During treatment, the therapist attends to the interactions and influences between themselves and the client. According to Linehan (1993), DBT focuses on acceptance. Clients are expected to accept themselves and their current life situations in the moment. The therapist is expected to accept the client in the moment and they are both expected to accept the therapeutic relationship. Within these expectations, an expectation for change must also exist. Change is the client’s responsibility, the therapist is not supposed to protect the client from the aftermath of change, instead attempt to help promote healthy coping tools.
According to Swales, Heard, and Williams (2000), validation is the main acceptance of treatment. They described six levels of validation in DBT treatment. Levels 1-4 are common forms of validation found in most forms of psychotherapy including active listening, accurate reflections, articulating the "unverbalised", and validation of past events. Level 5 validation, validation of current circumstances, informs clients that their current behaviors are functional to their situations. Radical genuiness, the final level of validation, requires the DBT therapist to respond and validate the inherent capacity of the client’s ability to improve.
The goals of DBT are to increase mindfulness, the capacity to non-judgmentally attend to the present moment, and increase distress tolerance skills, the ability to accept in a non-evaluative way. The hope is that individuals are able to accept negative situations and not become overwhelmed (Swales, Heard, and Williams, 2000).
Through increased DBT skills, clients are expected to better able to regulate their emotions. Linehan (1993) suggested