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Dialectical Behaviour Therapy (DBT)

What is Dialectical Behaviour Therapy (DBT)?

Dialectical Behaviour Therapy (DBT) is a type of cognitive-behavioural therapy (CBT) developed by Dr. Marsha M. Linehan in the late 1980s. It was initially designed to treat individuals with borderline personality disorder (BPD), a complex and challenging mental health condition characterised by intense mood swings, unstable relationships, impulsivity, and a poor sense of self.
DBT incorporates a dialectical approach, which means it combines seemingly opposing ideas or concepts to create balance and change. In the case of DBT, these opposing ideas include acceptance and change. The therapy aims to help individuals develop a balance between accepting themselves and their current circumstances (acceptance) while also working to change problematic behaviours and emotions (change).

Key components of DBT include:

  • Mindfulness: Mindfulness skills are a core component of DBT. Individuals learn to become more aware of their thoughts, feelings, and bodily sensations in the present moment without judgment. Mindfulness techniques help them regulate their emotions and increase their ability to tolerate distress.

  • Distress Tolerance: DBT teaches individuals how to tolerate and manage distressing emotions without resorting to self-destructive behaviours. This includes learning crisis survival skills for moments of intense emotional distress.

  • Emotion Regulation: DBT helps individuals identify and regulate their emotions more effectively. This involves recognising and understanding emotional triggers, reducing emotional vulnerability, and developing healthy ways to cope with emotions.

  • Interpersonal Effectiveness: This component focuses on improving communication and interpersonal skills. Individuals learn how to assertively express their needs and boundaries while maintaining relationships and avoiding conflict.

  • Middle Path: The dialectical aspect of DBT encourages individuals to find a middle ground between extremes. This means balancing acceptance and change, as well as avoiding all-or-nothing thinking.

DBT is typically delivered in a structured and comprehensive manner through individual therapy sessions, group therapy, and phone coaching between sessions. The therapy is often used to treat a range of mental health issues beyond BPD, including depression, anxiety, substance abuse, eating disorders, and self-harm.
DBT has been extensively researched and has shown effectiveness in helping individuals improve emotional regulation, reduce self-destructive behaviours, and enhance their overall quality of life. It’s typically administered by trained therapists who have received specific training in DBT techniques.