Dialectical Behavior Therapy

When feelings are too big to manage alone.

DBT was developed by Marsha Linehan for patients whose emotions had overwhelmed every other framework. Today it is the evidence-based treatment for co-occurring substance use, trauma, borderline personality disorder, and mood dysregulation. At Pines, we deliver DBT-informed therapy and skills groups inside residential.

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4 ModulesIndividual + GroupDual-Diagnosis Friendly

Accredited & Certified

Joint CommissionGold Seal of Approval

LegitScriptCertified

SAMHSAListed

Florida DCFLicensed Provider

HIPAACompliant

DEARegistered

What DBT Is

Acceptance and change, held in balance.

DBT grew out of CBT in the 1980s when Marsha Linehan found that standard CBT wasn’t working for her most distressed patients. The addition was a “dialectic” — a balance of acceptance (this is what is) and change (this can be different). That shift transformed outcomes for patients the system had often given up on.

DBT is now first-line for borderline personality disorder (Linehan et al., 1991) and is adapted for substance use disorder, trauma, eating disorders, and chronic mood dysregulation. Coverage of DBT for SUD in NIDA and SAMHSA guidance recognizes it as an evidence-based option for this population.

The Four Modules

Every skill has a name, and a job.

DBT skills are taught explicitly — named, written down, rehearsed. You leave Pines with a reference binder you will use for years.

Module One

Mindfulness

The foundation. Observe, describe, and participate without judgment. Mindfulness skills anchor the other three modules and interrupt the autopilot that drives substance use.

Module Two

Distress Tolerance

For the moments you cannot fix. TIP (temperature, intense exercise, paced breathing), radical acceptance, distraction, self-soothing. These are the skills that prevent a craving from becoming a relapse.

Module Three

Emotion Regulation

Name the emotion, reduce vulnerability (PLEASE skills — sleep, nutrition, exercise, illness care), opposite action, check the facts. Build a life worth staying sober for.

Module Four

Interpersonal Effectiveness

DEAR MAN for getting needs met, GIVE for maintaining relationships, FAST for preserving self-respect. Because relationships are both the biggest trigger for relapse and the biggest protective factor in recovery.

How We Use DBT at Pines

DBT-informed care, fully integrated.

Every patient at Pines has access to DBT skills groups as part of residential programming. Patients with trauma, BPD, chronic suicidality, severe emotion dysregulation, or failed prior treatment are typically matched to a primary therapist with DBT training for individual work.

Our clinical lead, Travis Gray (LMHC, CAP, LPC), brings trauma-specialized training to DBT delivery. Full comprehensive DBT programs typically span six to twelve months; we begin the work at Pines and coordinate continuation through partner outpatient programs at discharge.

Dual diagnosis at Pines

Daily

DBT skills groupRotating module, 60–90 minutes.

2–3×/wk

Individual DBT therapyChain analysis, skills coaching, diary cards.

Ongoing

Diary cardDaily self-monitoring of emotions, urges, skills use.

Discharge

Aftercare continuationWarm handoff to DBT-trained outpatient clinician.

Who Benefits Most

When DBT is the right fit.

Co-Occurring BPD

The condition DBT was designed for. Pair with any substance use disorder — alcohol, opioids, stimulants.

PTSD & Complex Trauma

DBT’s distress tolerance and emotion regulation skills are often the groundwork before trauma-focused therapy.

Chronic Suicidality / Self-Harm

DBT is first-line. Comprehensive stabilization before deeper work.

Mood Dysregulation

Including bipolar spectrum. Works alongside psychiatric medication managed by Dr. Litvinov.

Relapse After CBT

If CBT alone hasn’t held, DBT’s acceptance framework often provides the missing piece.

High-Reactivity Presentations

Anger, impulsivity, relationship instability that has driven substance use.

Why Pines for dialectical behavior therapy

Physician-led, accredited, and built for unhurried care.

The choice of where to receive dialectical behavior therapy matters. Patients and families weigh credentials, environment, and continuity of care alongside cost and coverage. Here is what consistently brings people to our 18,000 sq ft private clinical campus in Pembroke Pines, Florida.

Physician-ledPsychiatrist Medical Director

Medical Director Sergey Litvinov, MD — a board-certified psychiatrist — directs clinical care. Every patient is reviewed by an attending physician, not a counselor signing off on a protocol.

Joint Commission accreditedGold Seal of Approval

Independent accreditation by the nation’s most recognized healthcare standards body. Surveyed against rigorous safety and quality standards.

LegitScript certifiedVerified addiction-treatment provider

LegitScript certification is the standard required by Google, Microsoft, and Meta to advertise addiction treatment. It signals an audited, transparent operator.

Co-occurring capabilityDual diagnosis from day one

Depression, anxiety, trauma, and ADHD frequently co-occur with substance use. Psychiatric assessment and care run in parallel with detox, not after.

In-network with major payersBCBS, UHC, Aetna, Cigna, Tricare

Most commercial and military plans are accepted. Verification is free, confidential, and typically completed in under 60 seconds.

Private 18,000 sq ft campus40-patient maximum

Private bedrooms, dedicated medical detox wing, therapy rooms sized for real clinical work, outdoor grounds. Not a strip-mall storefront.

Authoritative references and related resources.

Clinical authorities & sources. ASAM — Clinical Practice Guidelines · SAMHSA — National Helpline · CDC — Overdose Prevention

Related Pines resources. Medical detox · Residential inpatient · Dual diagnosis · Admissions process · Insurance carriers · For families

Insurance Coverage

DBT is covered. Verify in under a minute.

DBT delivered within residential is covered by every major carrier under Mental Health Parity.

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BCBS · UnitedHealthcare · Aetna · Cigna · Tricare · Humana Military · VA CCN

DBT — FAQ

Common questions.

Who is DBT best suited for?+

DBT was developed for high-distress, high-reactivity presentations — BPD, chronic suicidality, self-injury — and adapted for SUD, trauma, eating disorders, and mood dysregulation. If emotions feel intense and unmanageable, DBT is often the right fit.

Is DBT different from CBT?+

Yes. DBT grew out of CBT but adds acceptance and dialectical framework. Where CBT focuses on changing thoughts and behaviors, DBT balances change with radical acceptance and adds four skill modules.

What are the four DBT modules?+

Mindfulness, distress tolerance, emotion regulation, and interpersonal effectiveness. Each module teaches a set of concrete, named skills designed to be practiced daily.

Does Pines offer full DBT?+

Pines offers DBT-informed individual therapy and DBT skills groups within residential. Full, structured comprehensive DBT programs span six to twelve months — longer than residential. We start the work here and coordinate continuation through aftercare partners.

Is DBT covered by insurance?+

Yes. DBT delivered within medically necessary detox and residential care is covered by every major carrier under Mental Health Parity.

Reviewed by Sergey Litvinov, MD — Medical Director, board-certified psychiatrist. Updated April 2026.

Citations: Linehan 1991 (PubMed) · APA RCT · NIDA · SAMHSA