Dialectical Behaviour Therapy (DBT)

Dialectical Behaviour Therapy (DBT) is an approach to cognitive-behavioural therapy that was originally designed to treat individuals with borderline personality disorder (BPD) and those suffering from frequent suicidal thoughts and impulses.

Dialectical Behaviour Therapy (DBT) is an evidence-based structured therapeutic approach that focuses on reducing self-destructive, life-interfering behaviours. It follows a hierarchical treatment plan to address problems in order of priority. DBT also teaches its clients a balance of empathy and acceptance, while still attempting to change any problematic behaviours. Four sets of behavioural skills are taught in DBT: mindfulness, distress tolerance, interpersonal effectiveness and emotional regulation. These skills have been proven to be effective in reducing suicidal behaviour, self-harm, substance misuse, anger and depression, making it the gold standard psychological treatment for individuals with Borderline Personality Disorder (BPD). Additionally, there are adaptations of DBT that can be used to treat substance misuse, depression, post-traumatic stress disorder (PTSD) and eating disorders.

In Dialectical Behaviour Therapy (DBT), you can expect to meet with your therapist once or twice a week, depending on whether you join a skills training group. These sessions will consist of individual therapy and learning skills to manage emotions and relationships more effectively. Your therapist may challenge you to make sure you are motivated to reduce reliance on unhealthy, self-destructive behaviours. You may also receive out of session contact as a way to help apply newly learned skills to real life situations. In addition to this, you may be asked to complete diary cards and conduct behavioural chain analyses with your therapist in order to observe the events that lead to self-destructive behaviours and think about how new skills can be used to avoid them. DBT is a long-term, intensive therapeutic approach and so you should expect to work with your therapist for six months to one or two years.

If you struggle to regulate your emotions and have occasionally resorted to self-destructive behaviors, you may be offered Dialectical Behavior Therapy (DBT). This is especially true if other therapeutic approaches, such as Cognitive Behavior Therapy (CBT), have not been successful.