Starting therapy is a big step, and it's completely normal to have questions before your first session. What will we actually talk about? Will I have to dive into painful memories right away? What does a session even look like?
If you're considering DBT therapy at Abloom Therapy and Wellness, this guide will walk you through what typically happens during DBT sessions -- so you can arrive with a clearer picture of the work ahead and feel a little more prepared for it.
What DBT Actually Is
Before getting into the structure of a session, it helps to understand what makes DBT distinct. Dialectical Behaviour Therapy was developed by Dr. Marsha Linehan in the late 1980s and was originally designed to treat borderline personality disorder. Since then, it's been widely adapted for conditions including depression, anxiety, PTSD, eating disorders, and chronic emotional dysregulation.
The word "dialectical" refers to the core tension DBT holds: that you can accept yourself exactly as you are and work toward meaningful change at the same time. This balance is central to how DBT feels in practice. You won't be pushed to simply think positively or forced to confront everything at once. The work honours both where you are and where you're trying to go.
If you've read comparisons of cbt and dbt, you might know that CBT tends to focus heavily on identifying and changing thought patterns. DBT builds on those foundations but adds a stronger emphasis on emotional regulation, distress tolerance, mindfulness, and interpersonal skills. It's especially suited to people whose emotional experiences feel particularly intense or hard to manage.
The Structure of DBT: What's Involved
DBT in its full form has several components that work together. In standard DBT, clients typically participate in individual therapy sessions and skills training groups. At Abloom, our DBT offering is adapted for online delivery in Ontario, so the structure may be tailored to your needs and goals.
The core DBT skills training covers four modules:
- Mindfulness -- the foundation of everything else, helping you notice your experience without being pulled under by it
- Distress Tolerance -- skills for surviving crisis moments without making things worse
- Emotion Regulation -- tools for understanding and shifting emotional patterns over time
- Interpersonal Effectiveness -- skills for navigating relationships, setting limits, and communicating clearly
In your sessions, your therapist will teach these skills directly, practice them with you, and help you figure out how to apply them to real situations in your life.
What Happens in Individual Therapy Sessions
Your individual therapy sessions are where the more personal, relational work of DBT takes place. Here's a general picture of how they typically unfold.
At the start of most sessions, your therapist will check in using what's called a diary card -- a simple tracking tool where you note your emotional experiences, urges, and skill use from the past week. This isn't about being graded. It's a way to identify patterns and focus the session on what matters most right now.
From there, the session moves toward whatever the diary card reveals as most important. If you had a particularly hard moment during the week, you and your therapist might do what's called a behavioural chain analysis -- working backward through what happened to understand what triggered the moment and where a different skill might have helped. This is collaborative and curious, not critical.
Your therapist will also introduce and reinforce DBT skills training throughout your sessions, so you're not just talking about problems -- you're building a toolkit you can use outside the therapy room. Many people find this practical element to be one of the most valuable parts of DBT. You leave each session with something concrete to work with.
What to Expect in Early Sessions
In the first few sessions, your therapist will take time to understand your history, your goals, and what's bringing you to therapy right now. This initial phase is about building a clear picture together and establishing a therapeutic relationship where you feel safe enough to do the work.
You'll likely be introduced to the diary card early on, and your therapist will begin teaching foundational mindfulness skills. The early weeks tend to feel less intense emotionally -- it's a time for orientation, trust-building, and learning the basic framework.
Some people arrive expecting therapy sessions to feel immediately emotionally heavy, and are surprised to find that DBT often starts with a lot of psychoeducation and skill-building. That's by design. DBT wants you to have the tools before asking you to use them in harder emotional territory.
To learn more about how we approach this work, you can explore our DBT therapy page or read about our therapists and their backgrounds.
Online DBT at Abloom: What to Expect Practically
At Abloom Therapy and Wellness, all sessions are offered online, which means you can access individual therapy from anywhere in Ontario. Sessions typically run 50 minutes and take place over a secure video platform.
For online sessions, all you need is a private space, a stable internet connection, and a device with a camera and microphone. Many clients find that doing therapy from home actually increases their comfort and openness, particularly when working through emotionally sensitive material.
Our therapists will walk you through everything you need to know before your first session. You'll also receive any tools or materials -- like your diary card -- digitally, so you can keep track of things in the format that works best for you. If you're also exploring support for related concerns, we offer individual therapy for anxiety and depression online across Ontario.
How Long Does DBT Take?
DBT is generally considered a longer-term approach. Full standard DBT programs are typically six months to a year. That said, many people experience meaningful shifts in their quality of life within the first few months as they begin applying skills to everyday situations.
The timeline depends on your goals, the complexity of what you're working through, and how the work progresses. Your therapist will review your goals regularly and keep the focus on what's most useful for where you are right now.
Taking the First Step
If you've been curious about DBT but weren't sure what you were getting into, we hope this gives you a clearer picture. Sessions are collaborative, skills-focused, and built around a genuine belief that you can both accept yourself and build toward change -- at the same time.
Abloom Therapy and Wellness offers DBT online across Ontario, with therapists who are trained in this approach and committed to making the process feel accessible, warm, and genuinely useful. Reach out to us to book a consultation or ask any questions you have before getting started.
You don't have to have it all figured out before you begin. That's what the sessions are for.
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