The Ultimate Guide to Selecting a DBT Therapist
Choosing an individual Dialectical Behavior Therapy (DBT) therapist can feel overwhelming—especially when you're already trying to manage stress, emotions, or crisis. This guide is designed to make that process simpler, clearer, and more empowering.
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Before you use this guide, first determine if working with an individual DBT therapist is the right fit for you (or for your child). Outside of individual DBT therapy, there are other ways to engage with DBT; for instance, seeking out a DBT skills group or working with a DBT coach.
If you’re deciding between options like self-guided DBT, a skills-only program, or coaching, we recommend completing our completely FREE mini-course, Navigating DBT, before moving forward.
Finding the right DBT therapist won’t be like shopping for the perfect blender. You’ll quickly discover that DBT therapists don’t have reliable reviews online — and they won’t give you client references if you ask. That’s not because they’re hiding anything. It’s because therapists are held to strict confidentiality and ethical standards that discourage testimonials or referrals from former clients. As a consumer, this is frustrating, and you can still find a great therapist.
This is why it’s extra important to use the tools you DO have — asking thoughtful questions, using a checklist, evaluating how they teach skills, and paying attention to how you feel in sessions over time.
This guide will help you:
Understand the range of options for learning DBT skills (and where therapy fits in).
Know what qualifications and training to look for in a DBT therapist.
Evaluate cost and insurance options.
Prepare questions to ask during an intake session.
Use a scorecard and checklist to compare therapists and confidently make a decision.
And if you’re already into your search, feel free to jump ahead to specific sections of this guide that are most relevant to you!
Meta-analysis of DBT across diverse populations (Kliem et al., 2010)
DBT is an evidence-based approach that helps people build skills in four key areas: mindfulness, emotion regulation, distress tolerance, and interpersonal effectiveness. It has been shown to help individuals manage intense emotions, reduce impulsive and ineffective behaviors, increase mindfulness, improve relationships, and build a life that feels worth living.
Understanding the DBT Step-Up Model of Care
Not everyone needs the most intensive (and expensive) form of DBT. Depending on your needs you may begin by learning DBT Skills and follow a step-up model of care—starting with low-cost options focused on skills and gradually stepping up into therapy if your needs aren’t being fully met. Note, if you’re not sure where to start, it’s always good to consult with a licensed practitioner or your primary care provider.
Level 1: Self-Guided DBT (No Cost to Low Cost)
The first step towards learning DBT skills for many people.
- DBT books and workbooks (including one by TheraHive Co-Founder Dr. Jesse Finkelstein)
- Free online articles, podcasts, YouTube lessons
- Skill-tracking worksheets or DBT apps
This level is useful for learning concepts and building awareness, but most people eventually need real-time feedback and guidance to apply skills effectively.
Level 2: DBT Skills Programs or DBT Coaching
The next step up is focused on learning and practicing DBT skills—without formal therapy.
- Online group programs like TheraHive’s DBT Skills Program
- One-on-one DBT skills coaches (not licensed therapists)
- Short-term workshops or virtual DBT intensives
These options are more affordable than therapy, very structured, and ideal for people who want to actively practice skills but don’t require individual psychotherapy or crisis support.
Level 3: Individual DBT-Trained Therapist
This is the level where this guide becomes most relevant.
- Weekly sessions with a licensed mental health professional who uses DBT
- Focus on both skill use and changing specific behavioral patterns
- May or may not include formal diary cards, assigned skills practice, or phone coaching
People often combine individual DBT therapy with a separate skills group, like TheraHive, for a more in-depth experience.
Level 4: Comprehensive DBT Program (Full Model)
This is the gold standard for individuals with high-risk behaviors or severe emotional dysregulation. Comprehensive DBT includes all four components:
- Individual DBT therapy
- Weekly DBT skills group
- Between-session phone coaching
- A DBT consultation team for therapist accountability and treatment fidelity
Programs like these are typically offered in DBT-specialized centers (like Dr. Alicia Smart’s center Guidepost DBT), hospital outpatient programs, or university clinics.
Key Takeaway
You don’t have to start at the top. You can begin with affordable or skills-based care, and step up only if needed.
