Dialectical behaviour therapy (DBT)

The bodies of two people sitting and talking.

What is dialectical behaviour therapy (DBT)?

Dialectical behaviour therapy (DBT) is a type of cognitive behavioural therapy (CBT). It was developed with a focus on treating borderline personality disorder (BPD) but can also be effective in treating other mental health disorders that involve feeling intense emotions: e.g. self-harm, eating disorders, attempted suicide and/or depression. Both DBT and CBT aim to help you change unhelpful behaviour and ways of thinking, but DBT has an additional focus on accepting who you are.

Why is it done?

DBT supports patients in adjusting certain negative behaviours by helping them develop coping mechanisms to manage intense emotions and rapid fluctuations in mood. It also focuses on encouraging patients to accept who they are as a person as well as their feelings. In short, the objective is change and acceptance.

What does it involve?

It incorporates dialectics, which is the art of discussing truth and viewing concepts from opposing perspectives. The result is to enable patients to understand that contradicting things can be true. In DBT, two or more people discuss opposing points of view in order to resolve contradictions between self-acceptance and change. It can be done as individual therapy, group therapy or phone coaching.

There are four aspects of DBT

  • Mindfulness – staying present in the moment and being attentive to what’s happening
  • Emotion regulation – being able to manage intense emotions
  • Interpersonal effectiveness – how well you respond (emotions and actions) to the people around you and in personal relationships
  • Distress tolerance – learning to withstand distressing emotions

How do you prepare for DBT?

A therapist might offer you a pre-assessment to check if DBT is the most suitable therapy for you. If you and your therapist believe DBT is the right therapy, you’ll be asked to prepare for the commitment needed in and out of sessions.

Alternatives to this treatment

DBT is less focused on your past and instead focuses more on your present and future. If you aim to evaluate how your behaviour started and why you think the way you do, a different talking therapy may benefit you more.

Other therapies include:

  • Cognitive therapy
  • Behavioural therapy
  • Mindfulness
  • Multimodel therapy
  • Rational emotive behavioural therapy (REBT)
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