Comprehensive DBT in Columbia, Lee's Summit, and Across Missouri
If you're looking at a DBT page, you've probably tried other things first.
Maybe you've done general talk therapy. Maybe you've been in and out of treatment for years, or been hospitalized, or been handed a diagnosis that never quite explained what was actually happening to you. Maybe you've been told you're doing well and then something small happened and everything came apart again.
That doesn't mean you failed. It usually means you got a treatment that wasn't built for what you're carrying.
Dialectical Behavior Therapy is different. It was designed specifically for people whose emotions come on faster, hit harder, and take longer to come down than they do for other people. People who have found ways to survive those emotions that work in the moment and cost them later. DBT doesn't ask you to want it less or feel it less. It teaches you an entirely new set of skills for getting through those moments without making your life worse.
Some of this may sound like your life
A lot of people who come to us for DBT describe feeling like everyone else got a playbook for how to be a person and their copy was missing pages. Like their emotions get the best of them, and then they do things afterward they can't fully explain, even to themselves. Like they've been called "too much" their whole lives, while also having feelings that are completely valid and that nobody around them seems able to understand.
Some of this may sound familiar:
Your emotions come on bigger and faster than other people's, and they take a long time to settle
You've hurt yourself on purpose, or thought about it, or thought about dying
You've used food, substances, self harm, spending, or something else to make an unbearable feeling stop
Your relationships are intense, and they keep ending in ways that leave you devastated
You feel empty a lot, or numb, or unsure who you actually are underneath everything
You've been in therapy before, sometimes for years, and you're still here
Life the way it's currently being lived doesn't feel like a life you want
Maybe you've had stretches where things were actually okay. You were doing well, people noticed, you started to believe it might hold. And then something happened and it came apart again, and you still aren't sure exactly why.
If any of that landed, you're in the right place.
That list isn't a description of someone who's broken. It's a description of someone whose emotional system runs hot and who was never taught the specific skills that go with it. Those skills exist. They can be learned.
DBT calls the goal a life worth living. Not a perfect life, and not a life where nothing hurts. A life you actually want to stay for.
What we believe about you before you ever walk in
Most of what makes DBT different isn't a technique. It's a set of assumptions the whole team agrees to hold about you, especially on the hard days. Marsha Linehan, who developed DBT, wrote these out, and every clinician on our consultation team signs an agreement to work from them.
We're putting them here because we think you should know what your therapist has already decided about you before meeting you.
You are doing the best you can. Not "you should be trying harder." When a behavior looks self defeating from the outside, the usual explanation is that the person isn't really trying. There's almost no evidence for that. Your behavior came from somewhere. Given everything that led up to that moment, it made sense, even if it hurt you.
You want to get better. Something can be true and still not be enough on its own. Fear, shame, not having the skill yet, believing it won't work anyway, all of these can stop someone who genuinely wants to change. Your therapist's job is to figure out what's actually in the way, not to question whether you want it.
You need to do better, try harder, and be more motivated to change. This one sounds harsh next to the others. It's the dialectic. You are doing the best you can right now, and you also have to do more than you're doing now, because that's what building a different life requires. Both of those things are true at the same time. Our job is to help you find the effort, not to demand it and walk away.
You may not have caused all of your own problems, and you have to solve them anyway. This isn't fair. We know it isn't fair. Plenty of what you're dealing with was done to you, or handed to you, or happened in a family or a body or a brain you didn't choose. We can't undo it and we can't do the work for you. What we can do is be alongside you while you do it.
Lives like the one you're living right now feel unbearable as they are currently being lived. We're not going to pretend otherwise, and we're not going to try to talk you out of how bad it feels. That's the starting point, not something to get past before therapy can begin.
You have to learn new skills in every situation where you need them. Being calm in your therapist's office and being skillful at 11pm during a fight with your mother are two completely different things. Skills learned in one state of mind don't automatically show up in another. This is exactly why DBT includes coaching calls instead of just sessions.
You cannot fail at DBT. If you drop out, don't get better, or get worse, that is a failure of the therapy or the therapist, not of you. When an antibiotic doesn't clear an infection, nobody blames the patient. We treat this the same way. If it isn't working, we look at what we're doing.
