This chapter presents the intricate work of Marsha Linehan that has shown much efficacy in treating a specific population of clients, as well as others. It lists basic tenets of Dialectical Behavior Therapy (DBT) and the basic concepts used in conceptualizing and addressing a client’s concerns. DBT is a skills-based approach first targeted toward and found through extensive research to be highly effective with those experiencing extreme emotional dysregulation patterns, suicidal ideation, and non-suicidal self-injury consistent with a diagnosis of Borderline Personality Disorder (BPD). DBT is derived from cognitive behavioral therapy (CBT) with modifications specifically added for treating emotional dysregulation and related behaviors. The DBT therapist is highly flexible and uses a dialectical approach. There are four procedures for eliciting change in DBT clients: contingency procedures, exposure-based procedures, cognitive modification, and the didactic strategy of skills training itself.