Neurocove Behavioral Health, LLC

 Specialists in psychological assessment, therapy, and counseling for 

anxiety, depression, and trauma throughout Florida. 

Dialectical Behavioral Therapy (DBT)

Photo by Pierre Bamin on Unsplash

Do you have a hard time managing intense emotions?

Is it difficult to know what you are feeling in the moment, or do you feel your emotions are all-or-nothing? Perhaps you frequently feel things are easiest described as “love or hate”. Have you felt the need to cling to those around you out of fear of abandonment?

What is Dialectical Behavior Therapy?

Dialectical Behavioral Therapy (DBT) is a cognitive-behavioral therapy with proven effectiveness for people who struggle with emotional regulation. Emotional regulation can be seen on its own, or as a part of other conditions such as eating disorders and borderline personality disorder.

Its main goal in Dialectical Behavioral Therapy is to change negative thinking patterns and behaviors. It also helps people develop better skills for regulating their emotions and managing their day-to-day lives by improving destructive patterns into more adaptive responses and behaviors. 

Does Dialectical Behavioral Therapy (DBT) work?

The short answer is yes. DBT was originally intended for people with borderline personality disorder (BPD). Clinical research has repeatedly shown it to be very effective for individuals with personality disorders which are generally considered difficult to treat. It has also studied as an intervention for eating disorders and also appears effective for these conditions. Today, DBT is considered an effective intervention for a variety of conditions and problems, such as borderline personality disorder, eating disorders, and suicidal thoughts, among others.

dialectical behavior therapy dbt orlando

Photo by Anthony Tran on Unsplash

“Emotions are not good, bad, right, or wrong. The first step to changing our relationship to feelings is to be curious about them and the messages they send to us.”

Who developed DBT?

Dr. Marsha Linehan developed this approach in the 1980s when she saw that cognitive-behavioral therapy, though generally effective, did not work very well with patients who had BPD. These patients had unique needs that were not being met, so this approach tried to help them specifically. Later, the approach was also used for other problems because it seemed that many of these issues were shared by others.

DBT has a philosophical foundation in the form of dialectics that considers the idea that everything that exists is composed of opposites and change happens when the two opposites can be reconciled.

In DBT, the core element is the resolution of the contradictory ideas of self-acceptance and positive change. The therapy examines a person’s actions, emotions, and experiences and validates them as something that makes sense in the person’s unique context, even if it might not be the best solution to the problem at hand. This approach is especially powerful for BPD because people often find themselves acting impulsively, practicing self-harm, and often changing the way they experience the world.

By making sense of these behaviors and experiences rather than simply trying to change them, there are better outcomes. Something similar could happen with eating disorders, as, on one hand, the person might be suffering because of it and seeing their health get worse, and, on the other, also experiencing their weight loss or extreme dieting as something positive. DBT can help reconcile these opposites and promote positive change as a result.

How does Dialectical Behavior Therapy work?

Like other types of cognitive-behavioral therapies, DBT tries to help clients shift thought patterns and behaviors to be more constructive. The term dialectical refers to a core difference that distinguishes dialectical behavior therapy vs. CBT or other treatments. Dialectical means bringing together two opposites, acceptance and change. It provides acceptance for the situation rather than just attempts to change it, which can lead to better outcomes. Acceptance is a critical part of the process. DBT operates through four domains that include the following:

Distress Tolerance:

It helps individuals accept that they feel intense emotions but changes the patterns of coping. Many individuals with borderline personality disorder or other conditions may experience intense emotions and react impulsively or turn to self-harm. The therapy helps shift the behaviors towards acceptance and avoid destructive reactions.

Emotional Regulation:

Emotion regulation is a significant goal in the therapeutic process. These skills help individuals understand, identify, and express emotions in a healthier way.


Mindfulness involves becoming more aware of the self and the experience that is happening at the moment without trying to change it or judging it. Mindfulness helps limit our emotional responses to the current or present moment, which often helps us realize our current experiences are less impactful than originally believed thus lowering the emotional intensity of that experience. Further, taking  

Interpersonal Effectiveness:

Finally, interpersonal effectiveness skills help individuals manage relationships and reducing conflict with others. These domains distinguish DBT from other therapeutic approaches.

Who is dialectical behavior therapy for?