Therapists doing this work need support. This kind of treatment is hard on clinicians, and a tired or frustrated therapist stops being helpful. That's why every DBT therapist here is on a consultation team. More on that below, because it matters more to you than it sounds like it does.
Through this treatment program, people learn skills to:
Stay in treatment
Reduce self-harming behaviors
Build a life worth living
Stay out of the psychiatric hospital
Improve relationships with family and friends
Decrease conflict
Decrease suicidal thoughts
Improve family functioning
Reduce disordered eating behaviors
What each person gets out of it is a little different. But the overarching theme is that you start moving toward the things that matter most to you. You build the life you want. A life with meaning, purpose and less pain. You shed the behaviors right now that seem so automatic you may have troubles believing you can give them up. But in DBT, you’re not just chatting about how your week was for 45 minutes. You get true, comprehensive support to build a life that you want to stay present in every day…even when it gets difficult.
What comprehensive DBT actually includes
You'll see practices offer "DBT informed" therapy. That usually means a therapist who knows some skills and teaches them in individual sessions. It can genuinely help some people, and we offer that too.
Comprehensive DBT is a different thing. It has four parts, and the research showing DBT works is research on all four together.
Weekly individual therapy
You'll meet with your DBT therapist every week for a full session. This is where the skills stop being classroom material and start applying to your actual life, your actual relationships, and the actual things you're struggling with.
You'll bring a diary card. You'll look at what happened during the week together. And you'll work through things in a specific order, starting with anything life threatening, then anything that's getting in the way of the therapy itself, then the things making your life hardest to live.
Weekly two hour skills training group
Group is where the skills get taught. Mindfulness, distress tolerance, emotion regulation, and interpersonal effectiveness, over a six month cycle.
Almost everyone is anxious about group. That's a normal reaction and it's worth naming. But group is honestly some of the magic of DBT. It's one thing to have a therapist explain a skill. It's another to sit with other people who also feel things at full volume, hear how they've used a skill during a week that went sideways, ask the question you were too embarrassed to ask, and realize you're not the only one. Nobody is asked to share their trauma history in group. It's a class, not a process group.
Our skills groups meet online, so you can join from anywhere in Missouri.
We run two:
An adult skills group
A multifamily skills group for teens, where a parent or caregiver attends alongside the teen and learns the same skills. Families change faster when everyone is speaking the same language.
Skills coaching between sessions
Life doesn't wait for your appointment.
Coaching calls exist because of that assumption above, the one about needing to learn skills in every context where you need them. The whole point is to get help using a skill in the moment when your emotions are high and you can't think of one, or you've never tried this particular skill in this particular situation, or you know exactly what to do and cannot make yourself do it.
You're not just allowed to call. You're expected to. Not calling before acting on an urge is something we'll actually work on in treatment.
This is coaching, not a crisis line or a therapy session by phone. It's usually short. Your therapist will talk with you during orientation about how to reach them, when, and what to expect. There is no additional charge for coaching calls.
A weekly consultation team
Every week, our DBT clinicians meet for an hour and a half. Not to chat about cases. This is a structured team that follows the standard DBT format, and our therapists hold a 90% attendance expectation.
Here's why this matters to you: in DBT, the team takes on responsibility for the care of everyone under its umbrella. Your therapist isn't making decisions about your treatment alone. When they're stuck, when something isn't working, when you've had a hard week, there's a room full of people who know DBT thinking about how to help you. It also keeps your therapist from burning out or drifting away from the treatment that actually works.
You're paying one therapist. A whole team is holding your care.
What Makes DBT Different
DBT isn’t a once a week how are you doing type therapy. It’s a very different approach. It’s for those who tried regular therapy and didn’t improve. Or for those who’s behaviors or feelings are so intense that they know they need something more.
To be honest, there’s a lot that makes it different. The coaching calls to help you practice your new skills in your daily life. The support your therapist recieves on the consultation team to make sure they’re giving you the best care. The skills training groups where you are learning alongside peers and together figure out how to make this work. The diary cards that help you track your behavior and emotions.
