Dialectical Behavior Therapy (DBT) is a mindfulness based behavioral therapy that was developed by Marsha Linehan. It targets disorders of emotion dysregulation and has been proven to be a comprehensive treatment for most disorders although it is commonly prescribed for patients diagnosed with borderline personality disorder (BPD), binge eating disorder, or substance abuse. DBT targets destructive, impulsive behaviors first and then targets the underlying emotional experiencing.


Radically Open Dialectical Behavior Therapy (RO DBT) is a mindfulness based behavioral therapy that was developed by Thomas Lynch. It targets disorders of over control such as anorexia nervosa or obsessive compulsive personality disorder (OCPD). RO DBT targets over controlled coping and maladaptive social signaling and puts an emphasis on what can be learned from emotional experiencing.


Individual therapy occurs between a licensed therapist and client or patient. Sessions through Katy DBT Center occur virtually and are typically held weekly or every other week for 60 minutes. Typically patients will establish goals, like eradicating a problem behavior, deepening relationships, or improving communication. Overall, therapy is used to improve quality of life or affect change.

In a DBT individual therapy session, the therapist will analyze the patient’s behaviors for cues or prompting events, colloquially known as “triggers,” then determine the function of the behavior and its reinforcers. Do the behaviors bring relief? Do they communicate something important? Solutions are analyzed as well. Is there a way to get relief or communicate something important without engaging in the problem behavior?

Family Involvement

It is sometimes helpful to involve family members or other close relationships in your individual therapy. Those closest to us can sometimes see our blind spots, providing feedback and insight the therapist or individual wouldn’t otherwise see.


Group therapy occurs with a therapist and two or more individuals. Typically, groups take place weekly for 60-90 minutes. Some people participate in individual therapy in addition to group therapy, while others only participate in group. Confidentiality and trust are mainstays or group therapy.

Group provides a safe, supportive place to practice new behaviors and strategies so you can more easily call on these new skills in real-world situations. Groups also act as a sounding board and support network.


When in an emotional crisis, it is difficult to remember new skills, let alone apply them. A feature of DBT is that clients are offered free coaching between sessions to learn to apply skills in difficult situations.

Free skills coaching is available for patients in individual and group therapy.

Dungeons and Dragons (DND)

The research on Dungeons & Dragons as a behavioral intervention is still in its infancy but it is believed that D&D does a good job at addressing the social isolation that comes with disorders of over-control. It does this by providing structure, social engagement, and the experimentation of new roles and behaviors in a safe environment. Interestingly, fun is also an important, evidence based intervention that is practiced when treating disorders of over control such as OCPD or anorexia nervosa. In our D&D groups we hope to provide all of these tools as an adjunct to RO DBT or other on going therapy.

What is D&D?

Dungeons and Dragons (aka DND, D&D), is a tabletop roleplaying game invented by Gary Gygax and Dave Arneson in 1974. DND players create a character in a fantasy world and collaborate with other players to pursue a goal, collect treasure, explore new lands, and go on quests. Players improvise to create the storyline and explore fantastical lands together. Chance is introduced into the game by using die. At pivotal points in the story, a player will roll the die to determine strategies and attacks during play.

A “Dungeon Master” leads and facilitates the game. Players roll a die to see how well their plan works. It’s not competitive, and there are no winners or losers: everyone works together toward a common goal.

There are many mental health benefits to DND, including improved social skills, navigating conflict, learning to express and assert yourself, improving impulse control, and so much more.

DND groups consist of 3-4 people plus a therapist facilitating as Dungeon Master. DND groups meet weekly for 2+ hours.

RO DBT Dungeons & Dragons program.

DBT Dungeons & Dragons Intensive Outpatient Program (IOP).