Many people with social anxiety are successful in overcoming their anxiety-driven challenges through the use of traditional treatments like talk therapy, including a form of therapy that’s known as cognitive behavioral therapy (CBT). For some, anxiety medication is helpful. However, others find the use of dialectical behavior therapy (DBT) to be the most beneficial anxiety treatment. 

Dialectical behavior therapy is evidence-based psychotherapy, similar to CBT, but focused specifically on the social-emotional aspects of life. In a recent study DBT improved emotional regulation and mindfulness more effectively than CBT. If you’ve tried other treatments for anxiety without success, DBT skills for anxiety may be a more effective way to treat and manage your symptoms. Learn how in-person or online DBT therapy might be the answer you are looking for.

Is DBT Good for Treating Anxiety?

Does DBT work for anxiety? While CBT is often the first treatment approach for people with anxiety, it’s not always successful for everyone. Dialectical behavioral therapy is an alternative treatment for anxiety, especially for those with emotional dysregulation. DBT therapy for anxiety is a more specific form of cognitive behavioral therapy that teaches people with anxiety how to interact with their environment in healthier, less emotional, more productive ways.

“DBT is an effective therapeutic tool to help manage anxiety. The distress tolerance skills help target anxiety when it’s severe and intense, for example during a panic attack. DBT helps target the physical symptoms of anxiety by changing the body temperature which helps decrease anxiety.”

Talkspace therapist Bisma Anwar, MA, MSc, LMHC

While for some people, certain other forms of treatment may show a higher efficacy rate, DBT has been found especially beneficial for those who didn’t have success with other therapies. In a recent study, roughly 22% of people with social anxiety who received DBT treatment had a successful outcome. 

Treatment with DBT for anxiety can be very useful for those who struggle with emotional and impulsive behaviors associated with rejection or pain, like sexual or domestic assault survivors. In addition, DBT can be helpful for people with self-harm or suicidal ideation tendencies. 

How Does DBT Work for Anxiety?

DBT focuses on changing negative behavior patterns instead of talking someone through their anxious thoughts. Although dialectical behavior therapy was initially developed for and used to treat people with borderline personality disorder, many of its concepts and tools are helpful for people with anxiety and other mental health conditions. 

Therapy doesn’t just teach emotional and cognitive skills. It also shows you how to apply those skills in real life. This process can improve emotional regulation, ultimately training you to achieve better control over your feelings, which can be hugely beneficial in managing anxiety. Multiple studies have demonstrated that the coping skills learned through DBT for managing anxiety can successfully reduce symptoms. 

“DBT focuses on managing anxiety by focusing on physical symptoms such as rapid breathing, racing heart rate or pulse, and muscle tenseness. Some of the skills are specifically designed to help manage these symptoms and decrease overall anxiety.”

Talkspace therapist Bisma Anwar, MA, MSc, LMHC

DBT Techniques for Anxiety

DBT for anxiety usually consists of individual therapy, group skills training, homework, and skills coaching. These pieces work together so you can learn how to be in control of your emotions and feelings. 

In addition, dialectical behavior therapy uses four techniques to treat anxiety, including: 

  • Mindfulness
  • Distress tolerance
  • Emotional regulation
  • Interpersonal effectiveness


Mindfulness is the foundational skill in DBT. Mindfulness teaches self-awareness and the ability to be present in the here and now. This technique helps people who excessively worry about past events or fear the future. Learning how to be grounded in the present can help you filter out past trauma and focus on the moment. 

Distress tolerance

Anxiety and fear are emotions that can seem unbearable at times. The distress tolerance technique helps people who suffer from anxiety learn how to tolerate these intense emotions and avoid behavior that may worsen them. 

“Distress tolerance skills teach clients how to breathe and move their bodies to prevent increased anxiety or a panic attack. Therapists trained in DBT can tailor the skills to their clients’ needs and make it easy for them to implement these in their daily lives.” – Talkspace therapist Bisma Anwar, LMHC

Talkspace therapist Bisma Anwar, MA, MSc, LMHC

Distress tolerance includes learning and applying skills that can be used in place of unhealthy or destructive behaviors. For example, radical acceptance  is a taught skill that empowers you to deal with panic-inducing thoughts in a better way. Radical acceptance can be very effective at helping break the cycle of anxiety. 

Instead of contemplating how something should be different, radical acceptance teaches self-soothing techniques to tune out negative thoughts and worry. Deep breathing, taking a mental timeout, visualization, and other techniques can all be implemented during the distress tolerance component of DBT. 

Emotional regulation

Emotional regulation is the third module of DBT, which teaches people with anxiety to manage overwhelming emotions. In addition to addressing negative emotions, this part of therapy aims to increase positive emotions.

Emotional regulation includes:

  • Understanding one’s emotions
  • Reducing emotional vulnerability
  • Decreasing emotional suffering

This module teaches that negative emotions are not necessarily harmful and don’t need to be avoided. However, there are ways to acknowledge negative emotions and then let them go. Once you learn how to do this, you won’t be controlled by them. 

Interpersonal effectiveness

The last module, interpersonal effectiveness, teaches you to deal with others. For example, if your anxiety prevents you from telling someone no, or if you often feel taken advantage of, focusing on interpersonal effectiveness skills can prepare you to handle these situations better. 

By practicing healthy responses to everyday situations, you can learn to apply them in real life. 

Get Professional Help for Anxiety with Talkspace  

If you’ve been diagnosed with anxiety and feel overwhelmed by fear or emotions, rest assured that your life doesn’t have to be this way forever. Treatment is available. While the first approach is usually a form of psychotherapy, know that sometimes, medication is necessary. 

Cognitive behavioral therapy may be successful for many people who suffer from anxiety, but it’s not effective for everyone. If CBT doesn’t work for you, DBT techniques for anxiety might be more effective. DBT has been a valuable alternative for many people who’ve tried CBT with little to no success. 

The first step is to find a mental health provider who you can trust and who can start teaching you DBT skills for anxiety. For some, online therapy is an easy way to begin the process. Talkspace is an online therapy platform that offers therapy and support from experienced mental health experts.

Remember, anxiety can feel overwhelming, but with the proper treatment, possibly including DBT therapy for anxiety, you can live a successful and rewarding life, where you control your anxiety, instead of letting it control you. 

For more information on DBT techniques, and in particular, DBT for bipolar or DBT for depression, turn to Talkspace.

Medically reviewed by: Elizabeth Keohan, LCSW-C, MSW

Reviewed On: September 28, 2022