrive at full volume and stay long past their usefulness. You learn to spot what set an emotion off, check whether it fits the facts of the situation, and change the conditions that keep it burning. Sleep, food and illness turn out to matter more than most people expect.
Interpersonal Effectiveness
Asking for something, refusing something, and disagreeing with someone, without losing either the relationship or your own self-respect. This module is often the reason people stay in DBT, because the skills are immediately testable on the next difficult conversation.
101 Psychotherapy – Always caring, always here
What It Helps With
DBT is most useful when the central difficulty is the intensity and speed of emotion rather than its content. That pattern goes by the name emotional dysregulation, and it cuts across diagnoses. It shows up as anger that overshoots, as relationships that swing between closeness and distance, as impulsive decisions made to end a feeling quickly. The skills also support work on anxiety, depression and ADHD, though those are usually approached with a broader treatment plan.
What to Expect in a Session
Much of the work is applying skills to things that actually happened to you. A session will often slow down around one moment from the past week that went badly, tracing what led where, until the point becomes visible at which a different skill could have changed the outcome. From there the session turns to teaching or rehearsing that skill. Part of your therapist’s job is keeping motivation alive when the practice gets dull, because it does.
Practice between sessions is where DBT does most of its work. Skills learned in a quiet room and never used under pressure tend not to hold, so expect to leave with something to try, and to come back and talk about how it went.
Is DBT the Right Fit for You?
DBT suits people who want structure, practice and homework. It suits people who already know what they feel and cannot yet steer it. It suits less well those looking for open-ended exploration, and it asks for a consistency that can be hard to sustain during an acute crisis.
If your difficulty is mainly with unhelpful thinking patterns rather than emotional intensity, cognitive behavioural therapy may fit better, and if restlessness and attention are the core problem, neurofeedback is a different route again. Our comparison of DBT and CBT goes through the differences in detail.
The fastest way to find out is to ask. Book the free initial assessment, describe what has been happening, and we will tell you honestly whether DBT fits, or which approach would suit you better.
The Evidence Behind DBT
Marsha Linehan developed DBT for adults living with chronic suicidal thinking and self-harm, most of whom met criteria for borderline personality disorder, and that is where the strongest trial evidence still sits. The Centre for Addiction and Mental Health describes DBT as an evidence-based model that helps people learn and use new skills so that they build lives they feel are worth living.
One trial shaped how we work. In a randomized component analysis of DBT in 99 women at high suicide risk, published in JAMA Psychiatry in 2015, every version of the treatment reduced suicide attempts and self-injury. But the versions that included skills training did better on self-injury and depression than individual therapy without skills, which is why our sessions are built around teaching and rehearsing skills rather than conversation alone. Measured against that same skills-free arm, the full programme also kept people in treatment longer, and the authors concluded that standard DBT may be superior in some areas.
Outside that population the evidence is thinner, and full DBT programmes draw criticism for being long, expensive and scarce. DBT skills are well supported and useful, but they are not a cure.
Dialectical Behaviour Therapy Pricing in Vaughan
Individual sessions start at $100. Your first 30 minutes with us are free. That consultation exists so you can hear how we would approach your situation, and so we can tell you if DBT is not the right therapy for it.
Sessions with a Registered Psychotherapist are not covered by OHIP. Many extended health plans reimburse psychotherapy in whole or in part, and coverage depends on your plan and on your therapist’s designation, so check the wording of your benefits before your first appointment.
Book a Free ConsultationMeet Our Therapists
Natalie Besharat
Clinician, Pediatric Care and Addictions Specialist, MSc, CCAC, CICAPP Candidate
Full profileDBT Near You: Vaughan and Online Across Ontario
We're here to support individuals and families across Vaughan, including Concord, Woodbridge, and Maple, and in nearby communities such as Aurora, Brampton, Markham, Mississauga, Milton, Oakville, Oshawa, and Richmond Hill, as well as Thornhill. We also welcome clients from across Toronto, including North York, Midtown, and Uptown Toronto. If you can't make it to our office, we offer virtual appointments across Ontario.
Frequently Asked Questions
Is Dialectical Behaviour Therapy Covered by OHIP?
Not when a Registered Psychotherapist delivers it. Sessions with a Registered Psychotherapist are not covered by OHIP.
How Much Does DBT Therapy Cost in Vaughan?
Our sessions start at $100. Your first 30-minute consultation with us is free.
What Kind of Therapy Is DBT?
It is a talking therapy, and a close relative of cognitive behavioural therapy. Where CBT concentrates on the thoughts that shape how you feel, DBT was adapted for people who feel emotions very intensely, and it teaches skills for tolerating and steering those emotions. It is structured, practical and built around practice between sessions.
What Are the Four Skills of DBT?
Mindfulness, distress tolerance, emotion regulation and interpersonal effectiveness. Mindfulness is noticing an emotion accurately as it happens. Distress tolerance is getting through a crisis without making it worse. Emotion regulation is changing the conditions that keep an emotion running. Interpersonal effectiveness is asking, refusing and disagreeing without damaging the relationship or your self-respect.
Who Is DBT Not Recommended For?
DBT asks for structure, homework and regular attendance, which is difficult to sustain in an acute crisis or when untreated substance use or a medical condition is making stability impossible. Those usually need addressing first. People looking for open-ended exploration of their history often find DBT too directive. And if emotional intensity is not the main difficulty, another therapy is likely to serve you better. We would rather tell you that at a free consultation than three months in.
What Is the 24 Hour Rule in DBT?
The 24 hour rule belongs to comprehensive DBT programmes that offer telephone coaching between sessions. Under it, a client who has self-harmed does not receive coaching calls for the following 24 hours, so that the therapist’s attention does not become a reward for the behaviour, and coaching resumes afterwards. It applies only where that kind of between-session coaching is part of the programme. If you are in crisis, call or text 9-8-8, the Suicide Crisis Helpline, or call 911.
Is DBT or CBT Better?
Neither, in the abstract. They answer different questions. CBT works best when unhelpful thinking patterns are driving the distress, and it has the broader evidence base across anxiety and depression. DBT works best when the difficulty is the intensity of emotion itself, and it has the strongest evidence in populations with chronic self-harm. Many people use elements of both.
Book Your Appointment Today!
Arriving without the right words for the problem is normal. Describe roughly what has been happening, and we will say plainly whether DBT is the therapy that suits it.
