Have you ever made a decision in the heat of the moment and regretted it later? Maybe you said something you didn’t mean, spent money you couldn’t afford, or picked up a harmful habit again. If so, you’re not alone. Many people struggle with impulse control, especially during times of emotional stress. Dialectical Behavior Therapy (DBT) is a powerful treatment approach that can help.
In an Adult Intensive Outpatient Program (IOP), DBT provides support and structure. It helps people slow down, manage urges, and make better choices in real life. DBT helps adults improve impulse control and decision-making. Let’s look at how it works, one skill at a time (and these are just a few of the skills that will be helpful in making better decisions).
What Is DBT?
DBT means Dialectical Behavior Therapy. Dr. Marsha Linehan created it for people who feel strong emotions. It helps them control their actions better. DBT started as a treatment for borderline personality disorder. Now, it helps with many mental health issues. These include anxiety, depression, addiction, PTSD, and others.
In an Adult IOP program, DBT is taught in groups and supported by individual therapy. Our program is four days a week for two hours a day. Clients learn practical skills and get real-time coaching and feedback from skilled DBT therapists. The goal isn’t perfection. It’s about being more mindful, in control, and better at handling life’s challenges.
Why Do We Struggle With Impulse Control?
Before learning how DBT helps, it’s key to know why impulse control is challenging.
When we feel strong emotions—like anger, fear, shame, or sadness—our brain goes into survival mode. The “thinking brain” (prefrontal cortex) slows down. Then, the “reactive brain” (amygdala) takes charge. Our brain sees this as a threat situation, and it goes into fight/flight. This works well when we need to escape real danger, like running from a wild animal. But it’s not useful when we’re trying to talk through a problem or make smart choices.
How Emotional Reactions Show Up in Daily Life
For example, if someone says something hurtful during an argument, the reactive brain might make you yell, slam a door, or say something you don’t really mean. You might feel like you have to defend yourself right away instead of calmly solving the issue.
In school or at work, pressure or stress can also trigger the reactive brain. If a teacher or boss gives you criticism, you might feel attacked and suddenly want to quit, argue, or shut down instead of listening and learning. These quick, emotional reactions can cause more problems later.
For people with ADHD or other neurodivergent brains, the reactive brain may take over even faster. They might feel emotions more intensely and have a harder time slowing down their response. For example, someone with ADHD might blurt out something in frustration, walk out of class, or give up on a task that feels overwhelming. It’s not because they’re trying to be difficult—it’s because their brain reacts quickly and strongly to stress or conflict.
The Role of The Reactive Brain
The reactive brain acts fast to protect us, but it doesn’t always help us do what’s best in the long run. That’s why it’s important to learn ways to calm down and bring the thinking brain back online before we act.
Impulse control is the ability to pause, think, and act in a way that aligns with our values and goals. It’s something anyone can learn to strengthen, just like a muscle.
DBT’s Four Skill Modules
DBT teaches four key skill groups. These skills work together to boost impulse control and decision-making:
1. Mindfulness
Mindfulness helps us pause and see what’s happening now, without judgment. When we are mindful, we are more aware of our thoughts, feelings, and urges. Being aware is the first step. It helps us make smart choices instead of just reacting.
In DBT IOP groups, clients practice skills like:
- Observing your thoughts, emotions, and body sensations
- Describing what you’re experiencing with words
- Participating fully in the moment without overthinking
- Doing one thing at a time
- Letting go of judgment
2. Distress Tolerance
Distress Tolerance skills teach us how to survive a crisis or intense emotion without making the situation worse. This is where we learn to “ride the wave” of emotion instead of being swallowed by it.
Surfing The Urge
One of the most powerful tools in this module is “Surfing the Urge.”
Imagine a fighter pilot in training. When they first start flying, they might get sick from the motion. But with time and practice, they learn to tolerate the feeling without vomiting. The same goes for emotional urges. We may feel a strong urge to yell, quit, use a substance, or shut down—but we can learn to ride that urge like a wave. This is called urge surfing.
Urge surfing is a skill that helps you get through strong emotions or impulses without acting on them. Here’s how it works:
- Notice the urge – First, you recognize that you’re having a strong urge or emotion. Maybe your heart is racing, your fists are tight, or you feel like screaming or walking away.
- Name it – Say to yourself, “I’m feeling the urge to ____.” Naming it helps you take a step back and see the urge instead of being controlled by it.
- Breathe and observe – Take slow, deep breaths. Notice where you feel the urge in your body. Is it in your chest, stomach, hands, or head? Just observe it without trying to push it away.
- Imagine the urge like a wave – Think of the urge like an ocean wave. It builds up, gets strong, and then slowly goes back down. Most urges don’t last more than 30 minutes. If you can ride it out without reacting, it will pass.
- Stay curious, not judgmental – Try to be kind to yourself. You’re not doing anything wrong by feeling the urge. You’re practicing a new skill.
- Choose your action – Once the wave passes, use your thinking brain to decide what to do next—something that lines up with your goals and values.
Strengthening Your Skills Over Time
Just like the fighter pilot, you get stronger and more skilled with practice. The more you ride the waves, the easier it becomes to stay in control and not let urges steer the plane. Riding the urge lets us pause and let the emotional storm pass. Then, we can respond more effectively.
