Why DBT Works for Trauma
DBT, or Dialectical Behavioural Therapy, is a structured psychotherapy originally developed to help people experiencing very intense emotions, self-harm behaviours and borderline personality disorder. Over time it has been adapted to help people experiencing trauma and post-traumatic stress as well.
At its core DBT teaches four key skill-areas:
Mindfulness (being present and aware)
Distress tolerance (coping when things feel intolerable)
Emotion regulation (understanding and managing intense emotions)
Interpersonal effectiveness (managing relationships, setting boundaries)
When someone has experienced trauma, whether a single event or repeated/complex trauma, these skills become especially relevant. DBT provides tools not just to process trauma but to help stabilize and build resilience so the person can engage in healing.
What Types of Trauma Can DBT Be Used For
DBT has been used for a range of trauma-related conditions and experiences, including:
Single‐incident trauma (for example, a serious accident, assault, natural disaster)
Repeated or ongoing trauma (for example childhood abuse, chronic neglect, complex interpersonal trauma)
Trauma that leads to or overlaps with diagnoses such as Post‑Traumatic Stress Disorder (PTSD) or Complex Post‑Traumatic Stress Disorder (CPTSD)
Trauma that is accompanied by behaviours such as self-harm, emotion dysregulation, relationship instability (areas DBT was originally built for)
In other words, DBT is not only for “borderline personality disorder” but it has been adapted for trauma work and shows good evidence of effectiveness in many trauma-populations.
How DBT Is Used for Trauma
Here are some ways DBT is applied when working with trauma survivors (clients) in therapy:
Stabilization and Skills Building
Before addressing trauma memories directly, DBT focuses on stabilisation — helping you to be safe, grounded, able to tolerate distress, and regulate intense emotional responses. This is especially important in trauma because memories / triggers can activate overwhelming emotions or dissociation
Skills training (mindfulness, distress tolerance, emotion regulation, interpersonal effectiveness) becomes the foundation for being able to engage in deeper trauma-work without becoming retraumatized or overwhelmed.
Trauma-Focused Adaptations
There are adaptations of DBT specifically for trauma: for example DBT‑PTSD (Dialectical Behaviour Therapy for PTSD) and DBT PE (DBT with Prolonged Exposure).
These adaptations include modules that directly address trauma-related emotions (fear, shame, guilt, powerlessness), help reduce avoidance of trauma memories, and include exposure-based work in a supported way.
Integration of Skill Use and Exposure
For example, during exposure to trauma memories the DBT skills (mindfulness, distress tolerance, emotion regulation) are used “in the moment” to help you stay present, notice what is happening, and manage your reaction. In that way, you gradually build the capacity to process trauma without being flooded.
Interpersonal effectiveness skills help you set boundaries, communicate your needs and manage relationships that may have been impacted by trauma.
Phase-Based Approach
Many trauma-adapted DBT programmes use a phase-based model: first stabilise and build skills; then trauma processing; then consolidation and integration. This helps to avoid jumping straight into the hardest work before the foundation is in place.
This is especially valuable for complex trauma, where clients may have layered difficulties (emotion dysregulation, self-harm, relationship instability) and need the skills component before trauma-processing.
What the Research Shows
Here’s a summary of what studies and meta-analyses tell us about DBT’s effectiveness for trauma:
A large meta-analysis found that trauma-specific DBT treatments (DBT-PTSD, DBT PE) showed moderate effect sizes in reducing PTSD symptom severity and comorbid depressive symptoms.
One study found DBT-PTSD outperformed treatment-as-usual in reducing trauma related symptoms, dissociation and other trauma-based reports in a real-world clinical setting.
While DBT is promising for trauma, it is not necessarily a “magic bullet” — it works best when tailored to trauma, delivered by trained clinicians, and integrated thoughtfully.
What This Means for You
If you are considering therapy for trauma or what might feel like ongoing effects of trauma (such as persistent emotional dysregulation, self-harm urges, difficulty managing relationships, intrusive memories, hypervigilance, etc) here are some key points to consider:
Understand that part of the work will involve building your capacity (skills-work) before or alongside deeper trauma-processing. That might feel slower than a “straight to trauma memory” approach, but it helps you build safety and resilience.
Expect a combination of individual sessions, skills-group work (if offered), and practice outside of session (homework, skills use in real life).
Be aware that trauma work can stir up strong emotions and require commitment, but with the right support and foundation it can lead to meaningful change.
If you find yourself dropping out or avoiding sessions, that may reduce the benefits — adherence really matters in research findings.
DBT can help with not just trauma symptoms but the wider emotional and relational impact of trauma: managing impulses, communicating needs, staying grounded when triggered, and building more stable relationships.
How This Fits With a Mindfulness-Based Therapy Practice
Because your practice is mindfulness-based, you already have a strong match with one of the core pillars of DBT (mindfulness). Mindfulness is foundational for trauma survivors who may find themselves either stuck in the past or in high alert in the present. DBT simply builds on that by layering in distress tolerance, emotion regulation and interpersonal skills, and then adapts them for trauma contexts.
In your blog or in your practice you might emphasise how mindfulness isn’t just “quieting the mind” but helping someone stay grounded when trauma triggers arise, observing what comes up without judgement, and using that as a platform to change how one reacts rather than being overwhelmed.
Conclusion
DBT is a well-evidenced therapy for people with intense emotional and behavioural challenges, and has been adapted for trauma work. It works best when trauma-specific adaptations are used, when clients build skills first, and when therapists are experienced in trauma work.
If you are considering therapy for trauma, consider whether DBT (or trauma-adapted DBT) might be a good fit for your goals, especially if you struggle with emotional regulation, relationship issues, self-harm risks or persistent trauma symptoms.
Contact us to learn more about how we utilize DBT to treat trauma.
