DBT-PE for Trauma and Emotion Regulation
What Is DBT-PE?
DBT-PE stands for Dialectical Behavior Therapy Prolonged Exposure. It’s a treatment designed for people who have both post-traumatic stress disorder (PTSD) and high emotional sensitivity. DBT-PE combines the trauma-processing techniques of prolonged exposure therapy with the skills-based support of dialectical behavior therapy. It helps people confront trauma memories safely while building tools to manage intense emotions, urges, and behaviors.
Why Combine DBT and Prolonged Exposure?
Traditional prolonged exposure therapy is very effective for PTSD, but it can be overwhelming for people who struggle with emotion dysregulation, self-harm, or suicidality. DBT-PE was developed to address this challenge. Before starting trauma processing, clients first stabilize through standard DBT—learning skills like distress tolerance, mindfulness, emotion regulation, and interpersonal effectiveness. Only once they’re ready do they begin the exposure work.
How DBT-PE Works
DBT-PE starts with a strong foundation in DBT. Once clients have built enough safety and skills, they transition into the trauma-focused phase of treatment. The exposure portion involves imaginal exposure—revisiting trauma memories in a structured, safe way—and in vivo exposure, which means gradually approaching avoided situations or triggers. The therapist helps guide the client through each step while continuing to support emotional safety and skills use.
What to Expect in DBT-PE Sessions
During DBT-PE, sessions often include both DBT check-ins and exposure work. Clients are encouraged to process trauma memories in detail, while also identifying stuck beliefs and body responses. Between sessions, they track distress, practice exposure tasks, and use DBT skills to manage any emotional activation. The process is highly collaborative, structured, and designed to keep clients both safe and empowered.
Who DBT-PE Is For?
DBT-PE is ideal for people who have PTSD and also struggle with intense emotions, impulsive behaviors, or a history of self-harm or suicidality. It’s especially well-suited for survivors of childhood trauma, abuse, or neglect. Research has shown DBT-PE to be highly effective for this population, with many clients showing significant reductions in PTSD symptoms and improvements in emotional functioning.
Safety and Readiness for DBT-PE
Not everyone is ready for trauma processing right away, and that’s okay. One of the key benefits of DBT-PE is its built-in focus on safety and stability first. The decision to begin the exposure phase is made together with the therapist, based on clear readiness criteria. This careful pacing helps protect clients from retraumatization and supports long-term healing.
Finding a DBT-PE Therapist
If you’re interested in DBT-PE, look for a therapist who is trained in both DBT and prolonged exposure. DBT-PE requires a specific skill set, and it’s important to work with someone who can support both trauma processing and emotion regulation. A trained DBT-PE therapist will guide you through each phase with skill, care, and structure.
A Pathway to Deep Healing
DBT-PE offers a powerful path for people living with trauma and emotional intensity. By combining the strength of DBT skills with the effectiveness of prolonged exposure, this approach allows for healing that is both deep and sustainable. With the right support, it’s possible to reclaim your life from the effects of trauma.
