Grigore Counselling & Associates

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DBT

Feel overwhelmed by intense emotions or conflict?

DBT helps you regain control, find balance, and build a life worth living.

Dialectical Behaviour Therapy

Dialectical Behavior Therapy (DBT) is a structured form of cognitive-behavioral therapy (CBT) that teaches four core skills: mindfulness, distress tolerance, emotional regulation, and interpersonal effectiveness. While CBT focuses on changing unhelpful thought patterns, DBT adds mindfulness and acceptance to provide tools for navigating difficult situations. The “dialectical” aspect emphasizes balancing change and acceptance to help create a fulfilling life.

  • Used With Over 5 Million Clients World-Wide
  • Developed From CBT (Most-Widely Used Approach)
  • Increase Mindfulness, Acceptance, and Distress Tolerance
  • Endorsed by Leading Health Authorities Around the World

Skill 1

Mindfulness

Skill 2

Emotional Regulation

Skill 3

Distress Tolerance

Skill 4

Interpersonal Effectiveness

How Does DBT Work?

DBT is a well-researched therapy proven to reduce self-harm, improve treatment adherence, shorten treatment duration, lessen episode severity, and enhance well-being.

It teaches four core skills: mindfulness, distress tolerance, emotional regulation, and interpersonal effectiveness.

Clients often begin with mindfulness to build awareness before focusing on the most helpful skills.

DBT is typically delivered in groups alongside individual therapy, with full skill acquisition taking about six months.

DBT helps clients replace harmful coping strategies, like self-injury or substance abuse, with healthier alternatives:

  • Mindfulness: Increases awareness of triggers and responses.
  • Distress Tolerance: Teaches self-soothing and acceptance.
  • Emotional Regulation: Balances urges with rational choices.
  • Interpersonal Effectiveness: Develops assertiveness and boundary-setting skills.

DBT Can Help With...

Anxiety &
Depression

DBT helps you recognize and change negative thought patterns while encouraging positive activities that support your well-being.
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Self-Harm

DBT offers targeted strategies to manage self-harm urges and prevent unhealthy behaviours.
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Borderline
Personality
Disorder

DBT helps regulate intense emotions, build tolerance for high stress and triggers, and address related behaviors such as problematic relationships, self-harm, and impulsivity.
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Substance
Abuse

DBT helps you manage cravings, steer clear of high-risk situations, and develop healthier ways to cope with stress.
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Adolescents
& Teens

Our expert therapists can help adolescents and teens with: Social Anxiety, Social Media Compulsion, Body Dysmorphia, Suicidal Ideation, Anxiety, Depression, Substance Abuse, Trauma, Bullying, School Performance, Career Planning, Exam Stress, and more!
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Eating Disorders
& Self-Image

DBT supports managing bulimia and binge eating by building distress tolerance and emotional regulation skills.
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ADHD &
Neurodivergence

Learning DBT skills can help individuals to enhance impulse control and help you build better life organization (ADHD, ADD, Autism, etc.), and more!
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Trauma
& PTSD

DBT has proven effective in processing traumatic events and using grounding techniques to alleviate PTSD symptoms.
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Anger
Management

DBT helps you identify triggers and equips you with tools to manage emotions without resorting to aggressive behavior.
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Work Stress

Our expert therapists can help to obliterate career-related stress such as: Fear of Failure, Imposter Syndrome, Low Confidence, Procrastination, Perfectionism, Boredom, Burnout, and more!
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Daily Stress

Stress can be both positive and negative, but unmanaged negative stress can harm health. Learning effective coping strategies is key to a healthy life.
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Relationship
Stress

Individuals and couples often struggle with communication, connection, and problem-solving. Research shows structured programs like CBT & DBT improve communication, focus on shared values, and foster positive behaviours.
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Self-Confidence
& Self-Esteem