This guide is designed for people who are at Level 3 or considering Level 4—those who want to work with a DBT therapist and want to choose the right one.
Credentials & Training: What Makes Someone a DBT Expert?
One of the biggest challenges in choosing a DBT therapist is that any therapist—or even a coach—can say they “use DBT.” There is no legal protection around the term. As a result, some providers list DBT on their profiles even if they’ve only read a book or taken a short training course. This makes it difficult for clients to know who is truly qualified.
For therapists in particular, you might assume that professional licensing would solve this problem. Unfortunately, it doesn’t. A therapist’s license simply means they meet the licensinglegal requirements to practice therapy in their state. DBT is not a required modality for all therapists to learn, so being licensed—it does not guarantee specialized training in DBT or the ability to teach DBT skills effectively.
At TheraHive, our team includes some coaches who happen to be licensed therapists as well as non-licensed DBT coaches—because of that, we’ve been able to observe something surprising: when it comes to teaching DBT skills, being licensed does not necessarily mean someone is better at teaching or modeling DBT skills. What makes someone effective at teaching DBT skills is not just their credentials—but their depth of training and experience with DBT, how well they understand the skills, and perhaps most importantly, whether they actually use them in their own life.
That said, if you are specifically seeking therapy—not just skills coaching—there are things only a licensed therapist can provide:
✔ a mental health diagnosis
✔ a treatment plan
✔ therapy within legal and ethical guidelines of your state
So while licensure is essential for therapy, it is only the starting point. To evaluate the quality of DBT skills instruction and therapy, you need to look beyond licensure and assess their DBT-specific training, experience, and skill competency.
This section explains what to look for and how to assess their DBT expertise.
Minimum Requirements (Baseline Qualifications)
At the very least, a DBT therapist should:
- Be a licensed mental health professional in your state (LCSW, LMFT, LPC, PsyD, PhD, MD/psychiatrist). They could also be an associate working under the direction of a licensed therapist.
- Be legally allowed to provide therapy where you live (important for telehealth).
- Be able to explain DBT clearly in simple language—not just mention it as an “approach I use.”
DBT-Specific Training
Here is how DBT training is commonly structured—from most rigorous to more general training:
Green Flags – Strong Indicators of a Qualified DBT Therapist
These are signs you're likely working with someone who truly understands and practices DBT:
- They can clearly explain DBT skills (like Wise Mind, Opposite Action, Chain Analysis) without needing notes or a script.
- They assign diary cards, skills homework, or actively review skills used in session.
- They are part of a DBT consultation team (required in adherent DBT models).
- They regularly use DBT skills in their own life and can speak to them personally.
- They’ve completed formal DBT training (Behavioral Tech, PESI Intensive, LBC-DBT, university practicum, TheraHive CEU program, etc.).
- They emphasize both behavioral change and acceptance—not just talk therapy or insight-building.
Yellow Flags – Proceed With Curiosity, Ask More Questions
These don’t necessarily mean the therapist is unqualified, but they require deeper exploration:
- They describe their approach as “DBT-informed” but can’t clearly describe what that means in practice (no mention of diary cards, skills coaching, structure, or behavioral approaches).
- They say they don’t use DBT workbooks, handouts, or structured materials because they “prefer a more organic approach.”
- They incorporate therapeutic approaches that are not strictly evidence-based, which may be meaningful for some clients but lack consistent scientific support.
- They are new to DBT or recently trained but haven’t used it extensively with clients—or practiced it in their own life.
- They can’t explain how DBT modules relate to each other in a way that is consistent with this overview.
Red Flags – Strong Signs You Should Look Elsewhere
These suggest the therapist is not adequately trained in DBT:
- They have no formal DBT training (only self-study or use of the DBT workbooks).
- They say something like: “I do my own version of DBT—I’ve never had official training, but I understand the concepts.”
- They do not know core DBT terminology or skills (e.g., can't describe Chain Analysis, Wise Mind, or Opposite Action).
- They dismiss structure or skills-based approaches entirely (“DBT is too rigid,” “I don’t believe in worksheets or structured tools”).
