For Therapists & Clinicians

WithMarsha for Therapists

Extend DBT Skills Beyond the Therapy Room — Safely and Ethically

A Complementary DBT Practice Companion

WithMarsha helps clients practice Dialectical Behavior Therapy (DBT) skills between sessions through structured lessons, mood tracking, and guided AI conversations.

It's not therapy — it's a practice environment that keeps clients engaged with mindfulness, emotion regulation, and distress tolerance skills long after they leave session.

Built by a DBT practitioner and AI engineer who's lived the work, WithMarsha bridges the gap between learning DBT and living DBT.

Why Skill Generalization Matters

Therapists know that the hardest part of DBT isn't learning the skills — it's remembering to use them when emotions spike.

Research consistently shows that between-session skills practice is one of the strongest predictors of client outcomes, yet most clients struggle to maintain consistency outside therapy.

"Between-session engagement predicts stronger DBT outcomes, yet clients often underutilize skills in daily life."
— Linardon et al., 2024, A Dialectical Behavior Therapy Skills Training Smartphone App: Feasibility and Outcomes.

WithMarsha helps close that gap by guiding users through real-time, context-sensitive skill use — without crossing therapeutic or ethical boundaries.

How WithMarsha Supports Your Work

WithMarsha is designed to complement, not replace, your clinical care.

Reinforces Homework Compliance

Keep clients engaged with DBT skills between sessions through structured practice.

Reduces Re-Teaching Time

Clients retain foundational skills, freeing up session time for deeper work.

Enhances Skill Retention

Daily practice with guided feedback strengthens generalization.

Maintains Boundaries

Clear disclaimers and ethical guardrails protect therapeutic relationships.

Clients Can:

  • Practice DBT skills (e.g., STOP, PLEASE, Wise Mind) through interactive micro-lessons
  • Log emotions, intensity, and triggers in mood entries
  • Reflect on daily experiences with guided prompts
  • Receive educational feedback from the AI coach "Marsha"

Therapists Benefit By:

  • Reinforcing homework compliance between sessions
  • Reducing re-teaching time for foundational skills
  • Enhancing skill retention without direct involvement
  • Maintaining professional boundaries and confidentiality

Ethics, Boundaries, and Data Privacy

We take therapist trust seriously. WithMarsha is structured to protect client privacy and therapeutic integrity from end to end.

Safeguards Include:

  • Clear disclaimers throughout: "This is not therapy, medical advice, or crisis care."
  • Escalation resources displayed in-app (988, 911, and Crisis Text Line)
  • End-to-end encryption and row-level security
  • De-identified data storage with no PHI/PII used for model training
  • Crisis-safe language model guardrails and zero data resale
  • Optional data deletion at any time

We're a consumer educational product, not a HIPAA covered entity — but we meet and exceed comparable standards in encryption, data isolation, and ethical guardrails.

Evidence Base & Research Sources

WithMarsha is grounded in research on DBT skills training, digital mental health, and mobile generalization tools.

Linardon J., et al. (2024)

A Dialectical Behavior Therapy Skills Training Smartphone App: Feasibility and Outcomes.

Frontiers in Psychology / PMC11773374

Demonstrates that mobile DBT skills training improved user outcomes and feasibility across adult populations.

Read full text →

Wilks C.R., Gurtovenko K., Rebmann K., et al. (2021)

A Systematic Review of Dialectical Behavior Therapy Mobile Apps for Content and Usability.

Borderline Personality Disorder and Emotion Dysregulation, 8(1)

Evaluated all available DBT apps; concluded that clinician-informed development and evidence-based structure are essential for safety and effectiveness.

Read full text →

Ramzan N., Camp J., Tranah T. (2025)

The DBT Coach App as an Adjunct to a Comprehensive DBT Programme for Adolescents: An Acceptability and Feasibility Study.

The Cognitive Behaviour Therapist (Cambridge University Press)

Found high clinician and patient acceptability when using DBT coaching apps as adjuncts, supporting ethical use alongside therapy.

Read full text →

Daros A.R., et al. (2024)

Feasibility, Acceptability, and Potential Efficacy of a Self-guided iDBT Intervention in Treatment-Seeking Adults with Substance Use Disorders.

JMIR Mental Health, 11(1), e50399

Demonstrates how self-guided DBT-based interventions can reinforce behavior change and reduce distress independently.

Read full text →

Schroeder J., Wilks C., Rowan K., et al. (2018)

Pocket Skills: A Conversational Mobile Web App to Support Dialectical Behaviour Therapy.

Proceedings of CHI 2018 (Microsoft Research)

Early validation of conversational DBT apps for skills reinforcement — the same foundation WithMarsha is built upon.

Read full text →

Integrating WithMarsha in Clinical Workflows

Therapists can recommend WithMarsha as a skills practice tool, not as part of formal therapy.

Best Practices for Introducing Marsha:

  1. 1Frame it as "structured DBT homework" between sessions.
  2. 2Encourage the client to track one skill per day (Mindfulness, Emotion Regulation, or Distress Tolerance).
  3. 3Check in during session: "What did you notice when using Marsha's skill reflection?"
  4. 4Encourage autonomy — no therapist oversight needed.

Do:

Recommend Marsha as a practice supplement.

Don't:

Use it as part of psychotherapy documentation or treatment planning.

Download Clinician Handout

WithMarsha Ethical Use & Integration Guide (PDF)

Built by Someone Who's Been There

"I've been through DBT group therapy myself. I've lived the work. As an AI engineer, I built Marsha to make DBT practice easier for people like me — those learning to build a life worth living."

— Alex Avila, Founder, WithMarsha
DBT Practitioner & AI Engineer

Frequently Asked Questions

Everything therapists need to know about WithMarsha

Is WithMarsha therapy?▼

No. WithMarsha is an educational tool for DBT skill reinforcement. It never replaces professional care.

Can therapists use client data?▼

No. User data is de-identified and never shared. Therapists can optionally ask clients about reflections in session.

Does WithMarsha require therapist supervision?▼

No. It's designed for autonomous, self-guided skill practice.

Is it HIPAA-compliant?▼

While not a covered entity, WithMarsha uses comparable security: TLS 1.3, RLS database security, and zero third-party data resale.

Can I try it first?▼

Yes — we're inviting DBT clinicians to join the beta. You'll get free access, preview new modules, and shape our ethical framework.

Join the Clinician Beta

You're invited to preview WithMarsha and help shape its development for DBT practitioners and clients everywhere.

Join the Clinician BetaSchedule a Feedback Session

Help us bring evidence-based DBT practice to more people — safely, ethically, and effectively.