DBT in Orange County
Dialectical Behavior Therapy — concrete skills for the moments when an emotion is bigger than your reasoning, and for the patterns that keep showing up because the moment kept winning.
DBT is a skills-based form of cognitive behavioral therapy developed by Marsha Linehan at the University of Washington. It teaches concrete skills in four areas — mindfulness, distress tolerance, emotion regulation, and interpersonal effectiveness — for situations where talking through a feeling isn't enough.
The original problem DBT was built to solve: when emotions are intense, regular cognitive therapy can feel like trying to think your way out of a fire. You need cognitive work and you need something to do in the moment. DBT keeps the cognitive piece and adds a library of in-the-moment skills, plus a structure for learning them.
The work is practical. Each skill is a thing you can name, rehearse, and use in your actual life. The diary card you bring to session shows what you tried, what worked, what didn't. The pattern across weeks shows what's changing.
Four toolkits, one practical framework.
DBT skills are organized in four modules. Each one targets a different problem. Most people don't need all of them at full depth; we start with the area where the gap is biggest and build out from there.
Watching what's happening in you without instantly reacting to it.
The foundation skill. Before you can regulate an emotion or pick a different response, you need to notice what's actually happening. Mindfulness in DBT is concrete and practical — short, on-purpose attention to the present moment, repeated often enough that you can find it when the wave hits.
Skills for the moments when an emotion crests and you can't think your way out.
When the feeling is too big to reason with, distress tolerance gives you something to do that isn't make-it-worse. TIPP changes your body chemistry in 90 seconds. ACCEPTS distracts on purpose. IMPROVE shifts the moment without pretending it isn't happening. These aren't long-term answers; they're how you get to the other side of the wave without acting on it.
Lowering your baseline vulnerability so emotions don't run you.
Some of emotion regulation is in-the-moment work. Most of it is what you do before the moment — sleep, food, movement, treating illness, avoiding mood-altering substances. PLEASE covers the biological floor. Opposite Action handles the urge to do the thing that keeps the feeling going. Build Mastery is the long game: small, regular wins that change what you believe you're capable of.
Asking for what you need, holding your ground, and keeping the relationship.
Most of us are better at two of these three: getting what we want, keeping the relationship, and keeping our self-respect. DBT names the trade-offs and gives you a structured way to handle each. DEAR MAN is how you ask. GIVE is how you stay connected while doing it. FAST is how you keep your self-respect when the answer is no.
Two true things at once.
The dialectic at the center of DBT: you're doing the best you can, AND you can do better. Both true. The work is figuring out which side of that to lean on in any given moment.
Most stuck patterns come from collapsing the dialectic. If it's all "you're doing the best you can," nothing changes. If it's all "you can do better," there's no kindness left to do the work from. DBT keeps both alive.
Acceptance and change are not opposites. They are the two wings of the same bird. — After Marsha Linehan, DBT founder
DBT was originally built for severe emotion dysregulation. The skills have since been studied and applied across a wider range. Each label below will link to its specialty page when those pages exist.
Not a certified DBT clinician. Not running a comprehensive DBT program. Trained in DBT skills and integrating them into individual therapy where they fit.
Honest about what this is and isn't.
Janie has done DBT training and uses DBT skills regularly in her individual work. What that means: when emotion regulation, distress tolerance, or interpersonal patterns are part of what's keeping you stuck, she'll bring DBT skills into the session and teach them as part of the work.
What it doesn't mean: a full DBT program. Those typically require weekly individual therapy plus a separate skills group plus phone coaching between sessions plus a therapist consultation team. That's a real commitment of time and money, and if that level of structure is what you need, ask in a consultation and Janie can point you toward programs that offer it.
Last week is the data.
The shape of a session is steady, so the work compounds. You bring the week. We pick the moment. We work the skill.
A quick review of the week — what came up, what skills you used, what you didn't. The data we work from.
Pick the moment worth working on. Usually the one with the biggest gap between what you did and what you wanted to do.
Walk through what actually happened step by step — what set it off, what fueled it, where a skill could have changed the path.
Try the skill out loud, in role-play, in the session itself. Reading about a skill isn't the same as using one.
What you'll watch for this week, what you'll try when it shows up, what we'll look at next time.
Skills are learnable.
Start with a free 15-minute consultation. We'll talk through what you're working on and whether DBT skills are the right fit for it.
Are you a certified DBT therapist?
Janie is trained in DBT and uses DBT skills in her individual work, but she is not a certified DBT clinician and does not run a comprehensive DBT program. Full programs typically include weekly individual therapy, a separate skills group, phone coaching between sessions, and a therapist consultation team. If that level of structure is what you need, ask Janie in a consultation and she can point you toward programs that offer it.
How is DBT different from regular CBT?
Regular CBT focuses on changing thought patterns. DBT keeps the cognitive work but adds two things: acceptance (some pain and difficulty can't be reasoned away in the moment — you also need skills to ride it out) and concrete behavioral skills you actually learn and rehearse. The 'dialectical' part is the both/and stance: change what can change, accept what can't, and figure out which is which.
What does 'dialectical' mean?
It means holding two things that look contradictory and finding what's true in both. The core DBT dialectic: you're doing the best you can, AND you can do better. Both true at the same time. Most of the skills work from that frame — accept the moment as it is while also building toward something different.
Who does DBT help most?
DBT was originally developed for people experiencing severe emotion dysregulation, particularly when other approaches hadn't worked. The skills have since been shown effective for a wider range — anxiety, depression, chronic interpersonal conflict, impulsive behaviors, and patterns that intensify under stress. In a consultation Janie can give you her honest read on whether DBT skills fit what you're working on.
Is there homework?
Yes. DBT skills only work if you actually practice them outside session — that's where the change lives. You'll often leave with something specific to track or try, and we'll look at what happened the next week. It's not busywork; it's the work.