Our expert therapists can help individuals and/or couples with: Improving Self-Esteem, Self-Confidence, Performance Anxiety (Professional, Personal, or Intimate), and more!
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Healthcare
Staff

Our expert therapists can assist Nurses, Doctors, and other Healthcare Professionals (Counsellors, Physiotherapists, Massage Therapists, etc.) to Manage Day to Day Stressors, Process Trauma, Heal Vicarious Traumatization, and More!
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Employee
Engagement

Our experts can help corporations develop excellent Trauma-Informed Mental Health Skills, and Develop Comprehensive Wellness Plans, Workshops, Trainings, Wellness Retreats, and More!
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DBT Fast Facts

Five randomized controlled trials (RCTs) were identified in a systematic search that examined the efficacy of DBT in reducing suicide attempts, parasuicidal behavior, attrition during treatment, or symptoms of depression, in adult patients with BPD. DBT demonstrates efficacy in stabilizing and controlling self-destructive behavior and improving patient compliance.
Panos, P.T., Jackson, JW., Hasan, O., & Panos, A. 2014.Meta-analysis and systemic review assessing the efficacy of Dialectical Behavior Therapy (DBT). Res Soc Work Pract. 2014. 24(2): 213-223. doi: doi:10.1177/1049731513503047. Retrieved from: https://pmc.ncbi.nlm.nih.gov/articles/PMC6405261/pdf/nihms599137.pdf
DBT consistently reduces parasuicidal behavior in BPD patients, outperforming treatment-as-usual (TAU). An RCT with 44 women showed DBT reduced parasuicide, inpatient days, anger, and improved social functioning. These benefits persisted throughout the 12-month follow-up, with better social adjustment and fewer inpatient psychiatric days.
Alexander Chapman, 2006.Dialectical Behaviour Therapy: Current indications and unique elements. Retrieved from: https://pmc.ncbi.nlm.nih.gov/articles/PMC2963469/pdf/PE_3_9_62.pdf
The largest RCT of DBT to date (N=101) replicated earlier findings with a more rigorous control, treatment-by-community experts (TBCE). DBT patients showed greater reductions in suicide attempts, psychiatric hospitalization, medical risk of parasuicidal behaviour, angry behavior, and emergency room visits compared to TBCE patients over a 12-month treatment and follow-up period.
Alexander Chapman, 2006.Dialectical Behaviour Therapy: Current indications and unique elements. Retrieved from: https://pmc.ncbi.nlm.nih.gov/articles/PMC2963469/pdf/PE_3_9_62.pdf
Studies have explored DBT for women with BPD in community settings, such as mental health centers and VA hospitals. In one study, DBT, focusing on individual therapy, resulted in greater reductions in suicide attempts, self-harm, inpatient days, impulsivity, anger, and mental health issues compared to client-centered therapy. Another study of women veterans found that DBT led to greater reductions in suicidal ideation, hopelessness, depression, and anger compared to treatment-as-usual (TAU).
Alexander Chapman, 2006.Dialectical Behaviour Therapy: Current indications and unique elements. Retrieved from: https://pmc.ncbi.nlm.nih.gov/articles/PMC2963469/pdf/PE_3_9_62.pdf
DBT has shown promising results for women with BPD and a substance use disorder (SUD). One study compared DBT to treatment-as-usual (TAU) and found greater reductions in drug use and lower dropout rates during the 12-month treatment and four-month follow-up. Another study by Linehan’s group assigned opiate-dependent women with BPD to DBT or a control condition, Comprehensive Validation Treatment with 12-step (CVT-12S), both combined with opiate replacement medication. While both groups saw reductions in opiate use, DBT patients achieved greater sustained abstinence at a 16-month follow-up.
Alexander Chapman, 2006.Dialectical Behaviour Therapy: Current indications and unique elements. Retrieved from: https://pmc.ncbi.nlm.nih.gov/articles/PMC2963469/pdf/PE_3_9_62.pdf
Several RCTs outside the US have examined DBT for substance abusers with BPD. A study at CAMH in Canada (N=27) compared DBT to treatment-as-usual (TAU) and found DBT patients had greater reductions in suicidal, parasuicidal behaviors, and alcohol use, though not other drug use. Another study in the Netherlands included BPD patients, 53% with SUD, and showed DBT led to greater reductions in parasuicidal and impulsive behaviors, including alcohol use, maintained through a six-month follow-up.
Alexander Chapman, 2006.Dialectical Behaviour Therapy: Current indications and unique elements. Retrieved from: https://pmc.ncbi.nlm.nih.gov/articles/PMC2963469/pdf/PE_3_9_62.pdf
A meta-analysis indicating that both DBT-PTSD and DBT PE effectively reduce PTSD symptom severity and comorbid depressive symptoms. Further research on stage-based treatments should systematically evaluate non-suicidal self-injury (NSSI), BPD symptoms, and suicidality.
Prillinger, et. al. (2024).A systematic review and meta-analysis on the efficacy of dialectical behavior therapy variants for the treatment of post-traumatic stress disorder. Eur J Psychotraumatol. 2024;15(1):2406662. Retrieved from: https://pubmed.ncbi.nlm.nih.gov/39351658/
A multisite trial of 173 adolescents showed DBT had a significant advantage over supportive therapies in reducing repeat suicide attempts, nonsuicidal self-injury, and total self-harm. While the DBT advantage slightly declined over time, secondary analyses revealed DBT participants were more likely to maintain reduced self-harm at both post-treatment and 12-month follow-up.
McCauley, E., Berk, M. S., & Asarnow, J.R. 2018. Efficacy of Dialectical Behavior Therapy for adolescents at high risk for suicide: A randomized clinical trial. JAMA Psychiatry. 2018;75(8):777-785. doi:10.1001/jamapsychiatry.2018.1109. Retrieved from: https://jamanetwork.com/journals/jamapsychiatry/fullarticle/2685324

