Treatment Approach / DBT
DBT Therapy.
DBT therapy in Orange County — dialectical behavior therapy (DBT) skills for adults who need emotion regulation, distress tolerance, and relationship tools — practiced daily inside our PHP/IOP DBT program, not just in a weekly therapy group skills class.
Admissions answers when you call.
A real person — never a call center.
Format
Skills + coaching
Levels of care
PHP & IOP
Modules
4 core
Evidence
Research-backed
What DBT actually is
Skills that work when emotions peak.
The question isn’t whether you need support. It’s whether the support you have matches the weight you’re carrying.
Dialectical behavior therapy (DBT) is a highly effective skills system — four modules, daily practice, individual coaching — not a diagnosis page. This URL is about how DBT works mechanically inside PHP and IOP in Orange County, CA: what each module teaches, how chain analysis runs, and how coaching turns concepts into reflexes under stress.
DBT isn’t insight therapy. It’s skills training toward a life worth living: mindfulness, distress tolerance, emotion regulation, and interpersonal effectiveness — practiced, coached, and rehearsed until they become reflexes. For BPD, DBT has the strongest evidence base of any psychotherapy approach we deliver.
If you’re looking for how borderline and other personality disorder patterns are assessed and treated at the diagnosis level, see our personality disorders page at /what-we-treat/personality-disorders. This page goes deep on the DBT curriculum itself.
Who it's for
For people who need skills, not just insight.
DBT at High Tide fits when emotional intensity drives crises and you need daily practice, not weekly discussion.
This level of care fits when
- Emotional reactions are fast and intense — and you struggle to recover once triggered.
- Self-harm, suicidal gestures, or impulsive behaviors happen when emotions overwhelm you.
- Relationships cycle through conflict because interpersonal skills haven’t been learned.
- You’ve done talk therapy and understand your patterns — but they haven’t changed.
- You want DBT skills with enough structure to actually practice them daily.
A different approach may fit better when
- Primary concern is trauma processing — EMDR or somatic therapy may lead.
- Symptoms are mild and a weekly DBT skills group with outpatient therapy is enough.
- You’re looking for insight-oriented psychodynamic therapy without skills focus.
- Primary presentation is OCD — ERP is the evidence-based first line.
What we treat here
What DBT treats best.
DBT was designed for emotion dysregulation. It helps across many conditions where emotions drive symptoms.
01
Emotion dysregulation
The core DBT target — intense emotions, slow recovery, impulsive reactions.
- Borderline patterns
- Self-harm
- Suicidal ideation
- Impulsivity
02
Mood instability
DBT skills complement medication for mood disorders with emotional flooding.
- Bipolar disorder
- Depression with emotional storms
- Anxiety with panic
- Cyclothymia
03
Relationship patterns
Interpersonal effectiveness skills for conflict, boundaries, and connection.
- Relationship instability
- Fear of abandonment
- Conflict cycles
- Social isolation
04
Substance use
Distress tolerance skills replace substances as emotion regulation tools.
- Emotion-driven use
- Impulsive use
- Relapse prevention
- Dual diagnosis
DBT skills work for many conditions — but they require practice. That’s why daily PHP and IOP structure matters.
See everything we treatWhat to expect
Programming hours and weekly groups.
Here is how PHP and IOP are structured — plus the group types offered every week. This modality is delivered inside PHP and IOP programming hours — scheduled into the week with regulation and psychiatry support, not as a fixed sample-day clock.
Our groups aim for a holistic, clinically excellent, and human approach to healing. Programs address the whole self — brain, mind, and body — with a wide range of perspectives and ways to engage in treatment. Individual therapy and psychiatry are scheduled inside PHP or IOP; the weekly mix shifts with your plan.
PHP
9 AM – 4 PM
Full-day programming five days a week — individual therapy, group work, psychiatry, and holistic practices in one integrated day.
IOP
Morning & afternoon tracks
Part-day sessions several days per week. Morning and afternoon tracks are offered so you can keep work, school, or family routines while staying anchored in treatment.
Group
Dialectical behavior therapy (DBT focus)
Dialectical behavior therapy skills for emotion regulation, distress tolerance, and interpersonal effectiveness.
Group
Therapeutic Process Groups
Small-group therapy where emotional triggers, relationship patterns, and recovery challenges surface and get worked in real time.
Group
Relationships / Family Based Groups (IFS/ACT Focus)
Internal Family Systems and Acceptance and Commitment Therapy lenses on attachment, family dynamics, and values-aligned connection — including family therapy themes when clinically useful.
Group
Physical Movement Groups
Body-based sessions that support regulation, energy, and the physical side of recovery — part of the clinical week, not optional fluff.
Group
Recovery (SUD & MH track focus)
Integrated recovery groups with substance use and mental health tracks — cravings, relapse prevention, and the mental health drivers underneath both.
Group
Somatic Healing Groups
Breathwork, sound bowls, and mindfulness exploration for nervous-system regulation and trauma-informed body awareness.
Group
Art-Based Expression / Music-Based Process Groups
Creative process groups for clients who access emotion and insight more readily through art and music than talk alone.
