Can I Do DBT Online, and Does It Still Count as Real DBT?

QUESTIONS WE HEAR

The short answer: Yes. DBT can be delivered through secure telehealth, but the screen does not determine whether the treatment is “real DBT.” What matters is the treatment structure, clinician competence, safety planning, privacy, and whether the DBT components you need can be delivered effectively online.

For people in Saskatchewan, this question is practical as much as clinical.

Distance, winter travel, shift work, caregiving, and limited access to specialized DBT services can make in-person treatment difficult or impossible.

Telehealth can improve access. But it should not be treated as automatically appropriate for every person or every level of risk.

Online is a delivery method, not a treatment model

A video call can be used to deliver many different forms of therapy. Calling something online DBT does not tell you whether it is a skills class, individual DBT, DBT-informed counselling, or comprehensive DBT.

The clinical structure still matters.

What can be done online?

Many DBT activities translate well to secure video care, including:

• individual therapy
• skills teaching and group participation
• behaviour chain analysis
• diary-card review
• skills rehearsal and role-play
• treatment planning and progress review
• some forms of between-session coaching when the program includes it

For many clients, being in their own environment can even make skill generalization easier because the situations where they need the skills are close at hand.

What makes online DBT harder?

Online care creates practical demands that do not exist in the same way in an office.

The client needs sufficient privacy. The internet connection and device need to be reliable enough for clinical work. The clinician needs to know where the client is located during the session when required for safety planning. There needs to be a clear plan for disconnection, emergencies, and what happens if risk escalates.

Group care also requires clear expectations around privacy, headphones, who else is in the room, recording, and how participants identify themselves.

What does the research say?

Research on telehealth DBT is growing. A 2025 multi-site pilot study of comprehensive telehealth DBT for adults with borderline personality disorder found the approach feasible and acceptable with encouraging clinical changes.

That is useful evidence, but pilot data are not the same as proving that telehealth is equivalent to in-person DBT for every population, risk level, and service format.

The clinical decision still needs to be individualized.

The Five-Check Online DBT Test

Before starting online DBT, ask:

1. Privacy: Do I have a private enough place to participate honestly and safely?
2. Technology: Is my connection and device reliable enough for regular sessions?
3. Safety: Is there a clear plan for emergencies, disconnection, and escalation of risk?
4. Treatment structure: Am I receiving the DBT components I actually need, or only a generic therapy session using some DBT language?
5. Participation: Can I stay engaged online, complete practice, and use the format consistently?

What if I live in a rural or northern community?

Telehealth can be particularly valuable when specialized care would otherwise require hours of travel.

The goal should not be to treat online care as a second-rate substitute. The question is whether the service is clinically sound, secure, and realistic for the person’s circumstances.

For many Saskatchewan clients, telehealth is the format that makes regular specialized care possible.

When might in-person care be preferable?

Some people engage better when they physically leave home and enter a therapy environment. Others do not have sufficient privacy, have unstable internet access, or need a level of observation and support that is difficult to provide remotely.

High or rapidly changing risk may also affect whether telehealth is appropriate or what additional supports are required.

The decision is not simply about preference. It is about whether the format supports effective treatment.

Questions people also ask

Is an online DBT group still a real group?

Yes, if it is structured as a DBT skills group and delivered appropriately. The online format changes logistics, not the fact that the group is teaching and practising DBT skills.

Do I have to keep my camera on?

Programs set their own participation expectations. Because engagement, safety, and group process matter, camera expectations should be explained before the program begins.

Can I join from work or my car?

Only if the environment is private, safe, and clinically appropriate. A parked car may sometimes offer privacy, but driving during therapy is not appropriate.

Is online DBT available across Saskatchewan?

DBT Saskatchewan provides secure online services across Saskatchewan when the service and telehealth format are clinically appropriate for the client.

What can I do next?

Review the DBT Saskatchewan services and FAQ. Intake is where privacy, technology, location, risk, treatment history, and the level of DBT needed can be reviewed together.

You may also be wondering

What’s the Difference Between DBT Skills Training and Individual DBT Therapy?

How Do I Know Whether I Need Comprehensive DBT or a Skills Group?

Clinical sources and further reading

• American Psychiatric Association: Practice Guideline for the Treatment of Patients With Borderline Personality Disorder (2024)
• NICE: Borderline personality disorder — recognition and management
• Behavioral Tech Institute: DBT Skills Training
• Vonderlin et al. (2025): Pilot study of telehealth DBT for adults with BPD

Clinical review

Clinically reviewed by Chris de Feijter, EdD., MACP
Clinical Lead & CEO, STG Health Services Inc.
DBT Saskatchewan

DBT Saskatchewan is a specialized DBT service of STG Health Services Inc.

Educational information only. Telehealth suitability, privacy, and safety should be assessed individually. Online therapy is not an emergency response service.