Dialectical Behaviour Therapy (DBT)

Dialectical behaviour therapy (DBT) represents a modified approach to cognitive behavioural therapy (CBT), aiming to instruct individuals on living in the present moment, fostering healthy coping mechanisms for stress, managing emotions, and enhancing interpersonal relationships.

Initially designed to treat individuals with borderline personality disorder (BPD), DBT has since been adapted to address various other mental health conditions. It extends support to individuals struggling with emotional regulation challenges or engaging in self-harming behaviours, encompassing issues like eating disorders and substance use disorders. Additionally, DBT is occasionally utilised in the treatment of post-traumatic stress disorder (PTSD). It combines principles of acceptance and change, emphasising mindfulness, interpersonal effectiveness, emotion regulation, and distress tolerance.

DBT has undergone significant development to establish itself as a psychotherapeutic approach supported by empirical evidence, effectively employed in the treatment of various conditions. Common settings where DBT is implemented include:

• Group therapy sessions wherein participants are instructed in behavioural skills within a collective environment.
• Individual therapy sessions conducted by qualified professionals, tailored to integrate acquired behavioural skills into the specific challenges faced by each patient in their personal life.
• Phone coaching services allowing patients to reach out to therapists between sessions for assistance in navigating challenging situations they may be currently experiencing.

Techniques in DBT

• Mindfulness: DBT teaches individuals to observe and describe their experiences without judgment, fostering awareness of thoughts, feelings, and sensations in the present moment.
• Distress Tolerance: Clients learn coping strategies to tolerate distressing emotions without resorting to harmful behaviours. This includes techniques such as distraction, self-soothing, and improving the moment.
• Emotion Regulation: DBT helps individuals understand and manage intense emotions by identifying triggers, increasing emotional awareness, and learning healthier ways to express and regulate feelings.
• Interpersonal Effectiveness: Clients acquire skills to navigate relationships effectively, including assertiveness, setting boundaries, and balancing priorities while maintaining self-respect and respect for others.

What DBT Can Help With

DBT is effective in treating various mental health issues, including but not limited to:

• Borderline Personality Disorder (BPD)
• Mood disorders such as depression and bipolar disorder
• Anxiety disorders
• Post-Traumatic Stress Disorder (PTSD)
• Eating disorders
• Substance abuse and addiction
• Self-harming behaviours
• Suicidal ideation and behaviours

Benefits of DBT

Enhanced Emotional Regulation

DBT equips individuals with practical skills to understand, manage, and regulate their emotions effectively. By learning to identify triggers, recognise emotional responses, and implement coping strategies, individuals can experience greater stability and control over their feelings. This leads to reduced emotional volatility and impulsivity, promoting overall emotional well-being.

Improved Interpersonal Relationships

One of the core components of DBT is interpersonal effectiveness, which focuses on communication skills, setting boundaries, and maintaining healthy relationships. Through DBT, individuals learn to navigate social interactions more skilfully, express their needs assertively, and cultivate empathy and understanding in their relationships. This often leads to improved communication, deeper connections, and greater satisfaction in personal and professional relationships.

Effective Coping Mechanisms

DBT teaches individuals alternative and healthier ways to cope with distressing emotions and challenging situations. By developing distress tolerance skills, individuals learn to tolerate uncomfortable emotions without resorting to harmful behaviours such as self-harm or substance abuse. This fosters resilience and adaptive coping strategies, reducing the reliance on maladaptive coping mechanisms.

Increased Mindfulness and Present-Moment Awareness

Mindfulness is a fundamental aspect of DBT, emphasising non-judgmental awareness of the present moment. Through mindfulness practices, individuals learn to cultivate greater awareness of their thoughts, feelings, and sensations, without getting entangled in negative patterns or rumination. This heightened mindfulness leads to improved self-awareness, clarity of mind, and the ability to respond to situations with intention rather than react impulsively.

Reduction in Self-Destructive Behaviours

DBT has been particularly effective in reducing self-destructive behaviours such as self-harm, suicidal ideation, and impulsive behaviours. By addressing underlying emotional dysregulation and providing practical skills for managing distress, individuals are empowered to break free from harmful patterns and engage in more adaptive and life-affirming behaviours.

Long-Term Symptom Management

Research has shown that DBT is effective not only in reducing symptoms in the short term but also in promoting long-term stability and well-being. By addressing the root causes of emotional dysregulation and providing ongoing support and skill-building, DBT equips individuals with the tools needed to manage their symptoms effectively and maintain progress over time.

Increased Quality of Life

Ultimately, the overarching goal of DBT is to improve the quality of life for individuals struggling with mental health challenges. By providing a comprehensive and holistic approach to treatment, DBT helps individuals lead more fulfilling, meaningful, and balanced lives. Whether it’s pursuing personal goals, nurturing relationships, or engaging in activities that bring joy and fulfilment, DBT empowers individuals to live their lives more fully and authentically.

Effectiveness of DBT

Numerous studies have demonstrated the effectiveness of DBT in treating various mental health conditions. Research indicates that DBT can lead to significant improvements in symptom severity, interpersonal functioning, and overall quality of life for individuals receiving treatment. Furthermore, DBT has been shown to reduce the risk of hospitalisation, self-harm, and suicidal behaviour among those with BPD and other high-risk populations.

Things to Consider Before Pursuing DBT

• Commitment to Treatment: DBT typically involves a significant time commitment, including weekly individual therapy sessions, group skills training sessions, and homework assignments. Prospective clients should be prepared to dedicate time and effort to the treatment process.
• Openness to Change: DBT requires a willingness to engage in self-reflection, learn new skills, and implement behavioural changes. Clients should be open to exploring their thoughts, emotions, and behaviours in order to benefit fully from the therapy.
• Finding the Right Therapist: It’s essential to work with a therapist who is trained and experienced in delivering DBT. A qualified therapist can provide guidance, support, and structure throughout the treatment process, increasing the likelihood of successful outcomes.
• Cost and Accessibility: Considerations such as cost, insurance coverage, and the availability of DBT programmes in your area may impact your ability to access treatment. It’s essential to explore these factors and determine the feasibility of pursuing DBT.

Implementation of DBT at Our Hospitals