Not all DBT is what it claims to be.
You’re ready to get serious about your mental health, and DBT sounds like the right fit. But before you commit to a DBT therapist in Philadelphia or a program for dialectical behavior therapy, it’s worth asking a few key DBT questions.
Why? Because many therapists use DBT-informed approaches without offering the full, research-backed method, called Adherent DBT, that actually leads to results. Whether you’re new to therapy or switching providers, these 7 questions will help you figure out if the therapist you’re considering offers real DBT or just pieces of it.
What Is Adherent DBT?
Most people don’t even know that therapists mainly offer DBT-informed approaches rather than Adherent DBT. Adherent or comprehensive Dialectical Behavior Therapy (DBT) was developed by Dr. Marsha Linehan. It strictly follows the protocols and original treatment plan that is evidence-based. Dr. Linehan created DBT to help individuals diagnosed with bipolar personality disorder and chronic suicide behaviors.
This form of DBT has 4 key modes:
- Weekly individual therapy
- Group skills training
- Phone coaching
- Therapist consultation teams
Standard or less structured DBT programs for therapists lack these and usually hand-pick DBT skills that are not consistent with the whole model. To learn core skills like mindfulness, distress tolerance, emotion regulation, and interpersonal effectiveness DBT’s dialectical philosophy should be adopted as the whole comprehensive DBT approach.
7 Questions to Ask Your DBT Therapist
You can ask as many or as few questions as you want to your therapist. However, if you want to make sure you find a DBT therapist in Philadelphia or near you who provides the full DBT experience, ask all 7 of the following questions.
Q1. Do you offer all four DBT modes?
As we discussed above, comprehensive DBT has 4 distinct modes that help a person get dialectical behavior therapy as it was meant to be. Many only offer individual sessions or skills training. True DBT includes all four. If your therapist isn’t offering all 4 modes in the DBT program, it’s not it.
Q2. What DBT training have you received?
Any therapist can call themselves a DBT expert, but the true ones have knowledge and supervision by certified DBT therapists in Philadelphia and other cities. Always ask your therapist whether they’ve had intensive training or supervision by certified experts. Your DBT therapist for mental health needs to be a licensed, independent mental health practitioner (such as a psychologist, social worker, counselor, or psychiatrist). They should also have:
- Master’s in a mental health field from an accredited school
- Completed specialized DBT training (e.g., workshops or intensives)
- Experience in individual DBT, skills groups, and consultation teams
They may also be certified by groups like the DBT-Linehan Board, but it’s not required. If your therapist hasn’t completed basic DBT training, it may be worth exploring other options for your mental health care.
Q3. Do you follow specific behavioral targets?
In the model made by Dr. Linehan, treatment is structured around clearly defined behavioral targets. To make sure a therapist and client settle on working efficiently, behavioral targets are set in the following order:
- Life-threatening behaviors (e.g., suicide attempts, self-harm)
- Therapy-interfering behaviors (e.g., skipping sessions, not completing homework)
- Quality-of-life interfering behaviors (e.g., substance use, impulsivity, unstable relationships)
This makes your session meaningful, goal-oriented, and responsive to adherent DBT. If the therapist in DBT you are working with right now isn’t following such protocols, they are not offering true “DBT”.
Q4. Do you use diary cards or track progress weekly?
Any therapy you take requires a collaborative effort. The same goes for DBT. A good, trained DBT therapist will help you track your weekly progress to measure the effectiveness of the DBT program objectively. Here are some ways they can encourage you:
- Track behaviors week to week
- Use a diary card to monitor your emotions and actions
- Prioritize goals that bring real change in your daily life
Get a DBT therapy consultation that touches on tracking, progress, and follow-up. If that’s not what’s happening, it isn’t a meaningful DBT experience.
Q5. Do you tailor DBT to my diagnosis or challenges?
DBT is flexible and can be personalized. A therapist trained in adherent DBT will naturally adjust the approach based on your diagnosis and challenges. From session focus to which skills come first, like distress tolerance or emotion regulation, DBT can be shaped around you.
Whether it’s BPD, trauma, or substance use, this therapy is built to adapt. If any therapist makes you feel like you have to follow a strict regime, it isn’t authentic DBT.
Q6. What happens if I miss a session or fall behind?
If you’ve missed a therapy session before, you should know it’s okay. DBT therapists who act like it is a crime to miss a session, aren’t the right choice for you. Missing a session isn’t a failure but you can learn with your therapist why you shouldn’t do it. While most DBT programs have clear attendance rules, a good therapist will help you explore what got in the way and how to get you back on track without judgment.
Q7. Are you part of a DBT consultation team?
This might seem like a personal question to you for your DBT therapist, but it’s not. Participation in a consultation team is a requirement of comprehensive DBT and allows for continuous growth professionally and accountability. Your treatment provider should at least have weekly meetings to support conversations, discuss challenging cases, and stay true to the DBT model. Any therapist who denies being involved in one can be considered a red flag.
It’s Okay to Ask These Questions
You can and should ask your DBT therapist these questions. Therapists trained in DBT usually welcome them and see your curiosity as a sign of commitment and self-awareness.
If a therapist avoids or resists answering, it could be a red flag. Your care should meet your needs, not just follow a routine.
Your Therapy, Your Right to Know with Growth thru Change
Asking the right questions helps you find real DBT, not just a watered-down version. Ask these 7 questions to find a therapist who truly understands DBT and can support your growth, resilience, and long-term mental health journey.
We at Growth thru Change have DBT-adherent therapists who have years of experience. You can choose individual therapy or group DBT skills therapy in Philadelphia PA, and online Pennsylvania, New Jersey, & Delaware.
