For some individuals experiencing severe emotional distress, traditional mental health services may not be enough. Dialectical Behavior Therapy (DBT), the gold standard treatment for adolescents and adults with severe emotional dysregulation, including self-harm and suicidal behaviors, offers a different path — one that teaches people practical skills to manage overwhelming emotions, navigate relationships, cope with distress and build a life they feel is worth living.
Thanks to a $750,000 grant from the California Department of Health Care Services’ Children and Youth Behavioral Health Initiative, Pacific Clinics has expanded access to this evidence-based practice while building the expertise and infrastructure to sustain it for years to come.
Expanding Access to Specialized Care
When the grant began in 2024, Pacific Clinics had one full-scope DBT team, serving clients in Los Angeles County. Over the two-year grant period, the agency expanded services to programs in Santa Clara, Sacramento and Solano counties, bringing this specialized treatment to more communities statewide.
The investment also helped Pacific Clinics develop a growing network of DBT-trained clinicians. In collaboration with Treatment Implementation Collaborative, LLC, an expert DBT training and consulting organization, 48 clinicians completed a combined 2,655 hours of intensive DBT training, learning the comprehensive approach that includes individual therapy, skills groups, phone coaching and a therapist consultation team.
Pacific Clinics also invested in building an internal training model. Licensed Learning Partner Effie Orme now serves as the agency’s lead DBT trainer, supported by four regional training leads. Together, the team has developed an introductory DBT course for clinicians and is developing an ongoing 30-hour training program to help sustain and expand DBT services across Pacific Clinics.
In other words, the grant didn’t simply fund treatment, it helped build the capacity to keep providing it.
Turning Skills into Meaningful Change
During the two-year grant period, 56 clients ages 14-26 enrolled in DBT, and among those who completed treatment and provided pre- and post-treatment assessments, 92% reported being better able to handle daily life.
Clients also reported clinically significant improvements in their overall mental health, their ability to cope with unexpected events, relationships with others and a sense of belonging within their communities.
Behind those numbers are people who learned skills that changed how they respond to some of life’s most difficult moments.
One young adult, Delila, had spent much of her life in and out of therapy. When she first began DBT at Pacific Clinics, she reported minor self-harm twice a week and intrusive thoughts of suicide daily, as well as severe anxiety in public, depression, dissociation and daily psychosis symptoms. She had previously participated in years of traditional therapy, but continued to have challenges.
DBT gave her a new set of tools, and a structured way to practice using them.
Through individual therapy, structured around the daily diary cards which track symptoms, emotions and progress toward goals, Delila learned to identify and address the factors contributing to her suicidal thoughts and urges and how to manage or eliminate them. Skills groups gave her practical strategies for managing distress, regulating her emotions, using mindfulness and skills for improving her ability to communicate her needs, while coaching calls helped her apply those skills at home and in her community.
Within two months, her suicidal thoughts and urges had decreased to nearly zero.
After six months of treatment, she made progress in areas that extended far beyond symptom reduction. She used DBT skills to manage relationships with family, communicate more confidently with medical providers and cope with her psychosis symptoms. Her diary cards documented a gradual shift away from experiencing intense anger, fear, shame and sadness every day toward greater self-acceptance, compassion and joy.
Delila also began making progress toward goals that mattered deeply to her: moving with her mother out of an abusive living environment, working toward her GED and finding a new primary care provider who better understood her complex medical needs.
More than a year after she graduated from therapy, Delila reflected on what DBT had given her:
“The goal isn’t to be perfect because there’s no such thing. It’s about control and management. Real growth isn’t linear,” she said. “I’m doing awesome. I no longer have severe episodes, and the ones that I do have are 3-7 months apart.”
An Investment That Will Continue to Grow
The success of this grant is measured not only by the number of clients served or clinicians trained, but by the foundation it has created for the future.
By investing in specialized training, regional expertise and an internal train-the-trainer model, Pacific Clinics is positioned to continue expanding DBT access beyond the grant period.
“Our goal is to ensure more individuals and families can access a treatment that gives them practical tools to navigate intense emotions, strengthen relationships and build healthy, happy lives,” says Director of Learning and Development Karen Guan. “For clients who have spent years feeling overwhelmed by their symptoms, the comprehensive treatment offered by DBT can be transformative.”
