Inclusion Criteria:  Thirty (30) adolescents (ages 14-17 years old) living with youth onset T2D will be recruited to participate in Pilot 1, fifteen (15) adolescents, and one caregiver, will be randomized to receive DBT and fifteen (15) adolescents will be randomized to a control group. An additional thirty adolescents (14-17 years old) will be recruited to participate in Pilot 2.  Exclusion Criteria:  Diabetes not diagnosed as type 2 diabetes including: type 1 diabetes, genetic diabetes, cystic fibrosis diabetes, diabetes secondary to medication use. Ever cancer Other chronic illness associated with systemic inflammation (ex. Juvenile rheumatoid arthritis, Crohn's disease) Active psychotic disorder Past year suicide attempt or an active plan Self-reported substance/alcohol use disorder in past (1 year) Patient and/or caregiver unable or unwilling to provide voluntary informed assent/consent Currently pregnant (eligible at 3 months post-partum) Exclusion criteria would include significant self-harm behaviour and substance abuse, which would impair affective participation in a DBT group setting based on clinical judgement.