Dialectical Behavior (DBT) Therapists in Frostburg, MD

Photo of Kimberly Sibley, Clinical Social Work/Therapist, LCSW-C
Kimberly Sibley
Clinical Social Work/Therapist, LCSW-C
Online Only
My approach integrates CBT, DBT, EFT, strengths-based, talk and supportive therapy.
For the past 22 years I have built a diverse background in therapy, case management & behavioral health. I've had the honor of working with individuals, families, couples, parents, professionals, first responders, military personnel, students & children navigate a wide range of challenges, including stress management, parenting, grief/loss, anxiety, depression, trauma, divorce, relationship difficulties, major life transitions, addictions & various mental health conditions. Additionally, I have experience in crisis intervention, adoption/foster care, IOP, EAP men’s abuse intervention programs, and juvenile sex offender programs.
My approach integrates CBT, DBT, EFT, strengths-based, talk and supportive therapy.
For the past 22 years I have built a diverse background in therapy, case management & behavioral health. I've had the honor of working with individuals, families, couples, parents, professionals, first responders, military personnel, students & children navigate a wide range of challenges, including stress management, parenting, grief/loss, anxiety, depression, trauma, divorce, relationship difficulties, major life transitions, addictions & various mental health conditions. Additionally, I have experience in crisis intervention, adoption/foster care, IOP, EAP men’s abuse intervention programs, and juvenile sex offender programs.
(301) 478-4554 View (301) 478-4554
Photo of Amanda M Vandivier, Counselor, PhD, LCSW-C
Amanda M Vandivier
Counselor, PhD, LCSW-C
Online Only
I’m currently accepting new clients from MD for online sessions, with set slots and flexibility week to week. Because of my own life experience (HI, MTHFR, MCAS, mold poisoning), I work with people with chronic illness. So many of us have been medically gaslit and even shamed for the way our own bodies work, and of course this affects our mental health! I take a holistic, integrative, and functional approach to mental health, recognizing that our well-being is shaped by biological, psychological, environmental, spiritual, and cultural influences. My clients are seekers who want to heal, and they are looking for someone to walk with.
I’m currently accepting new clients from MD for online sessions, with set slots and flexibility week to week. Because of my own life experience (HI, MTHFR, MCAS, mold poisoning), I work with people with chronic illness. So many of us have been medically gaslit and even shamed for the way our own bodies work, and of course this affects our mental health! I take a holistic, integrative, and functional approach to mental health, recognizing that our well-being is shaped by biological, psychological, environmental, spiritual, and cultural influences. My clients are seekers who want to heal, and they are looking for someone to walk with.
(240) 895-9744 View (240) 895-9744
Photo of Angela J Welch, Counselor, LCPC
Angela J Welch
Counselor, LCPC
1 Endorsed
Online Only
I also have training in the use of DBT skills to assist with emotion regulation.
My name is Angela Welch and I'm a licensed professional counselor in MD. I have 10 years practice in counseling, with an additional 15 years in the human services field. I provide counseling sessions via telehealth only. My practice helps clients who are struggling with anxiety, depression, and/or trauma manage symptoms through an attachment-based model, grounded in CBT. I am certified in EMDR and have found it to be life changing for those with trauma.
I also have training in the use of DBT skills to assist with emotion regulation.
My name is Angela Welch and I'm a licensed professional counselor in MD. I have 10 years practice in counseling, with an additional 15 years in the human services field. I provide counseling sessions via telehealth only. My practice helps clients who are struggling with anxiety, depression, and/or trauma manage symptoms through an attachment-based model, grounded in CBT. I am certified in EMDR and have found it to be life changing for those with trauma.
(301) 701-5088 View (301) 701-5088
Photo of Nahtanha Marler, Counselor, LCPC
Nahtanha Marler
Counselor, LCPC
Online Only
Hello, I’m Nahtanha, I am a Licensed Professional Clinical Counselor who is passionate about offering therapy that is inclusive to all. I have 3 years of experience working with a very diverse population. My clients come from a wide range of social-cultural backgrounds. I have worked with individuals and couples in dealing with depression, anxiety, trauma, body image issues, grief, low self-esteem, and life transition. I have a strength-based and person-centered approach. I work in collaborative ways that keep the client’s priorities and goals the main focus during their path to recovery.
