Skills-based Dialectical Behavior Therapy (DBT) is a type of therapy that combines elements of cognitive-behavioral therapy (CBT) with mindfulness techniques. Originally developed by Dr. Marsha Linehan to treat individuals with borderline personality disorder (BPD), it has since been adapted to address a range of mental health issues, including mood disorders, anxiety disorders, eating disorders, and substance use disorders. Our approach to DBT (and CBT) focuses on an active skills-based method.

We offer in-person and virtual appointments for those in Montana. If you live outside our area or cannot travel – our team is licensed to treat anyone in Montana.
Skills-based DBT focuses on teaching individuals specific coping skills to manage their emotions, improve relationships, and deal with distressing situations effectively. These skills are typically divided into four skills-based modules teaching emotional and behavioral regulation. The four skills are:
- Mindfulness
- Interpersonal effectiveness
- Distress tolerance
- Emotion regulation
Each of these modules work together to help develop physical, emotional, and cognitive awareness to achieve emotional regulation.
- Mindfulness is the cornerstone of DBT, teaching non-judgmental awareness of the present moment. This skill is essential in helping patients understand and accept their emotions, leading to greater self-control and well-being.
- Interpersonal effectiveness equips individuals with strategies to discover and explain their needs and manage conflicts in relationships. Managing relationships is vital for individuals who experience intense emotions.
- Distress tolerance is geared toward increasing a person’s tolerance of negative emotion, rather than trying to escape from it. This component of DBT emphasizes learning to tolerate pain skillfully through techniques such as distraction, self-soothing, and improving the moment. It is particularly beneficial for individuals who might otherwise react to emotional pain with self-destructive behaviors.
- Emotion regulation is designed to identify and develop strategies to manage emotions that are causing distress in a person’s life.
DBT is structured in such a way that it requires a multifaceted approach to treatment. This typically includes individual therapy sessions, during which the therapist and patient work towards improving harmful behaviors. Group therapy sessions are also a key component of DBT, involving skills training that helps patients learn and practice behaviors related to the four skills modules. This comprehensive approach ensures that the therapeutic strategies are reinforced and applied across different settings, contributing to the overall effectiveness of the therapy.
In summary, DBT’s strength lies in its ability to provide a structured, yet flexible, treatment adapted to the needs of individuals struggling with a spectrum of psychological issues. By focusing on the truth of acceptance and change, DBT helps patients discover new ways to manage distressing emotions and improve their relationships. Our goal is for our patients to develop skills that provide lasting improvement and a better quality of life.
TMS
by Deb (age 64)
Category: generalThe hoops I jumped through in order to be evaluated were straightforward and efficient. I met with PA Kaitlin for about an hour to discuss my history and previous medications. Then Dr. Amato joined us to further discuss my history, the TMS treatment, and answer any questions. Myrna gathered all of the information and submitted it to my health insurance company to request coverage for TMS. Fortunately, insurance approved the treatment and I was able to begin the next week. I’m sure most people have anxiety about starting a treatment like TMS. No matter how many times it’s described to you, there are many unknowns. How will I feel during treatment? Is it painful? What if this doesn’t work? What if it works for a while but then stops? In all honesty, I was very uncomfortable during the first couple of weeks of treatment. The alternating two seconds of tapping sensation caused some pain during treatment, and at the end of the first week I thought about quitting. But I had sworn to myself that TMS was a last resort and I HAD TO complete the treatment and give it a chance to work. My technician, Heather, told me that some people don’t feel the tapping at all, they only hear it. Guess I wasn’t one of those people! But as the days went by, it became easier to tolerate the treatments. During this time I also saw Lauren weekly for CBT (cognitive behavioral therapy). This is highly recommended for people undergoing TMS treatment, and it was a positive complement to my total of 100 minutes each week “under the helmet”. The weekend between weeks three and four, I started to notice subtle improvements in my mood, increased belief in my self-worth, and enthusiasm for simple things like going for walks, meeting friends for lunch, and taking on volunteer work in the community. I hesitated at first to believe that TMS was helping me. I was afraid that I was convincing myself it was working because I so desperately wanted it to! But now that I am past the treatment I can say with cert
TMS
by Barbie (age 68)
Category: generalI feel so blessed to participate in the TMS protocol at MT Psychiatry. After struggling so many years with depression and not getting significant results from medication, particularly of late, I noticed positive results in the first two weeks of treatment. TMS can literally give you back the beauty & joy in living as well as the courage to make positive life changes and improvements in your daily living situation. I heartily encourage anyone to put yourself into the hands of the amazing TMS team who so gently and graciously make this journey with you out of the black hole that is depression. It is my honor and privilege to give the TMS treatment the highest recommendation.
TMS
by Shayne (age 66)
Category: generalI am grateful for the support and caring I have received from Dr. Amato (and Heidi, Heather and Myrna) in my quest for mental health and a fuller more productive life. While the TMS results have been subtle, I feel more positive about my future and I would recommend this team absolutely. Thank you!
TMS
by Carrie (age 65)
Category: generalNot realizing how fuzzy my head was, I thought I was only going through severe anxiety and depression. Through the insight of Pat, I was able to go through TMS treatments which brought down the anxiety and depression immensely and has cleared up the fuzzy, far off substantially. All the personnel treated me with kindness and I’m sure their attitudes helped in my recovery.
TMS
by Bridget (age 47)
Category: generalThe first outcome of TMS I noted happened early in my treatment, at about the beginning of week two. I felt as though my “brain fog” had been chipped away. I wish I could report that I feel my mental health issues are in “remission”, but I can’t do so yet. My hope is that I will see improvement in the weeks to come, now that my TMS cycle has ended. I can say that my brain feels – in some way – different; I can’t explain exactly how. I continue to struggle at this point in time but sill have hope for more improvement.
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