- They cannot clearly explain how DBT relates to CBT or other modalities when asked.
- They’re not licensed (if you’re seeking therapy vs. coaching) and say they deliver “DBT therapy” anyway.
A strong relationship with your therapist matters—but not in the way you might think. Research shows the key isn’t simply liking your therapist as a friend; it’s having a collaborative working alliance in which you trust the person, feel safe, and know what you’re working on together.
In the context of DBT, this alliance enables you to use the skills, practice the tasks, and share difficult thoughts and behaviors. If the relationship is weak, you may hold back, become stuck, or drop out—and that can affect outcomes.
So ask yourself: do I feel seen and respected? Do I understand what we’re working on? Does my therapist give me structure and feedback? These matter more than whether we “get along socially.”
Remember: You don’t need your therapist to be your friend—but you do need them to be your partner in change.
Evaluating the Quality & Fit of a DBT Therapist
Once you’ve found a therapist who offers DBT and meets the basic requirements (licensed, trained, affordable), the next question is: Are they actually good at DBT, and are they a good fit for you?
This section focuses on how to assess:
- The therapist’s actual skill and experience using DBT
- Whether they practice what they teach
- Whether they are a good therapeutic match for your personality, goals, and learning style
What Makes a Great DBT Therapist?
Quality DBT therapy goes beyond credentials. The best DBT therapists:
✔ Teach and reinforce the actual DBT skills consistently (not just talk therapy)
✔ Can clearly explain DBT, why skills work, and when to use them
✔ Use behavior change tools — like behavioral chain analysis and diary cards
✔ Model DBT principles themselves — mindfulness, emotional regulation, dialectics, non-judgment
✔ Are compassionate and structured
✔ Are open to feedback and comfortable being asked questions about their approach.
How to Tell If They’re the Right Fit (Before or During the Intake Session)
Questions You Can Ask to Assess Fit:
“How do you typically use DBT in your sessions?”
→ You’re listening for structure: skills practice, diary cards, behavior change—not just “I use DBT principles.”
“Are you part of a DBT consultation team?”
→ This is required for full (adherent) DBT. If not, you’re listening for: supervision, peer consultation.
“Do you assign skills practice or diary cards between sessions?”
→ If they don’t assign skills at all, they may not be using structured DBT.
“Do you use the Linehan DBT workbook or another resource for skills education?”
→ Reputable DBT therapists will use the Linehan manual or a comparable resource. Or will rely on reputable skills group programs like TheraHive’s.
“What DBT skills do you personally find most helpful in your own life?”
→ A confident DBT therapist should be able to name 1–2 skills they genuinely use (e.g. Check the Facts, Opposite Action, Radical Acceptance).
“Do you offer phone coaching or between-session support if I need help using skills in the moment?”
→ This differentiates comprehensive DBT from therapy using only DBT techniques.
Putting It Together
Key Takeaway
A therapist can be licensed, compassionate, and affordable… but if they don’t actively teach, model, and practice DBT skills, they may not help you build the life-changing skills DBT is known for.
The best DBT therapist is someone who:
- Knows the skills deeply
- Practices them personally
- Teaches them clearly
- And makes you feel respected, capable, and challenged in the best possible way
Understanding the Cost of DBT
Cost is often the biggest barrier to starting DBT therapy. Unfortunately, DBT is not always covered by insurance, and coverage can vary dramatically between providers and plans. In this section, we help you understand how to evaluate cost realistically — and how to talk about it confidently with providers.