Hello, I’m Nahtanha, I am a Licensed Professional Clinical Counselor who is passionate about offering therapy that is inclusive to all. I have 3 years of experience working with a very diverse population. My clients come from a wide range of social-cultural backgrounds. I have worked with individuals and couples in dealing with depression, anxiety, trauma, body image issues, grief, low self-esteem, and life transition. I have a strength-based and person-centered approach. I work in collaborative ways that keep the client’s priorities and goals the main focus during their path to recovery.
(240) 471-6628 View (240) 471-6628
Photo of Taylor Allen - Eating Disorder & Sport Performance Psychologist , Psychologist, PhD
Eating Disorder & Sport Performance Psychologist
Psychologist, PhD
7 Endorsed
Online Only
You feel stuck in an exhausting push-and-pull with food, your body, or the pressure to perform. Your mind feels constantly busy—tracking, judging, or negotiating around eating, exercise, or appearance. What once felt intuitive now feels rigid or overwhelming, and rest or flexibility feels hard to allow. You're longing for relief: to feel more at ease in your body, to trust yourself again, and to live with greater balance and freedom. Whether you’re navigating an eating disorder, body image concerns, or the demands of sport, you don’t have to face it alone.
You feel stuck in an exhausting push-and-pull with food, your body, or the pressure to perform. Your mind feels constantly busy—tracking, judging, or negotiating around eating, exercise, or appearance. What once felt intuitive now feels rigid or overwhelming, and rest or flexibility feels hard to allow. You're longing for relief: to feel more at ease in your body, to trust yourself again, and to live with greater balance and freedom. Whether you’re navigating an eating disorder, body image concerns, or the demands of sport, you don’t have to face it alone.
(301) 666-2923 View (301) 666-2923
Photo of Duane Boyd, Clinical Social Work/Therapist, LCSW-C
Duane Boyd
Clinical Social Work/Therapist, LCSW-C
Serves Area
Helping adolescents, men and women feel understood, grounded, and mentally strong is at the center of my work. I provide a supportive and direct approach to therapy that helps clients navigate anxiety, depression, stress, relationships, self-esteem, anger, and major life transitions. Many men, women and teens struggle silently or feel pressure to keep emotions to themselves. Therapy can be a place to reset, build healthier coping skills, and gain tools that actually fit real life. I aim to create an environment where clients feel comfortable being honest without judgment.
Helping adolescents, men and women feel understood, grounded, and mentally strong is at the center of my work. I provide a supportive and direct approach to therapy that helps clients navigate anxiety, depression, stress, relationships, self-esteem, anger, and major life transitions. Many men, women and teens struggle silently or feel pressure to keep emotions to themselves. Therapy can be a place to reset, build healthier coping skills, and gain tools that actually fit real life. I aim to create an environment where clients feel comfortable being honest without judgment.
(240) 384-4172 View (240) 384-4172
Photo of Elise Celli - Elise Celli- Chronic Illness, Men, Grief, Clinical Social Work/Therapist, LCSW-C
Elise Celli- Chronic Illness, Men, Grief
Clinical Social Work/Therapist, LCSW-C
Serves Area
I'll likely introduce distress tolerance skills ( DBT) and help you observe thoughts, feelings and behaviors (CBT), connecting the dots from past experiences to current relationships (attachment), & exploring the different parts of yourself that pop up when triggered (IFS).
Virtual openings as of 6/6/26. Hi, I’m Elise! I enjoy working with 1) stressed out or grieving men & women- I connect well with both 2) young adults entering and surviving the adulting world; 3) chronic illness and pain; 4) those who feel disconnected in relationships or choose the “wrong” people after painful childhood. As a person who has both personal & professional experience with chronic pain/illness, I get it and am here to help! I am supportive & a little spunky, but also gently challenge you so that you can reach your goals.
I'll likely introduce distress tolerance skills ( DBT) and help you observe thoughts, feelings and behaviors (CBT), connecting the dots from past experiences to current relationships (attachment), & exploring the different parts of yourself that pop up when triggered (IFS).
Virtual openings as of 6/6/26. Hi, I’m Elise! I enjoy working with 1) stressed out or grieving men & women- I connect well with both 2) young adults entering and surviving the adulting world; 3) chronic illness and pain; 4) those who feel disconnected in relationships or choose the “wrong” people after painful childhood. As a person who has both personal & professional experience with chronic pain/illness, I get it and am here to help! I am supportive & a little spunky, but also gently challenge you so that you can reach your goals.
