DBT is a treatment that combines the benefits of both behaviorism and cognitive behavioral therapy, the radical acceptance strategies including meditation of Zen Buddhism, the warmth and validation of relationship-centered therapies such as that of Carl Rogers, and the perhaps undervalued power of psycho-education. DBT is both structured and flexible; it contains four primary treatment modes: weekly individual therapy, a weekly 2 hour psycho-educational skills training class; telephone contact with the therapist if a crisis occurs, and a weekly consult group for therapists. The overriding goal is to help the borderline client learn how to regulate her emotions, tolerate distress without self-harm or impulsive actions, act interpersonally effective, and focus and control her attention. Individual therapy sessions are directed to helping the client use the skills she is learning in the psycho-educational group, telephone contact is designed to help the client get through a crisis without doing something that makes it worse or sends her to a hospital, and the therapist consult group is to insure therapists are working within the DBT framework. Borderline clients can be difficult and therapists need support.

The core strategies in DBT represent a balance or a synthesis of validation and problem solving. Attempts to help the client change are balanced by interventions that validate her current feelings and actions as completely understandable given her past history and current situation. The opposing points of validation/acceptance of the client as she is and the message she needs to do better and work harder to change runs throughout DBT. Validation is a critical strategy, because invalidation played a significant role in producing the borderline symptoms.