Dialectical Behaviour Therapy

What is DBT?

Dialectical Behaviour Therapy (DBT) is a treatment approach that combines Cognitive Behavioural Therapy techniques (CBT) with Eastern philosophies centred on awareness and acceptance.  DBT focuses on learning new skills and strategies to reduce emotional suffering and create a life worth living. The four modules in DBT are: mindfulness (increasing self-observation and awareness), interpersonal effectiveness (dealing with conflicts, balancing getting your needs met with self-respect and maintaining the relationship), emotion regulation (understanding and managing emotions) and distress tolerance (learning to tolerate distress without making the situation worse).

DBT was initially developed to help people with Borderline Personality Disorder (BPD) and has since been shown to be effective for a variety of concerns, including chronic suicidality, self-harming behaviours, depression, eating disorders, traumatic stress, and substance abuse.

Rationale for DBT

Biology + Life experience = Emotional experience

DBT recognises that, due to a combination of biology and life experiences, some of us experience painful emotions more frequently, intensely and for a longer time. While our attempts to manage this emotional pain may be relieving in the short term, it can often create more difficulties for us in the long-term. Therefore, one focus in DBT is to regain our ability to make wise choices, even when overwhelmed by emotions.

The word ‘dialectical’ refers to the integration of two ideas or facts that seem to contradict each other. The main dialectic in DBT is the balance between acceptance and change; recognising that people are doing their best AND that they can do better.

How is treatment structured?

Typical DBT is designed to have group and individual sessions running in parallel. The weekly group workshop sessions teach specific skills across four modules of mindfulness, interpersonal effectiveness, emotion regulation, and distress tolerance. The individual therapy sessions focus on issues that have come up during the week that require immediate individual attention and ways to increase effective skills practice.

There is a strong focus on practising new behaviours and skills while engaging in DBT treatment as a way to gain relief and experience positive change.  It can be a demanding therapy to undertake and it is likely that the psychologist you meet will be focused initially on assessing your readiness and commitment.