But a big part is that “problematic behaviors” themselves are also treated differently.
When a target behavior shows up, we start with curiosity
You've probably been asked why you did it. Why you cut. Why you binged. Why you drank. Why you said that thing to that person.
And you probably didn't have a good answer, and the question itself may have felt like an accusation. Maybe someone told you to just do something different next time, as though that hadn't occurred to you.
We don't do that here.
When a target behavior comes up, we do what we call a chain analysis. We go through what happened, moment by moment, together. What was going on before. What you were feeling. What you thought. What the behavior did for you in that moment, because it did do something, or you wouldn't have done it.
We assume that in some context, it made sense. To change it, we have to understand what that context actually was, and figure out what you would have needed in that exact moment in order to do something else instead.
It's not an interrogation. It's the most useful conversation in DBT, and it works because there's no judgment in it.
Before you join our comprehensive DBT program, we take time to make sure this is right
You don't sign up for comprehensive DBT the way you book a first therapy appointment.
You'll start by meeting with your individual DBT therapist for an orientation and commitment process. This takes several weeks. You'll go through exactly what the program involves, what we're asking of you, and what you can ask of us. You'll talk about what you want your life to look like, what's getting in the way, and whether this is the treatment that will get you there.
Then you'll decide, on purpose, whether to commit.
We do it this way because DBT asks a lot. Six months minimum, weekly individual therapy, a weekly two hour group, diary cards, homework, coaching calls. That's a real ask, and people do better when they've genuinely chosen it rather than agreed to it in a first appointment while overwhelmed.
This is also where we'd tell you if it isn't the right fit. DBT is a life changing treatment for people who need their life to change. If what you're carrying is mostly stress, or a specific problem you're working through, or you're looking for some coping tools, there are other therapists and other approaches that would serve you better and cost you far less. We'd say so, and we'd help you find the right person.
Most people stay six months. Some repeat the six month cycle, because skills get deeper the second time through. That's normal and it's not a sign anything went wrong.
What it costs
DBT is an investment. We’re honest that it’s not cheap. However, it is effective. Here are our rates once you’ve been accepted into the full DBT program:
Individual DBT session (53 to 60 minutes): $175 for a fully licensed DBT clinician
Weekly two hour skills training group: $150
Coaching calls: no additional charge
Therapist Consultation Groups: no additional charge
Our DBT rates are higher than our standard rates, and we want to be clear about why. That rate covers your therapist's weekly hour and a half on consultation team, and it covers their availability for coaching calls between sessions. Both of those are required parts of your DBT treatment. We'd rather build them into the rate than nickel and dime you every time you need support at a hard moment.
People in comprehensive DBT attend both individual therapy and group each week for 6-12 months. Our practice does use a system called Thrizer, which submits superbills to your insurance on your behalf so many of our clients do get reimbursed for a significant portion of their care.
Where we offer DBT
We have offices in Columbia and Lee's Summit, and we see clients throughout Missouri by telehealth.
Skills groups and consultation team both meet online, so wherever you are in Missouri, you can be part of the full program. Ideally you'd see your individual DBT therapist in person at one of our offices, but that's not a requirement. Plenty of people do the entire program by telehealth.
Where our DBT program stands right now, as of September 2026
Our consultation team is meeting now, with six clinicians on it, several of whom have previous DBT training and experience delivering the full model. We anticipate offering the whole program, all four components, within the next three months.
We're taking that time on purpose. Every clinician on our team is going back through the full 40 hour DBT training. We're consulting with Linehan Board Certified clinicians as we build. And we're structuring the program against the standards used for DBT program certification, because DBT works when it's delivered the way it was designed and researched, and not when it's approximated.
Our adult skills group is expected to meet Tuesdays from 12:00 to 2:00, and our teen multifamily group is expected to meet Tuesdays from 8-10am. Both are still being finalized.
What that means if you reach out today:
Call or contact our Client Care team now. Sarah will get you matched with one of our DBT therapists if you specifically mention DBT by name.