In IOP groups, people learn and practice other distress tolerance skills like:
- TIPP (changing your body temperature and activity to calm down)
- Self-soothing with the five senses
- Distraction with healthy activities
- Improving the moment
- Radical acceptance of what you can’t change
3. Emotion Regulation
Emotion Regulation skills help us see where our feelings come from. They also teach us how to manage feelings without ignoring them or reacting too fast.
You’ll learn:
- Naming and tracking your emotions
- Reducing emotional vulnerability by taking care of your body and mind
- Building positive experiences
- Changing emotions with opposite actions (like doing something kind when you feel angry)
When you know your emotional patterns, you can respond better to feelings. This helps you make choices that support your long-term goals.
4. Interpersonal Effectiveness
This module focuses on relationships, but it’s just as important for decision-making. When we struggle with impulse control, it often shows up in how we communicate, set boundaries, or respond to others.
You’ll learn:
- How to ask for what you need
- To say no and maintain self-respect
- How to balance being kind with being firm
- And to build relationships that support your goals
Improving communication and relationship skills helps people think before they act. This means they are less likely to be impulsive in social situations. Also, they are more likely to stand up for themselves in smart and effective ways.
The DBT Decision-Making Model
DBT teaches a clear, step-by-step method for decision-making, especially during emotional times. It’s called the DBT Decision-Making Model, and it goes like this:
- Stop and Breathe: Pause before acting. Take a few deep breaths and notice what’s happening inside you.
- Name the Emotion and Urge: Ask yourself: What am I feeling right now? What do I feel like doing?
- Check the Facts: Is the situation as bad as it feels? Are you reacting to a thought or a fact?
- Ask: Will this action help me in the long run? Is this choice in line with your goals and values?
- Use a Skill: Pick a DBT skill that fits the moment—like mindfulness, TIPP, or opposite action.
- Act Mindfully: Move forward with intention and awareness, not just on autopilot.
This model gives you a clear path to follow when your brain wants to panic or escape. Over time, it becomes more natural to stop, think, and choose a response that supports your life.
Real-Life Example: Using DBT to Pause and Choose
Let’s say Sam is in the Adult DBT IOP program. One evening, Sam gets into an argument with their partner. Their heart is racing, their face is hot, and they feel a strong urge to scream or leave the house. In the past, they might have stormed out and spent money they didn’t have or used substances to calm down.
But now, Sam has learned some DBT skills.
Instead of reacting right away, they pause and breathe. They name their emotion (anger and hurt) and their urge (to run away and numb out). They check the facts. They see the argument is upsetting, but their partner didn’t mean harm. They were just overwhelmed, too.
Sam remembers their values: staying sober, being financially stable, and improving their relationship. They don’t act on the urge. Instead, they use the TIPP skill. This means splashing cold water on their face, taking a quick walk, and doing paced breathing. Once Sam calms down, they can come back and use their interpersonal skills to talk it out.
This may seem simple, but for someone who’s spent years reacting to strong feelings, it’s a huge win.
Why DBT Works in an Adult IOP Setting
An IOP is a perfect setting for DBT because it offers:
- Structure and routine to practice new skills
- Group support and shared learning
- Regular coaching to apply skills to real-life situations
- Accountability to stick with the program
Clients in an adult IOP don’t just talk about their problems—they learn how to handle them in the moment. They practice and get feedback. This helps them build real confidence. They learn to stay calm and in control, even when things get tough.
You’re Not Broken—You’re Learning
One of the most powerful messages in DBT is this: You are not broken. You are learning.
Impulses don’t make you a bad person. They are simply your brain’s way of trying to handle big feelings. With practice and support, you can learn to respond wisely. The right skills will help you stay aligned with your goals.
If you’re in an Adult IOP program or thinking about one, remember this: every skill you learn is a tool. These tools help you create a life that feels worth living. You don’t have to be perfect. You just have to keep practicing.
Ready to Start Surfing the Urge?
If your emotions feel too strong, your impulses are intense, or you struggle with choices, DBT can help. You can learn to slow down, check the facts, ride the wave, and make decisions you’re proud of.
It’s not always easy, but it is possible. With the support of the Houston DBT Center, the next time a wave of emotion comes crashing in, you won’t have to panic or fall. You’ll know how to surf it.
Take Control of Your Impulses and Improve Decision-Making with DBT at an Adult IOP in Houston, TX
If you’re struggling with impulse control or decision-making, an Adult IOP in Houston, TX focused on DBT can help you develop the skills needed to regain control. At Houston DBT Center, we specialize in supporting individuals through intensive DBT techniques that enhance emotional regulation and decision-making. Take the first step toward a more balanced and fulfilling life by joining our Adult IOP today! Follow these three simple steps to get started:
- Call 713-973-2800 or email administration@houstondbtcenter.com today for a free consultation.
- Meet with a skilled DBT therapist to evaluate your needs and goals.
- Begin taking control of your impulses and improve your decision-making!
Additional Services Offered by Houston DBT Center
At Houston DBT Center, we provide more than just an Adult IOP to support you in taking control of your impulses and improve your decision-making. Our services also include specialized trauma therapies like DBT, CPT, and EMDR, as well as Radically Open DBT, Teen IOP, parent coaching, and play therapy. With a team of over 15 experienced therapists, we offer comprehensive care for various mental health challenges and collaborate closely with families for the best outcomes. Be sure to check out our blog for more helpful insights!