Dialectical Behaviour Therapy (DBT)

What is Dialectical Behaviour Therapy? 

Dialectical Behavioural Therapy (DBT) is a type of cognitive-behavioural treatment which is specifically adapted to help people who experience emotions very intensely. There is an evidence base to suggest that this a therapy used to help manage borderline personality disorder. The word ‘Dialetical’ means understanding how opposite statements can be both be true.

An example of this may be saying ‘Accepting who you are’ and ‘changing your behaviour’. DBT coaches people to understand that it is possible for you achieve both of these despite appearing to be opposite statements.

How does Dialectical Behaviour Therapy work?

As a cognitive behavioural therapy, DBT works by helping people identify and change negative thinking patterns meanwhile also encouraging people to accept who they are.

DBT explores acceptance techniques such as understanding who you might be as a person and making sense of why you might engage in certain behaviours (for example, self-harming or substance use).

DBT also uses explore techniques such as challenging unhelpful thoughts and encouraging new ways or strategies to deal with stressful situations.

Why might I need DBT?

DBT was originally designed to help therapists work with people diagnosed with Borderline Personality Disorder. However, many people don’t like that label and may be resistant to attending therapy due to this.

DBT can be used to treatment many other issues especially if intense emotions are experienced by an individual. This does not mean if you experience intense emotions that DBT will be right for you. This would be discussed at assessment.

What problems can DBT help with?

The aim of DBT is to help you understand and accept difficult feelings, learn new skills and find emotional management techniques.

DBT has been adapted for the youth population and is an evidence-based treatment. DBT is especially effective for the following challenges and disorders:

• Borderline Personality Disorder
• Suicidal thinking or behaviour (suicide attempts)
• Self-injury and other self-destructive behaviours
• Anger and anger management
• Problems with emotions (such as intense sadness or recurrent fear)
• Impulsive behaviours that can be dangerous (such as reckless driving, recurrent unsafe sex, etc.)
• Difficulty building and maintaining healthy relationships
• Chronic feelings of emptiness
• Problems with substance use
• Eating disorders such as bingeing and purging
• Offending Behaviour (committing crimes, repeated patterns of re-offending).

The skills group focuses on how to:

• manage attention (mindfulness skills)
• manage and cope with emotions (emotional regulation skills)
• deal effectively with others (interpersonal skills)
• tolerate emotional distress (distress tolerance skills)

How many sessions would I need?

This is dependent on the individual and would be discussed at assessment if this was found to be the right therapy for you. Your issues and goals would be explored and the therapist could make recommendations about how many sessions would be beneficial for you to achieve these.

Sessions are usually approximately 45-60 minutes. The individuals sessions have a hierarchy of goals:

• To help keep you safe by reducing suicidal and self-harming behaviours.
• To reduce behaviours that may interfere with therapy.
• To help you reach your goals and improve your quality of life by addressing what’s getting in the way. There may be other mental health problems that you may be experiencing such as hearing voices or depression or personal issues such as relationships or work life.
• To help you learn new skills to replace unhelpful behaviours and help you achieve your goals.

DBT can be ran in group sessions, especially in community settings however this is an option to work on a one to one basis with a therapist.