(240) 775-1577 View (240) 775-1577

More Therapists Nearby

Photo of Yasmin Miranda, Counselor, LMHC
Yasmin Miranda
Counselor, LMHC
3 Endorsed
Online Only
Accepting new clients June 2026! Starting therapy can feel awkward or scary, especially if you’ve never done it before or you’re worried about being judged. I get that. My style is warm, conversational, and real. No jargon or pressure, just a space where you can talk honestly about what’s going on and not feel like you have to filter yourself. Many of my clients are people who tend to hold things in, help everyone else first, or feel like they should have it all together. If therapy has always seemed intimidating, my goal is to make it feel like a genuine conversation, not a cross-examination.
Accepting new clients June 2026! Starting therapy can feel awkward or scary, especially if you’ve never done it before or you’re worried about being judged. I get that. My style is warm, conversational, and real. No jargon or pressure, just a space where you can talk honestly about what’s going on and not feel like you have to filter yourself. Many of my clients are people who tend to hold things in, help everyone else first, or feel like they should have it all together. If therapy has always seemed intimidating, my goal is to make it feel like a genuine conversation, not a cross-examination.
(484) 766-4046 View (484) 766-4046
Photo of Reanna Murray, LMSW
Reanna Murray
Verified Verified
Serves Area
I often use Cognitive Behavioral Therapy (CBT) and Dialectical Behavior Therapy in my practice.
Accepts BlueCross Blue Shield, United Health Care, John Hopkins, Cigna, and more. Same week appointments available! If you’re feeling overwhelmed, anxious, or emotionally stuck, therapy can help you feel more grounded and supported. You don’t need the right words — just a place to start. Our work together focuses on the whole you: mind, body, emotions, and life circumstances. We’ll explore patterns, build practical tools, and support nervous system balance at your pace. When additional support is helpful, I can collaborate with trusted providers for referrals, ensuring your care feels coordinated and thoughtful.
I often use Cognitive Behavioral Therapy (CBT) and Dialectical Behavior Therapy in my practice.
Accepts BlueCross Blue Shield, United Health Care, John Hopkins, Cigna, and more. Same week appointments available! If you’re feeling overwhelmed, anxious, or emotionally stuck, therapy can help you feel more grounded and supported. You don’t need the right words — just a place to start. Our work together focuses on the whole you: mind, body, emotions, and life circumstances. We’ll explore patterns, build practical tools, and support nervous system balance at your pace. When additional support is helpful, I can collaborate with trusted providers for referrals, ensuring your care feels coordinated and thoughtful.
(410) 213-3947 View (410) 213-3947
Photo of Gilberto Aviles Figueroa - Trauma EMDR and Couples Therapist, Gilberto Aviles, Counselor, LGPC, NCC, MA, EMDR, DBT
Trauma EMDR and Couples Therapist, Gilberto Aviles
Counselor, LGPC, NCC, MA, EMDR, DBT
2 Endorsed
Online Only
My therapeutic approach, grounded in EMDR and DBT techniques, is tailored to your unique needs, empowering you to move forward.
Are unresolved trauma, chronic stress, or difficult relationships affecting your daily life? Do you often feel overwhelmed, exhausted, alone, unmotivated, or unsure how to manage it all, wondering if things will ever improve? Hello! I’m a Puerto Rican, (Spanish - English) bilingual therapist with availability and I am here to help. I specialize in guiding individuals, service members, and families through life transitions, healing from trauma, and building resilience through a God centered lens. Together, we can work toward creating balance, peace, and lasting growth in your life. ¡No esperes más, da el paso!
My therapeutic approach, grounded in EMDR and DBT techniques, is tailored to your unique needs, empowering you to move forward.
Are unresolved trauma, chronic stress, or difficult relationships affecting your daily life? Do you often feel overwhelmed, exhausted, alone, unmotivated, or unsure how to manage it all, wondering if things will ever improve? Hello! I’m a Puerto Rican, (Spanish - English) bilingual therapist with availability and I am here to help. I specialize in guiding individuals, service members, and families through life transitions, healing from trauma, and building resilience through a God centered lens. Together, we can work toward creating balance, peace, and lasting growth in your life. ¡No esperes más, da el paso!
