Trauma can leave lasting scars on the body and mind. For many people, past experiences continue to affect their daily lives—whether through flashbacks, avoidance, overwhelming emotions, or struggles in relationships. Traditional therapy approaches can help, but sometimes trauma requires a more specialized, structured path toward healing.
Dialectical Behavior Therapy with Prolonged Exposure (DBT PE) is one such approach. At The Wise Center in Birmingham, Alabama, our clinicians use DBT PE to help clients safely face and process trauma, while also building the coping skills needed for lasting recovery. This blog offers a clinician’s perspective on what DBT PE is, how it works, and why it can be so powerful for trauma healing.
What Is DBT PE?
DBT PE is an adaptation of traditional DBT that incorporates Prolonged Exposure therapy—a research-backed method for treating trauma and post-traumatic stress disorder (PTSD).
While DBT focuses on building skills for emotion regulation, mindfulness, and distress tolerance, PE adds another layer: directly addressing traumatic memories in a structured, supportive way. By combining these approaches, clients have both the tools to cope with overwhelming emotions and the opportunity to process trauma more fully.
DBT PE is especially effective for people who experience both trauma symptoms and difficulties with emotional regulation, self-harm, or intense relationships.
How DBT PE Sessions Work
Many clients wonder what DBT PE actually looks like in practice. Unlike general talk therapy, DBT PE follows a specific structure designed for both safety and effectiveness. Sessions often include:
- Preparation and Skills Building: Before starting exposure work, clients strengthen DBT skills such as distress tolerance and mindfulness to ensure they can manage difficult emotions.
- Imaginal Exposure: Clients gradually revisit traumatic memories in a safe, therapeutic setting, telling the story of what happened while being guided by the therapist.
- Processing: After exposure, the therapist helps clients explore new perspectives on the memory, reducing shame and fear.
- In-Vivo Exposure: Clients practice approaching real-life situations or reminders they’ve been avoiding, with the therapist’s support.
This combination helps break the cycle of avoidance and allows clients to reclaim parts of their lives that trauma once controlled.
Why DBT PE Is Different from Other Trauma Therapies
While there are several effective treatments for trauma, DBT PE stands out because of its dual focus. Clients don’t just face their trauma—they also learn the day-to-day skills needed to cope with distress, manage relationships, and regulate emotions.
This approach is especially valuable for clients who may have tried trauma therapy in the past but struggled with overwhelming emotions. By strengthening DBT skills first, clients are better prepared to tolerate the difficult work of exposure.
Clinicians often describe DBT PE as creating a “safety net”: clients can dive into painful memories knowing they have tools to keep them grounded.
The Healing Journey: What Clients Can Expect
Trauma healing is not linear, and DBT PE is no exception. Clients may feel heightened emotions at first as they begin to confront avoided memories. However, with ongoing support, many report significant improvements, such as:
- Reduced frequency and intensity of flashbacks or nightmares
- Less avoidance of people, places, or activities connected to trauma
- Greater ability to manage anger, fear, or sadness
- Increased confidence in relationships and daily life
Healing takes time, but with DBT PE, clients are not alone. They move through the process at a pace that feels challenging yet safe, supported by both their therapist and the DBT framework.
Who Is a Good Candidate for DBT PE?
Not everyone struggling with trauma needs or is ready for Prolonged Exposure work. DBT PE is best suited for people who:
- Experience trauma-related symptoms like flashbacks, avoidance, or intrusive memories
- Have also struggled with intense emotions, self-harm, or relationship difficulties
- Are willing to gradually face painful memories with therapeutic support
- Have built some coping skills through DBT or other therapy and feel ready to take the next step
At The Wise Center, clinicians carefully assess readiness before beginning DBT PE. This ensures clients have the foundation needed to approach trauma safely and productively. For many, the combination of DBT and Prolonged Exposure provides a path forward that feels both structured and hopeful.
A Path Forward for Trauma Recovery in Alabama
From a clinician’s perspective, DBT PE offers one of the most comprehensive and effective ways to address trauma—especially when combined with the supportive environment of DBT skills training and therapy. At The Wise Center, our DBT PE for Trauma Healing program is available to clients in Birmingham and across Alabama through secure telehealth.
If trauma has been impacting your life, it’s important to know that recovery is possible. Our team is here to provide a safe space for healing, combining compassion with evidence-based care.
To learn more or schedule a consultation, visit our Contact Us page. Taking that first step could open the door to lasting change and relief.