Group
Cognitive behavioral therapy (CBT focus)
Cognitive behavioral therapy for thought patterns, behaviors, and the loops that keep depression, anxiety, and related symptoms going.
Group
Aftercare Planning Groups
Discharge and aftercare planning so outpatient therapy, medication, recovery support, and home structure are mapped before you leave.
Group
Adventure
Experiential outdoor and adventure-based groups that practice regulation, trust, and peer connection outside the therapy room.
What's included
The four DBT modules.
Each module builds on the last. Your plan emphasizes modules most relevant to your patterns.
01
Mindfulness
Observe, describe, participate — without judgment. The skill underneath all other skills.
02
Distress tolerance
Survive crisis without making it worse — TIPP, self-soothe, radical acceptance, pros and cons.
03
Emotion regulation
Understand emotions, reduce vulnerability, change emotional responses, build positive experiences.
04
Interpersonal effectiveness
DEAR MAN, GIVE, FAST — ask for what you need, say no, maintain relationships and self-respect.
05
Chain analysis
Individual coaching that maps the links from trigger to behavior — and identifies where a skill could interrupt.
06
Phone coaching mindset
Between-session skills use — your therapist reviews what you tried and what to adjust.
What changes
What daily DBT practice builds.
Skills become reflexes — not concepts you understand but can’t execute under stress.
Daily
Skills practice in PHP — the frequency DBT was designed for.
4 modules
Full DBT curriculum available — not just distress tolerance snippets.
2–3×
Weekly individual coaching sessions for chain analysis and skills application.
Evidence
DBT has the strongest research base for borderline personality disorder and self-harm.
DBT vs. other approaches
Skills training vs. insight therapy.
DBT and CBT both work — but they emphasize different mechanisms. Here’s how to think about the difference.
DBT
This program- Primary focus
- Skills for emotion regulation and distress tolerance
- Best for
- Emotion dysregulation, self-harm, relationship instability
- Format
- Skills groups + individual coaching
- Crisis response
- Distress tolerance skills for surviving urges
- At High Tide
- Daily skills groups in PHP and IOP
CBT
The step down- Primary focus
- Thought patterns and behavioral change
- Best for
- Depression, anxiety, OCD, phobias
- Format
- Individual therapy with homework
- Crisis response
- Cognitive restructuring and exposure
- At High Tide
- Woven into individual and group sessions
How to start
From first call to first day — usually within a week.
Admissions is one phone call, not a paperwork gauntlet. Here’s the whole process.
01
Call or verify online
A confidential conversation with our admissions team — what’s going on, what you’re looking for, and whether DBT treatment is the right fit. We verify your insurance the same day, usually while you’re still on the phone.
02
Modality & program fit
We assess whether this approach belongs in PHP intensity, IOP flexibility, or outpatient cadence — and whether it should lead your plan or support other work. Modality choice follows clinical need, not marketing preference.
03
Integrated enrollment
Once admitted, your modality is scheduled inside the full program — regulation practice, psychiatry, and individual therapy around it — so EMDR, DBT, somatic work, or holistic elements land with enough structure to be safe and effective.
Most PPO plans cover this program. Verification is free, confidential, and usually same-day.
Common questions
Answers before you have to ask.
Can't find your question? Call us — a real person answers, and there's never pressure to commit.
Will insurance cover DBT therapy?
Most PPO plans cover PHP and IOP for mental health, and California parity law requires insurers to cover mental health care at the same level as physical health care. We verify your exact benefits before you commit — free, confidential, and usually same-day. Start at /insurance or read /mental-health-guides/does-insurance-cover-php-iop.
Is this modality covered inside PHP or IOP?
DBT skills are delivered inside PHP and IOP — insurance covers the program level, not the modality as a separate line item. Daily skills groups, coaching, and psychiatry are part of your covered day. Verify at /insurance.
How often will I receive this treatment?
DBT skills groups run daily in PHP and several times weekly in IOP. Individual coaching for chain analysis is scheduled 2–3× weekly in PHP.
Can this be combined with other approaches?
DBT pairs naturally with trauma processing (EMDR), psychiatry, and family work — your team coordinates which modality leads based on safety and goals. For personality patterns, see /what-we-treat/personality-disorders.
What if I only want this modality — not a full program?
Our modalities are delivered inside structured PHP, IOP, or outpatient care — not as standalone drop-in sessions. If weekly outpatient therapy with this approach is enough, we’ll say so during assessment.
What happens after I finish?
You’ll leave with outpatient referrals that continue this work — DBT skills group, trauma therapist, somatic practitioner, or psychiatrist — plus written guidance on practicing skills between sessions.
What is dialectical behavior therapy?
Dialectical behavior therapy (DBT) is a skills-based treatment with four modules — mindfulness, distress tolerance, emotion regulation, and interpersonal effectiveness — plus individual coaching. It was developed for emotion dysregulation and has the strongest evidence base for borderline personality disorder and self-harm.
Is DBT only for borderline personality disorder?
No. DBT helps whenever emotions drive crises — mood instability, anxiety with panic, substance use as emotion regulation, and relationship chaos. For diagnosis-level personality disorder assessment, see /what-we-treat/personality-disorders.