(301) 327-2403 View (301) 327-2403
Photo of Dr. Margaret Kocak, Psychologist, PsyD
Dr. Margaret Kocak
Psychologist, PsyD
Cumberland, MD 21502
I am a licensed clinical psychologist in Maryland specializing in comprehensive psychological and neurodevelopmental evaluations for children and adolescents ages 5–18. While much of my work focuses on Autism Spectrum Disorder (ASD) and ADHD, my training and experience span a broad range of emotional, behavioral, and cognitive concerns, allowing me to approach each evaluation with depth, precision, and careful diagnostic consideration.
I am a licensed clinical psychologist in Maryland specializing in comprehensive psychological and neurodevelopmental evaluations for children and adolescents ages 5–18. While much of my work focuses on Autism Spectrum Disorder (ASD) and ADHD, my training and experience span a broad range of emotional, behavioral, and cognitive concerns, allowing me to approach each evaluation with depth, precision, and careful diagnostic consideration.
(301) 637-4445 View (301) 637-4445
Photo of Sharon Staniforth, Counselor
Sharon Staniforth
Counselor
Online Only
Using CBT, MI, and DBT, we'll start by exploring what's weighing on you and what you'd like to change.
You're the one others lean on. You hold it together, show up, push through — and nobody really knows how much that costs you. Maybe you're managing ADHD while keeping up with everyone else's pace. Maybe burnout has crept in so quietly you didn't notice until you had nothing left. Maybe you're rebuilding your life in a new country, or somewhere in a transition that's left you wondering who you are outside of what you do for everyone else.
Using CBT, MI, and DBT, we'll start by exploring what's weighing on you and what you'd like to change.
You're the one others lean on. You hold it together, show up, push through — and nobody really knows how much that costs you. Maybe you're managing ADHD while keeping up with everyone else's pace. Maybe burnout has crept in so quietly you didn't notice until you had nothing left. Maybe you're rebuilding your life in a new country, or somewhere in a transition that's left you wondering who you are outside of what you do for everyone else.
(301) 477-8375 View (301) 477-8375
Photo of Layne Hitchcock, Licensed Professional Counselor, MA, LPC, ALPS
Layne Hitchcock
Licensed Professional Counselor, MA, LPC, ALPS
3 Endorsed
Serves Area
What does this season of life look like right now? Are you tired, worn out, or struggling to make it day to day? Have you been bottling up or pushing aside your emotions and feel as if you might explode? Is your inner critic loud? Or are you overwhelmed with grief, loss and pain? Whether you are new to therapy or not, I work in a way that puts you at the center of everything — your goals, your pace, your values. You're not told what to do — you're supported in discovering your own healing path, with expert guidance.
What does this season of life look like right now? Are you tired, worn out, or struggling to make it day to day? Have you been bottling up or pushing aside your emotions and feel as if you might explode? Is your inner critic loud? Or are you overwhelmed with grief, loss and pain? Whether you are new to therapy or not, I work in a way that puts you at the center of everything — your goals, your pace, your values. You're not told what to do — you're supported in discovering your own healing path, with expert guidance.
(304) 684-6380 View (304) 684-6380
Photo of Josie Bodenstein, Clinical Social Work/Therapist, LCSW-C
Josie Bodenstein
Clinical Social Work/Therapist, LCSW-C
Online Only
I use multiple approaches such as CBT and DBT and psychodynamic therapy to help explore, understand and manage various symptoms and problems.
There is no cookie cutter approach or one size fits all but there are tools available to help you feel better and develop coping strategies for various problems that stand in the way. We will work together to assess the problems you are facing and find the most appropriate strategies, whether the issues are related to internal or external stressors.
I use multiple approaches such as CBT and DBT and psychodynamic therapy to help explore, understand and manage various symptoms and problems.
There is no cookie cutter approach or one size fits all but there are tools available to help you feel better and develop coping strategies for various problems that stand in the way. We will work together to assess the problems you are facing and find the most appropriate strategies, whether the issues are related to internal or external stressors.