Anyone reaching out during this window will start with one of our most experienced DBT clinicians.
You can begin the orientation and commitment process and start DBT informed individual therapy right away.
You won't attend skills group until it launches, and you won't be charged the comprehensive DBT rate until the full program is available to you.
Your therapist has DBT support behind them the entire time.
Orientation and Commitment:
When you begin working with a DBT therapist, you will usually spend the first several sessions in the Orientation and Commitment phase of treatment before joining a DBT skills training group or beginning coaching calls. We absolutely want you to get into the full treatment as soon as possible, but this step is an important part of DBT—not just something to get through before the “real” treatment begins.
During these first sessions, you and your therapist will talk about what is bringing you to DBT, what behaviors are getting in the way of the life you want, and what you hope will be different as a result of treatment. Together, you’ll identify your most important treatment targets and begin developing clear, realistic goals for building a life that feels more manageable and worth living.
Your therapist will also make sure you understand how comprehensive DBT works, including individual therapy, skills training, diary cards, coaching calls, and the expectations that help these pieces work together. We’ll talk openly about what DBT asks of you, what you can expect from your therapist, and any concerns or mixed feelings you may have about making changes.
You do not need to begin DBT feeling 100% confident or motivated. In fact, part of the Orientation and Commitment process is talking honestly about the parts of you that want things to change and the parts that may be unsure. Our goal is for you to understand what you are committing to, why you are doing it, and how DBT can help you move toward the life you want.
If you are interested in participating in the comprehensive DBT program at Aspire Counseling, you can start the orientation and commitment process with one of our experienced DBT therapists now so that you are ready to join the comprehensive group when it begins in a few weeks.
Begin Counseling in Missouri
We know it can be hard to find good quality, comprehensive DBT services. It’s important to know that because we coordinate with DBT Columbia and these services are in high demand, it can take a little time to get started. Individual therapy sessions are offered through Aspire Counseling whereas the group skills training sessions are offered through DBT Columbia. It is a partnership we really value that has helped many people begin comprehensive DBT services more quickly than waiting on a long list for insurance-based services.
1.
Reach out to Aspire Counseling
First, you’ll speak to a member of our Client Care team who will ask you a few questions. They will then reach out to the member of the DBT Columbia consultation team to see if they have openings.
2.
Meet with a DBT Therapist
Because we know how important it is to find someone you feel comfortable with, all of our therapists offer a free 30-minute consultation where you can ask as many questions as you’d like.
3.
Begin Comprehensive DBT Services
You’ll begin with Orientation and Commitment sessions with your therapists. Then, comprehensive DBT will include phone coaching sessions, individual therapy and group skills training.
DBT helps you create a life worth living.
Not sure if you’re ready to get started? Check out some of these resources:
Blog Posts About DBT Skills
Other Dialectical Behavior Therapy Resources
Clients are often referred to DBT due to the seriousness of their self-harm, suicidal thoughts, eating disorders, or troubles with relationships. However, DBT is more than a suicide prevention program. It is an evidence-based mental health treatment that will help you create a life worth living.
Learn more about DBT and find resources here: https://behavioraltech.org/resources/resources-for-clients-families
Additional self-help DBT resources can be found here: https://www.dbtselfhelp.com/index.html
This article about the founder of Dialectical Behavior Therapy gives some insight into her own struggle with emotional dysregulation and suicidal thoughts that inspired the creation of DBT.
Other Mental Health Services
Life is complicated, and the reason you’re considering DBT may not be the only thing you’re dealing with.
In addition to DBT, our specialties at Aspire Counseling include trauma therapy and PTSD treatment, anxiety treatment, OCD treatment using Exposure and Response Prevention (ERP), therapy for stress, burnout and perfectionism, therapy for children with anxiety, depression counseling, teen counseling, counseling for chronic pain, grief counseling, caregiver stress, and other specialized services for adults, teens, children, and families.
We offer therapy in Columbia and Lee’s Summit, as well as telehealth throughout Missouri. Because our clinicians have different areas of expertise, our Client Care team can help you figure out which therapist and treatment approach are most likely to fit what you’re dealing with.