Dialectical Behaviour Therapy in Surrey BC

When Emotions Feel Too Big to Manage

Some people feel things more intensely than others. Anger that goes from zero to a hundred, waves of sadness or shame that are hard to come back from, conflict that keeps damaging the relationships that matter most. For teens especially, big emotions can show up as slammed doors, school refusal, risky choices, or hurting themselves to get relief. If this sounds like your family, or like you, Dialectical Behaviour Therapy may help.

At Sojourn Counselling and Neurofeedback in Cloverdale, Surrey, we offer DBT informed counselling for teens, adults, and families, in person and online across British Columbia, with evening and weekend appointments available. Our lead DBT counsellor, Katherine Ouano, MEd RCC, has completed formal DBT training (Levels 1 and 2) and brings over 25 years of experience with children, youth, adults, and families.

What Is Dialectical Behaviour Therapy?

Dialectical Behaviour Therapy (DBT) is an evidence based approach developed by psychologist Marsha Linehan in the late 1980s for people who experience intense, fast moving emotions and who had not been helped by standard talk therapy. The word dialectical points to the heart of the approach: two things that seem like opposites can both be true. You are doing the best you can, and you can learn skills to do better. Your feelings make sense, and some of the ways you cope with them may be hurting you.

DBT blends the practical, thought and behaviour focused tools of cognitive behavioural therapy with mindfulness and acceptance practices drawn from contemplative traditions. Rather than only talking about problems, DBT teaches concrete, named skills you can practise between sessions and use in the moments that are hardest. It has since been adapted for adolescents (DBT-A), for trauma, and for a wide range of concerns beyond the borderline personality disorder it was first designed to treat.

The Four DBT Skill Areas, and the Skills Inside Them

Most descriptions of DBT stop at the four module names. The skills inside them are what actually change daily life, so here is a closer look at what you would learn.

Mindfulness

Learning to notice what is happening inside you, thoughts, feelings, body sensations, without immediately reacting to it. Core skills include Wise Mind (finding the place where emotion and reason overlap, rather than being ruled by either), and the what and how skills: observe, describe, and participate, done non judgementally, one thing at a time, and effectively. Mindfulness is the foundation the other three modules build on. If this way of working appeals to you as a whole approach, not just one skill module, see our page on mindfulness based therapy.

Distress Tolerance

Skills for surviving intense moments without making things worse. TIPP uses temperature, intense exercise, paced breathing, and paired muscle relaxation to bring the body’s arousal down fast. STOP creates a pause before acting on an urge. Self soothing and distraction get you through a crisis hour. Radical acceptance is the harder, longer skill: fully accepting reality as it is, so that energy stops going into fighting what cannot be changed.

Emotion Regulation

Understanding what your emotions are telling you and reducing your vulnerability to emotional storms. Skills include naming and understanding emotions, checking the facts (does the intensity fit the situation?), opposite action (acting opposite to an emotion’s urge when the emotion does not fit the facts, such as approaching rather than avoiding), and PLEASE, caring for physical health, sleep, eating, and movement, because a depleted body has a shorter fuse.

Interpersonal Effectiveness

Asking for what you need, saying no, and handling conflict in ways that protect both the relationship and your self respect. DEAR MAN structures a request so it is more likely to be heard. GIVE keeps the relationship intact while you do it. FAST protects your self respect. For teens, this often means navigating friendships, family expectations, and social pressure; for adults, it often shows up at work and in partnerships.

Who DBT Informed Counselling May Help

Many clients find DBT skills helpful when they are dealing with:

• Emotions that feel overwhelming, fast, or out of proportion to the situation
• Self harm urges or other impulsive coping that brings short term relief and longer term pain
• Anger outbursts followed by shame or regret
• Anxiety, panic, or low mood that strains relationships and daily functioning
• Teen emotional dysregulation, school stress, and family conflict
• ADHD or neurodivergence, where big feelings and impulsivity make daily life harder
• Trauma responses, including the emotional swings and shutdown that often come with complex trauma
• Patterns often associated with borderline personality disorder, for which DBT was originally developed
• Relationship conflict driven by emotional reactivity, and difficulty repairing after a rupture

If you or your child are in immediate danger or thinking about suicide, please call or text 988, call 911, or go to your nearest emergency room. Counselling is not an emergency service.