(443) 351-6665 View (443) 351-6665
Photo of Ikechukwu Nwakanma, Clinical Social Work/Therapist
Ikechukwu Nwakanma
Clinical Social Work/Therapist
Online Only
As a Licensed Clinical Social Worker, I specialize in supporting individuals through life’s challenges—whether it’s anxiety, depression, trauma, or family stress. My ideal clients are those who are ready to make changes but may feel uncertain about where to start. Together, we’ll explore your experiences in a safe, compassionate space and build practical tools to help you cope, grow, and thrive. I use evidence-based approaches such as Cognitive Behavioral Therapy (CBT), Trauma-Informed Care, and Strengths-Based strategies, tailoring each session to your unique needs and goals.
As a Licensed Clinical Social Worker, I specialize in supporting individuals through life’s challenges—whether it’s anxiety, depression, trauma, or family stress. My ideal clients are those who are ready to make changes but may feel uncertain about where to start. Together, we’ll explore your experiences in a safe, compassionate space and build practical tools to help you cope, grow, and thrive. I use evidence-based approaches such as Cognitive Behavioral Therapy (CBT), Trauma-Informed Care, and Strengths-Based strategies, tailoring each session to your unique needs and goals.
(667) 222-5228 View (667) 222-5228
Photo of Geri Fox - Caring Space, PLLC, Clinical Social Work/Therapist, LCSW-C, LICSW, MSW
Caring Space, PLLC
Clinical Social Work/Therapist, LCSW-C, LICSW, MSW
2 Endorsed
Online Only
CBT, DBT, Solution Focused, among others.
Do you put your needs at the bottom of the to-do list? Do you wonder if life should feel somehow better or happier? Do you struggle with feeling disconnected from yourself and others? Pushing away your needs and not taking time for yourself can lead to long-term issues for your mind and body.
CBT, DBT, Solution Focused, among others.
Do you put your needs at the bottom of the to-do list? Do you wonder if life should feel somehow better or happier? Do you struggle with feeling disconnected from yourself and others? Pushing away your needs and not taking time for yourself can lead to long-term issues for your mind and body.
(304) 501-5819 View (304) 501-5819
Photo of Kami Bauer, Licensed Clinical Professional Counselor, LCPC
Kami Bauer
Licensed Clinical Professional Counselor, LCPC
1 Endorsed
Online Only
The need to be heard, understood, and validated without judgement is a need that crosses generational lines, backgrounds, beliefs, and cultures. I work with clients who struggle with anxiety, panic attacks, complex trauma, and insecure attachment styles by helping them understand the whys behind it, along with brain-based approaches and specialized integrative treatment plans designed for their individual needs.
The need to be heard, understood, and validated without judgement is a need that crosses generational lines, backgrounds, beliefs, and cultures. I work with clients who struggle with anxiety, panic attacks, complex trauma, and insecure attachment styles by helping them understand the whys behind it, along with brain-based approaches and specialized integrative treatment plans designed for their individual needs.
(240) 219-4995 View (240) 219-4995
Photo of Seme J Ndzana, Counselor, LGPC, MA, MBA, MCCC
Seme J Ndzana
Counselor, LGPC, MA, MBA, MCCC
Online Only
My integrative approach draws from CBT, DBT, ACT, Psychodynamic, and Multicultural therapies.
I specialize in helping clients recover from anxiety, depression, trauma, OCD, addiction, and life transition issues. Using CBT, DBT, ACT, and integrative therapies, I provide individual, couples, family, and group counseling. Sessions are available in English or French, with faith-based care upon request.
My integrative approach draws from CBT, DBT, ACT, Psychodynamic, and Multicultural therapies.
I specialize in helping clients recover from anxiety, depression, trauma, OCD, addiction, and life transition issues. Using CBT, DBT, ACT, and integrative therapies, I provide individual, couples, family, and group counseling. Sessions are available in English or French, with faith-based care upon request.
(240) 451-8226 View (240) 451-8226
Photo of Janice Hare, Clinical Social Work/Therapist, LCSW, LCSW-C, CWC
Janice Hare
Clinical Social Work/Therapist, LCSW, LCSW-C, CWC
Online Only
I use a range of therapeutic approaches in my practice, including Cognitive Behavioral Therapy (CBT), Dialectical Behavioral Therapy ( DBT), Solution-Focused Therapy, and Client-Centered Therapy.
