Dialectical Behaviour Therapy (DBT)

Dialectical behaviour therapy (DBT) is a comprehensive, evidence-based psychotherapy approach. It is a modified type of Cognitive Behavioral Therapy (CBT) and aims to teach people how to focus on the present and develop healthy ways to cope with stress, regulate emotions and improve interpersonal relationships. “Dialectical” refers to the notion that bringing together two opposites in therapy – “acceptance” and “change” – results in better results than using either one alone. Therapists using DBT “accepts” the client’s experiences and balances this with a need for “change” in negative behaviours. 

DBT is often used to treat higher risk conditions and/or clients with comorbid conditions. DBT is used to treat people who struggle with emotional regulation or exhibit self-destructive behaviours. This includes Borderline Personality Disorder, eating disorders and substance use disorders. It is also sometimes used to treat Post-Traumatic Stress Disorder (PTSD). Standard comprehensive DBT consists of 4 parts: Individual therapy, Group skills training, Phone coaching during crises, and Consultation group for health care providers.

DBT incorporates many aspects of other cognitive-behavioural approaches. This includes: 

• • Behaviour therapy
    • 1. Exposure
      2. Contingency management
      3. Problem Solving
      4. Stimulus Control
  • Cognitive restructuring

DBT focuses on 4 ways to enhance clients coping skills:

1. 1. 1. Distress tolerance 
         • Aims to help clients in reducing impulsive reactions and self-destructive behaviour to feelings of intense emotions such as anger
      2. Emotional Regulation
         • Encouraging clients to recognize, label and manage emotions
      3. Mindfulness
         • Increase clients’ ability to focus on the present moment, become more self-aware, and tune in to surroundings and others
      4. Interpersonal Effectiveness
         • Improves clients’ ability to navigate conflict and interact assertively

DBT begins by treating the most self-destructive behaviour, then starts to address clients’ ability to cope in daily life (e.g. emotional regulation, distress tolerance and interpersonal effectiveness), and subsequently focuses on improving clients’ relationships and self esteem. DBT ultimately aims to increase clients’ happiness and improve clients’ relationships.

Currently, DBT has shown to be an efficacious and specific treatment for Borderline Personality Disorder and related mental health conditions.