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Compared to other races, Native Americans have significantly higher rates of suicide and substance abuse. Dialectical behavioral therapy is an evidence-based program with efficacy for reducing suicidality and comorbid disorders within general populations but may not be effective for Native Americans because it is based in Western ideology. The purpose of this phenomenological study was to explore the lived experiences of Native American therapists who use DBT with Native American populations. Using biosocial theory, I investigated the perceptions and lived experiences of 8 Native American therapists through a phenomenological approach. The research questions encompassed the experiences, including the cultural appropriateness, effectiveness, and treatment barriers and challenges in using DBT. I analyzed data using the interpretive phenomenological analysis. The data displayed 3 superordinate themes from participants: cultural understanding, usefulness of dialectical behavior therapy, and challenges of dialectical behavior therapy. The findings revealed a lack of consensus on how DBT helps Native clients, but participants shared positive experiences using DBT. It was confirmed in the study that knowing the culture, being Native as a provider, understanding generational trauma, and the uniqueness of diversity with different tribes is an asset. The study may have significance for social change by identifying Native American therapists' experiences with using and modifying DBT for Native American clients and potentially providing a pathway for its future use in Native American communities, including current strengths and potential improvements.