I am a licensed therapist in Delaware, Maryland, and now Virginia, currently welcoming new clients who are ready to take the next step toward healing, growth, and emotional well-being. If you’ve been feeling overwhelmed, stuck, or exhausted from carrying so much on your own, you don’t have to do it alone anymore. I provide a warm, compassionate, space where you can feel heard, supported, and empowered. Using a client-centered approach, I incorporate Cognitive Behavioral Therapy (CBT) and solution-focused strategies tailored to your unique goals. I work with adults and families navigating anxiety, trauma, depression.
I use a range of therapeutic approaches in my practice, including Cognitive Behavioral Therapy (CBT), Dialectical Behavioral Therapy ( DBT), Solution-Focused Therapy, and Client-Centered Therapy.
I am a licensed therapist in Delaware, Maryland, and now Virginia, currently welcoming new clients who are ready to take the next step toward healing, growth, and emotional well-being. If you’ve been feeling overwhelmed, stuck, or exhausted from carrying so much on your own, you don’t have to do it alone anymore. I provide a warm, compassionate, space where you can feel heard, supported, and empowered. Using a client-centered approach, I incorporate Cognitive Behavioral Therapy (CBT) and solution-focused strategies tailored to your unique goals. I work with adults and families navigating anxiety, trauma, depression.
(240) 932-5529 View (240) 932-5529
Photo of Shanika McCallum-Coppage, Licensed Clinical Professional Counselor, LCPC, NCC
Shanika McCallum-Coppage
Licensed Clinical Professional Counselor, LCPC, NCC
3 Endorsed
Cumberland, MD 21502
Waitlist for new clients
I am a Licensed Clinical Professional Counselor and National Certified Counselor, with specializations in CBT, DBT, and Trauma-Informed approaches.
My ideal client is someone who is ready to engage in self-exploration, even if they feel unsure or overwhelmed about where to start. They may be navigating challenges such as anxiety, depression, trauma, identity struggles, or life transitions. Some have experienced generational patterns of dysfunction or a lack of emotional support and are now seeking to break cycles and build healthier lives. This client often comes to therapy feeling stuck, misunderstood, or emotionally exhausted. They may carry a deep desire to feel empowered, seen, and validated.
I am a Licensed Clinical Professional Counselor and National Certified Counselor, with specializations in CBT, DBT, and Trauma-Informed approaches.
My ideal client is someone who is ready to engage in self-exploration, even if they feel unsure or overwhelmed about where to start. They may be navigating challenges such as anxiety, depression, trauma, identity struggles, or life transitions. Some have experienced generational patterns of dysfunction or a lack of emotional support and are now seeking to break cycles and build healthier lives. This client often comes to therapy feeling stuck, misunderstood, or emotionally exhausted. They may carry a deep desire to feel empowered, seen, and validated.
(443) 342-9891 View (443) 342-9891

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Dialectical Behavior (DBT) Therapists
Who is DBT for?
Dialectical Behavior Therapy (DBT) is designed for people who experience extreme emotional suffering because they lack the skills of emotion regulation and distress tolerance. The basic affliction can underlie a wide range of conditions, from borderline and other personality disorders to PTSD and treatment-resistant anxiety and depression. The therapy is helpful to those whose emotional reactivity is so intense it is disruptive to everyday functioning and leads to frequent crises.

Why do people need DBT?
The ability to regulate emotions is a core psychological skill that enables people to function in life and pay attention to the world outside themselves; it is consistently associated with well-being. DBT is designed to help people learn how to manage and regulate their emotions. Originally developed to treat people with borderline personality disorder whose extreme emotional suffering led to self-harming behavior and suicide attempts, the therapy is now applied to other conditions involving emotion dysregulation, particularly when other treatments have failed.

What happens in DBT?
Individuals meet weekly with their therapist to discuss their experiences relating to moods, behavior, and skills. Using checklists they maintain, they review emotional experiences and positive practices they engage in. The diaries help individuals discern what led up to a specific problem encountered, this is followed by discussion of the consequences of their actions. In addition, individuals may meet in class-like small groups to learn skills such as mindfulness, emotion regulation and distress tolerance.

How long does DBT last?
Because it is intended to establish long-lasting behavioral change among those with persistent problems, DBT is designed to last six months to a year. DBT includes both weekly sessions of individual therapy and weekly skills-training sessions conducted in small groups. Studies of DBT have documented improvement within a year of treatment, particularly in controlling self-harmful behavior; nevertheless, individuals may require therapy for several years.