DBT for Anxiety and Low Mood

Anxiety and depression are often described as thinking problems, and CBT is very good at addressing the thoughts. But for many people the harder part is the feeling itself: the panic that arrives before any thought, the heaviness that will not lift, the avoidance that follows. DBT skills work directly on that layer. Distress tolerance skills help you ride out a panic spike without escaping; opposite action is one of the most effective tools for depression, moving toward activity and connection when every urge says withdraw; and mindfulness reduces the rumination that keeps both anxiety and low mood going. DBT informed work fits well alongside our anxiety counselling and depression therapy.

DBT and Trauma

Trauma, especially complex or developmental trauma, often leaves the nervous system swinging between too much and too little: hypervigilance, flooding, and anger on one side; numbness, shutdown, and dissociation on the other. Emotion regulation and distress tolerance skills give people a way to steady themselves in those swings, which is why DBT skills are frequently taught before or alongside memory focused trauma work. In practice this means DBT informed skills can prepare the ground for EMDR, or provide the stability someone needs when trauma processing is not yet the right step. See our PTSD therapy and complex trauma therapy pages for how we approach trauma more broadly.

DBT and ADHD

Emotional dysregulation is one of the least discussed and most disruptive parts of ADHD: feelings arrive fast and at full volume, and the brakes arrive late. DBT skills, particularly STOP, TIPP, and checking the facts, are practical enough to be used in the moment, and they are often adapted for ADHD brains: shorter, more concrete, more visual, and rehearsed rather than just discussed. Many adults and teens with ADHD find that DBT informed counselling, sometimes combined with neurofeedback for ADHD, gives them a regulation toolkit that medication alone does not. Learn more about our ADHD counselling.

DBT for Adults

Emotional intensity does not end at adolescence; many adults have simply become skilled at hiding it. It can look like a temper that costs you at work or at home, relationships that swing between closeness and conflict, harsh self criticism, or coping habits, drinking, spending, shutting down, that quietly take more than they give.

DBT informed counselling gives adults a practical framework: understand what your emotions are doing, build the skills to steady yourself in hard moments, and change the patterns that keep costing you. For many adults it pairs naturally with couples work, trauma therapy, or neurofeedback as things settle.

DBT for Teens

Adolescence turns the volume up on everything. A teen who struggles to regulate emotions is not being dramatic or difficult; their brain is still building the machinery for it. DBT for adolescents (DBT-A) adds a fifth module, Walking the Middle Path, that works on the tug of war between teens and parents. We have a dedicated page on DBT for teens in Surrey, including how parents are involved and how evening and weekend appointments work around school.

How DBT Works at Sojourn

A full model DBT program includes weekly individual therapy, a separate skills group, phone coaching between sessions, and a therapist consultation team. At Sojourn we offer DBT informed individual counselling: your counsellor weaves DBT skills training through one to one therapy, at a pace that fits you, alongside other approaches that suit your goals, such as CBT, EMDR, emotionally focused therapy, or neurofeedback. Many clients find this integrated approach is exactly the right level of structure. If your situation calls for a comprehensive full model DBT program, we will say so honestly and help you find one.

Some clients also pair DBT skills with neurofeedback: the skills give you something to do when emotions surge, and neurofeedback is used to support the nervous system’s own capacity to settle. Katherine provides both.

What the Research Says

DBT is one of the most studied psychotherapies for emotional dysregulation. Randomized controlled trials have found it reduces self harm and suicide attempts in people with borderline personality disorder, and later trials extended those findings to adolescents at risk of self harm. Research on DBT skills training alone, without the full program, has also found benefits for emotion regulation across a range of concerns, including depression, anxiety, and ADHD. As with any therapy, results vary from person to person, and DBT informed individual counselling is not the same as a full model program; we describe what we offer plainly so you can choose well.

Counsellors Who Provide DBT Informed Therapy

Katherine Ouano

MEd, RCC · Formal DBT training (Levels 1 and 2) · Neurofeedback provider · Evenings and weekends

Katherine is Sojourn’s lead DBT counsellor. She has completed formal DBT training (Levels 1 and 2) and brings over 25 years of experience supporting children, youth, adults, and families in school and community settings, including extensive work with Autism Spectrum Disorder and developmental disabilities. She works with teens, adults, and couples, weaving DBT skills through warm, practical one to one counselling, and can pair skills work with neurofeedback. In person in Cloverdale, Surrey, and online across BC.

Book with Katherine   View profile

Tarnia Pickard, RCC, integrates DBT informed skills alongside EMDR, IFS, and expressive approaches in her work with children, youth, and families.

