Comprehensive DBT

Behaviors like substance use, dissociation, disordered eating, emotional avoidance, self-harm, or suicide attempts can provide short-term relief, but often at a long-term cost. Over time, they tend to create more pain, deepen the suffering, and move you further from the life you want.

At one point, these strategies may have been the best tools you had. In fact, they might have helped you survive an unbearable situation. That doesn’t make them wrong; it makes them understandable.

But if you're here, it's likely that what once helped is now keeping you stuck. These patterns are no longer effective in helping you meet your goals. And they may even be making things worse.

It's not your fault that you learned to cope this way. But it is your responsibility to begin healing and the good news is, you don’t have to do it alone. At Nashville DBT, we’re here to help you find safer, more sustainable ways to manage pain and build a life worth living.

Comprehensive DBT is designed for people who struggle with intense emotions and high-risk behaviors that make daily life feel chaotic, painful, or out of control.

It’s especially effective for individuals who experience:

• Chronic emotion dysregulation (e.g., mood swings, intense anger, or frequent overwhelm)
• Impulsive or self-destructive behaviors, including self-harm, suicidal thoughts, substance use, or disordered eating
• Unstable or chaotic relationships
• Feelings of emptiness, identity confusion, or difficulty managing a sense of self
• A diagnosis of Borderline Personality Disorder (BPD) or related symptoms; DBT is considered the "gold standard" for BPD treatment!
• Treatment-interfering behaviors, such as dropping out of therapy, frequent crises, or resistance to traditional approaches
   

Comprehensive DBT is often appropriate when other therapies haven’t worked. If life feels overwhelming and it’s hard to manage emotions or behaviors in a consistent way, DBT may be the right path for you. 

Following the comprehensive assessment at our first appointment, we will have a few individual sessions (this is the pre-treatment stage) prior to beginning the full treatment stage. The pre-treatment stage functions to orient you to treatment, increase your commitment, and to identify treatment targets.

After pre-treatment, we will begin the treatment phase. 

Comprehensive DBT therapy requires all four modes of treatment:

1. Individual therapy weekly
2. Skills training group weekly: group format; more like a class than traditional group therapy
3. Phone coaching: between-session phone contact to help with using the skills in real-life situations or in crisis situations
4. Therapy consultation team: your DBT therapist must participate in a consultation team of other DBT therapists to ensure they are providing the most effective treatment possible

Treatment is conducted in six-month increments; most folks complete two 'rounds' for a full year of treatment. 

We will work together to figure out what’s getting in the way of the life you want to live-the life you value. I will help you develop new ways to effectively mitigate those barriers. 

When full DBT begins, you will have two appointments each week – one DBT individual therapy session and one dbt skills training session – for the duration of treatment. Between sessions, you are encouraged to contact me for phone coaching, so that I can help you try new skills and behaviors when you need it the most. 

You will also have regular homework assignments to practice the skills. This is the most effective way to learn the skills and is necessary for the treatment. You will also monitor emotions and target behaviors every week with a ‘diary card.’ We will use the information on the diary card to structure individual sessions.

Yes, DBT involves both a weekly individual therapy session and a weekly skills group. You’ll also be asked to complete homework, such as practicing DBT skills and tracking your emotions and behaviors with a diary card.

I know that sounds like a big commitment and it is. But there’s a reason: DBT therapy is designed to create real, lasting change, and that takes practice, structure, and support. The weekly rhythm gives you space to learn, apply, and troubleshoot skills in real life. Not just talk about change, but actually live it.

DBT works best when you’re all in and I’ll be with you every step of the way.

Graduating from a comprehensive DBT program is a major accomplishment and it doesn’t mean you’ll never struggle again, but it does mean you’ll be far better equipped to manage life’s challenges.

After completing comprehensive DBT, many clients report:

• Greater emotional stability and the ability to ride out intense feelings without being overwhelmed
• Stronger, more authentic relationships and improved communication skills
• A sense of self-respect and clarity about values and goals
• Increased confidence in managing crises or urges without destructive behaviors
• The ability to pause, reflect, and choose how to respond—rather than reacting impulsively
• A stronger foundation of mindfulness, self-compassion, and acceptance
   

Some clients transition to step-down care, like DBT-informed therapy or monthly check-ins, while others feel ready to end treatment entirely. Either way, the goal is for you to leave with a toolbox of skills, a deeper understanding of yourself, and a path forward that feels both doable and meaningful.

Real Skills. Real Change. DBT changes lives.