A Step-Up Cost Comparison
Level 1: Self-Guided DBT (Books, Worksheets, Apps)
- Typical Cost: $0–$50 (one-time)
- Insurance Coverage: Not applicable
- What You Get: Education only — no feedback or personalization
- Best For: People exploring DBT or not ready for therapy
Level 2: Online DBT Skills Program (e.g. TheraHive)
- Typical Cost: $60-90/week
- Insurance Coverage: Often not insurance-based, but some programs do accept insurance
- What You Get: Weekly group sessions, structured lessons, worksheets, peer accountability
- Best For: Learning and applying DBT skills with guidance
Level 3: 1:1 DBT Therapist (Private Practice)
- Typical Cost: $120–$250 per session
- Insurance Coverage: Sometimes covered, but depends on plan
- What You Get: Personalized therapy, skills coaching, treatment planning
- Best For: People needing individualized support
Level 4: Comprehensive DBT Program (Therapist + Group + Phone Coaching + Consult Team)
- Typical Cost: $250–$800/week
- Insurance Coverage: Sometimes covered, depends on plan
- What You Get: Full protocol: individual therapy + group + phone coaching
- Best For: High-risk behaviors, self-harm, suicidality, severe emotional dysregulation
Key Insight:
Sometimes the co-pay for a therapist ($0–$100/session) is similar to, or even more than, an online DBT program like TheraHive ($60/week). Though these are different levels of care, this means private-pay DBT skills instruction may have a comparable cost to insurance-based therapy, especially with a robust benefits plan.
Insurance: What You Need to Know
Insurance coverage for DBT depends on three things:
- Your insurance plan
- The therapist’s credentials and network status
- Whether DBT is billed as therapy or skills training (group therapy)
Insurance Coverage Checklist — Questions to Ask Your Insurance Provider
How to Ask a Therapist About Cost (Without Feeling Uncomfortable)
Here’s language you can copy/paste or rehearse:
“Before we move forward, could you share your session fee and whether you accept insurance or offer superbills for reimbursement?”
“I’m trying to understand the cost before committing. Do you take insurance? If not, do you offer sliding scale options or paperwork for out-of-network reimbursement?”
“Do your DBT services include individual therapy only, or do you also provide group sessions and phone coaching? If so, is that included in your fee, or priced separately?”
“If I’m not sure I can afford comprehensive DBT long-term, is it possible to start with individual sessions and step up if needed?”
Key Takeaways from This Section
Insurance coverage varies — don’t assume DBT is covered just because therapy is.
Out-of-pocket therapy may cost the same or less than your co-pay + deductible.
The most financially sustainable approach is to start at a lower-cost level (skills group, coaching) and step up only if needed.
Scripts and checklists help you ask financial questions confidently and professionally.
How to Find a DBT Therapist (Where to Look and How to Start)
Once someone knows what kind of DBT care they’re looking for and what makes a qualified provider, the next step is: where do you actually find a DBT therapist?
This section should give people practical, trustworthy places to search, plus tips on how to evaluate listings.
Primary, Trusted Sources for Finding DBT Therapists
What If There Are No DBT Therapists in My Area?
This is common — especially outside major cities. Options include:
- Telehealth DBT therapy (many therapists are licensed across multiple states)
- DBT-informed general therapist + TheraHive skills program (hybrid approach)
- Start with Level 2 (skills training) while on waitlist for Level 3
- Partial hospitalization or intensive outpatient DBT programs (PHP / IOP) available through hospitals for higher-need situations
- Bridge with a DBT coach while searching for a therapist licensed in your state
A Note About “DBT-Informed” Listings
Some therapists list “DBT-informed” on their profile but:
- Do not teach actual skills
- Do not run groups or assign diary cards
- Use mindfulness or emotional validation but not behaviors / skill rehearsal
This doesn’t mean you should dismiss them — it just means you’ll need to ask more follow-up questions (like those in Section 6) to understand what “DBT-informed” truly means in their practice.
Key Takeaway
Finding a DBT therapist isn’t just about location—it’s about verifying training, approach, availability, cost, and personal fit. The best strategy is:
- Start with trusted directories
- Make a shortlist
- Use this guide’s questions + scorecard to evaluate each therapist
- Choose the one who fits your needs and practices DBT in a structured, skill-based, compassionate way.
Conclusion
Learning DBT is an investment—of time, energy, and often money. That’s why it’s worth taking the time to understand your options before committing to a therapist or program.
The people who get the most out of DBT aren’t the ones who simply “find a therapist”—they're the ones who ask questions, make informed choices, and advocate for what they need.
We encourage you to do exactly that.
There’s no one right path into DBT. But with the right information, you can choose the one that fits you—your goals, your budget, your level of support, and your values.
And as you take that step, know this: we’re here to help.
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