Our Expert DBT Therapists...

Lacey Poltorasky
MCP, RCC, CCC

**$250 Per Hour** | Adults
EMDR | TI-EMDR | DBT | Progressive Counting
Cultural Trauma | ADHD | ADD | Sexual Abuse...
English

Dr. Cindi Saj
PhD, MSW, RSW

**$200 Per Hour** | Children | Adolescents | Teens | Adults
EMDR | IFS | CBT | DBT | Hypnosis | Yoga | SFBT
ADHD | Anxiety | Trauma | Spirituality | Sleep...
English

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Ujwala Cherian | British Columbia Therapists | Langley Counselling

Ujwala Cherian
MSc, RCC

$165-$180 Per Hour** | Adolescents | Teens | Adults | Couples
Trauma-Focused CBT | DBT | EMDR
Christianity | Spirituality | Anger | Depression | PTSD...
English | Hindi

Swati Dehariya
MEd, MA, RCC

**$155 Per Hour** | Adults
ACT | CBT | DBT | EFT | Existential | Mindfulness
Self-Esteem | Immigration | Racial Identity | Grief...
English | Hindi

Learn More
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FAQ

Most frequent questions and answers

Dialectical behavior therapy (DBT) was originally developed to treat borderline personality disorder (BPD), but its effectiveness spans a wide range of mental health conditions, including:

  • Depressive disorders
  • Anxiety disorders
  • Eating disorders
  • Post-traumatic stress disorder (PTSD)
  • Substance abuse
  • Bipolar disorder
  • Borderline Personality Disorder

Even if you don’t have a diagnosed mental illness, DBT can be a helpful tool for personal growth and development. It can assist in building healthy coping strategies, enhancing relationships, and fostering a more fulfilling life.

The benefits of DBT are extensive, including:

  • Reduced emotional distress
    Improved interpersonal skills
  • Increased distress tolerance
  • Better emotion regulation
  • Enhanced mindfulness
  • Reduced suicidal thoughts and behaviors
  • Greater self-acceptance and self-compassion

Most of our sessions are virtual aside from VIP EMDR Retreats (some of our Associates may elect to offer the occasional in-person session, so it’s important to check with them).