Not sure who to book with? Answer 5 questions and we will suggest counsellors who fit.

DBT, CBT, or EMDR: Which Is Right for You?

CBT focuses on identifying and shifting unhelpful thought patterns that drive difficult feelings and behaviour. DBT includes those tools but adds something CBT alone does not emphasize: acceptance and skills for tolerating intense emotion. EMDR works differently again, helping the nervous system process specific distressing memories. For people whose main struggle is the sheer intensity of their emotions, DBT skills often need to come first; for people carrying specific traumatic memories, EMDR may be the more direct route; for persistent unhelpful thinking, CBT is often the best fit. Your counsellor can help you sort out which emphasis fits you, and many clients benefit from a combination over time.

What to Expect

Your first session is a conversation, not a test. Your counsellor will want to understand what brings you in, what you have already tried, and what you want to be different. From there you will agree on goals and begin building skills, usually practising one small thing between sessions. Some clients keep a simple diary card to track emotions and skill use; when something goes badly, you may walk through a chain analysis together, tracing what led up to it so the same moment goes differently next time. Sessions are 50 minutes, weekly or biweekly to start.

Online DBT Informed Counselling Across BC

DBT skills translate well to secure video sessions, and practising them at home, where the hard moments actually happen, has real advantages. Katherine and our other counsellors see clients online across British Columbia, from Surrey and Langley to communities without local DBT trained clinicians. Learn about online therapy.

Fees and Coverage

Sessions with a Registered Clinical Counsellor are $160 to $175 for 50 minutes. Direct billing to many insurers is available through TELUS eClaims, and though we cannot direct bill every insurer, plans that cover RCC or RMFT services may still reimburse you; receipts are provided. See fees and insurance for details, or low cost counselling if budget is a barrier.

Why Choose Sojourn

Sojourn is a team based clinic in Cloverdale, Surrey, serving families across Surrey, Langley, White Rock, and online throughout BC. Our counsellors are Registered Clinical Counsellors with deep experience in trauma informed care, and DBT skills work here sits within a wider toolkit, EMDR, emotionally focused therapy, neurofeedback, so your therapy can adapt as your needs become clearer. You choose a counsellor whose approach, schedule, and experience fit your needs.

View therapist profiles and book online.

Frequently Asked Questions

Do you offer a full DBT program with a skills group and phone coaching?

No. We offer DBT informed individual counselling, in which DBT skills are taught and practised within one to one therapy. If a comprehensive full model program is the right fit for your situation, we will help you find one.

Is DBT only for borderline personality disorder?

No. DBT was originally developed for BPD, but research and clinical practice have extended it to intense emotions generally, including anxiety, depression, anger, self harm urges, ADHD related dysregulation, trauma responses, and teen emotional dysregulation.

Can my teen see someone in the evening or on weekends?

Yes. Katherine Ouano, our counsellor with formal DBT training, offers evening and weekend appointments, so sessions do not have to collide with school hours.

Does insurance cover DBT informed counselling?

Sessions are provided by Registered Clinical Counsellors, and most extended health plans that cover RCC services apply. We direct bill many insurers through TELUS eClaims, and receipts are provided for plans we cannot bill directly.

How long does DBT take?

It varies with your goals. Some clients find a focused period of skills work over a few months makes a meaningful difference; others prefer longer term therapy where DBT skills are one thread among several. Your counsellor will review progress with you regularly.

Is DBT available online?

Yes. DBT informed counselling works well by secure video, and skills practice can be woven into daily life at home. We see clients online across BC.

Can I do DBT if I am on medication?

Yes. DBT skills work is commonly combined with medication prescribed by your doctor or psychiatrist. Counselling does not replace medical care, and we are glad to coordinate with your physician if you wish.

What is the difference between DBT and CBT?

CBT focuses on changing unhelpful thoughts; DBT keeps those tools and adds acceptance and skills for tolerating and regulating intense emotion. If the intensity of your feelings is the main problem, DBT skills usually need to come first.

Can DBT help with self harm?

DBT was developed with self harm and crisis coping at its centre, and distress tolerance skills offer real alternatives in the moments that matter. If self harm is active, your counsellor will talk openly with you about safety planning, and in an emergency please call or text 988 or call 911.

Do you see people from outside Surrey?

Yes. Our Cloverdale office serves Surrey, Langley, White Rock, and the surrounding Fraser Valley, and online sessions are available anywhere in British Columbia.