While DBT is most often thought of to be for individuals with borderline personality disorder and eating disorders, or those who often experience intense emotions or suicidal ideation, almost anyone can benefit from DBT skills training as it helps regulate emotions and behaviors. There are studies showing the effectiveness of this condition for problems such as depression, bipolar disorder, and anxiety (see some of our coping skills for anxiety). DBT is focused on helping the person cope with their emotional state and better manage any destructive behaviors, which can be helpful for a wide variety of individuals.

DBT does not try to simply change the person’s experience but to help them find the right balance between change and acceptance, which can work better in a lot of cases. It is recognized as an evidence-based treatment and the evidence base it has is expanding rapidly. It has been used for a variety of conditions with positive results, showing its effectiveness for helping a person regulate emotions and change the behaviors associated with these. DBT is rather unique in its focus and philosophical approach but it does appear effective, especially for BPD and eating disorders, although there are also attempts to apply it to other conditions.

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Rachel Creamer, Ph.D.



My name is Dr. Rachel Creamer. I specialize in providing evidenced-based care to those struggling with anxiety, depression, substance use, and trauma. Seeking therapy takes tremendous courage. You are taking the first step toward positive change. We will work together to help you reach a fulfilling and values-driven life. 


The goal of our first session is to better understand what brings you to therapy and to get to know you better. In the first session we will also talk about your goals for treatment and ways to accomplish these goals. We will also focus on learning skills to help you start making positive changes today. 


Therapy can bring about great positive change. Fostering a safe and compassionate space for clients is the foundation for allowing growth in therapy. Therapy is collaborative. While I am the expert on evidence-based treatment, you are the expert on you. We will work together on reaching your treatment goals and creating a more gratifying life. 


  • Cognitive Behavioral Therapy (CBT)
  • Acceptance and Commitment Therapy (ACT)
  • Exposure Therapy
  • Cognitive Processing Therapy (CPT)
  • Dialectical Behavior Therapy (DBT)
  • Couples Therapy (Gottman method)
  • Motivational Interviewing (MI)
Nicholas James Psychologist Orlando Florida

Nicholas James, Ph.D.



My name is Nicholas James, Ph.D. I have experience working with individuals facing anxiety, depression, stress, trauma, insomnia, and caregiver strain. I focus on matching evidence-based therapies to the needs of my clients to meet their personal goals of recovery and growth.


I believe that change occurs through personal reflection, cultivating strengths and resources, and incorporating growth into everyday life. It is my goal that each session is collaborative and integrates needs, beliefs, and your background into a person-centered treatment plan.


I try to bring a genuine, humanistic atmosphere to every session. My therapeutic approach is centered in Cognitive Behavioral Therapy (CBT) and incorporates additional evidence-based practices to address unique needs that arise during therapy.


  • Trauma Focused
  • Exposure Response Prevention (ERP)
  • Acceptance & Commitment (ACT)
  • Behavior Modification
  • Humanistic
  • Motivational Interviewing (MI) 
  • Mindfulness-Based (MBCT)
  • Cognitive Processing Therapy (CPT)
  • Cognitive Behavioral Therapy (CBT)
Benson Munyan Psychologist Orlando Florida

Benson Munyan, PhD, ABPP



My name is Dr. Benson Munyan. I am a board-certified clinical psychologist. I specialize in working with those experiencing symptoms of anxiety, depression, and trauma. If you are reading this, there’s a good chance you’re looking for something. Whatever the origin of your story, you are here. There is no time like the present to change our tomorrow.


From our very first session, skills are introduced, demonstrated, and assigned as practice assignments between meetings. I collaboratively set each session agenda with my clients, ensuring we have time for following up since the last session, troubleshooting any problems with skills or homework, and working on new problems or material.


Let’s be honest. Sometimes, life is hard. And sometimes, it downright sucks. There, I said it. I believe we should be able to use everyday language in therapy, and that participating in therapy as our most genuine selves empowers us to better understand the challenges we’re facing as well as potential solutions.


  • Cognitive Behavioral Therapy (CBT)
  • Cognitive Processing Therapy (CPT)
  • Trauma-Focused Therapy
  • Dialectical Behavioral Therapy (DBT)
  • Acceptance and Commitment Therapy (ACT)
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