While offering virtual sessions nearly exclusively may seem unorthodox, during the COVID-19 pandemic lock-down, Robert discovered virtual sessions were superior in many ways to in-person sessions.

Some reasons for this are: allowing clients to meet in the comfort of their home or office, allowed clients to reach a new level of authenticity by not needing to get “dressed up for the world;” and not needing to account for travel time was greatly appreciated by most of our clients who have busy schedules. Furthermore, virtual sessions require the therapist to attune much more deeply to their client, and having a therapist who is even more deeply attuned to their client, can only benefit treatment.

Both DBT and CBT are effective therapies, but they differ in key ways:

  • Focus: DBT emphasizes accepting and validating emotions, whereas CBT focuses on challenging and changing negative thoughts and behaviors.
  • Structure: DBT often incorporates group therapy with specific skills training, while CBT is typically delivered through individual sessions with a more adaptable approach.
  • Suitability: DBT is often better suited for individuals who experience intense emotions and find traditional CBT methods difficult.

You’ll know therapy is working when you notice positive changes, such as improved coping skills, better relationships, reduced symptoms, and increased self-awareness. Additionally, if you feel heard, supported, and confident in applying what you’ve learned outside of sessions, therapy is likely making a difference.

While therapy itself doesn’t typically have physical side effects, emotional discomfort can arise as you work through challenging issues. However, most people experience relief, growth, and improved well-being over time.

Yes, you can take medication while receiving DBT. In many cases, combining medication with DBT can lead to the best results for managing various mental health conditions. Your therapist and healthcare provider can work together to create the most effective treatment plan.

DBT therapists are essential in helping individuals navigate skills training, offering support, and validating their experiences. Session frequency may vary based on the program and individual needs, typically ranging from weekly to biweekly.

With that said, DBT is frequently offered in a group therapy setting. This provides individuals the opportunity to learn from one another’s experiences, practice skills in a safe space, and foster a supportive community.

Most likely. It’s important to check with your insurance carrier to determine if they cover “Registered Clinical Counselling,” “Clinical Counselling,” “Counselling,” “Mental Health Counselling,” “Psychotherapy,” “Psychological Services.”

Some carriers only cover services from Psychologists, Psychiatrists, or Social Workers. Others accept Registered Clinical Counsellors (which is our designation). 

We have conveniently included all insurance carriers where our services are accepted (although others who have not been included may still provide reimbursement if they cover Registered Clinical Counsellors). 

If you determine your carrier will accept our services in full or in part, you are required to pay in full for our services, and then seek reimbursement from your insurance carrier.

It’s confusing isn’t it? Let’s bring some clarity here.

Psychiatrists are medical doctors (MD’s) with a focus on mental health. They can formally diagnose and prescribe medications.

Psychologists are “doctors of psychology” but are not medical doctors. They have a PhD. They are allowed to diagnose mental health conditions, conduct psychological assessments, but cannot prescribe medications.

Psychotherapists and Clinical Counsellors are interchangeable designations where each province will have certain protected rights to use a particular designation. For example, in British Columbia, we are called either Registered Clinical Counsellors or Certified Clinical Counsellors; in Ontario the term used is Registered Psychotherapist. Counsellors/Psychotherapists (whichever term is used) generally have a MA level degree, are able to conduct psychological /counselling services but are not able to formally diagnose, assess, or prescribe medication. 

Social Workers are able to conduct counselling sessions and are governed by the College of Social Workers. They may also belong to other professional associations and conduct therapy/counselling/psychotherapy within those guidelines.

Social workers most often have a MA level degree, and like Clinical Counsellors/Psychotherapists, cannot formally diagnose, assess, or prescribe medication.

Hope that helps!

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