Dialectical behaviour therapy (DBT) is a structured form of therapy developed by American psychologist, Marsha Linehan, to treat borderline personality disorder (BPD). It is based on cognitive behaviour therapy (CBT), but has been adapted to meet the needs of people who experience emotions very intensely. It can also be used to treat other conditions, like suicidal behaviour, self-harm, substance use, post-traumatic stress disorder (PTSD), depression, and eating disorders.
What Does Dialectics Mean?
Dialectics refers to finding the truth between two opposing ideas and trying to balance the seemingly contradictory positions. DBT aims to help clients balance acceptance of themselves whilst changing their behaviours to improve their quality of life.
There are multiple elements that form a full DBT intervention with group therapy at the core. In a group setting, individuals get to learn and practice new skills structured around four modules with homework.
- Mindfulness – clients learn to focus their attention and live life in the present, rather than constantly being distracted by distressing thoughts and worries about the past or future.
- Distress Tolerance – clients build skills to deal with crises in more effective ways rather than trying to cope through self-harm or other maladaptive strategies.
- Interpersonal Effectiveness – clients learn assertiveness in interpersonal relationships while maintaining self-respect to reduce conflict between clients and others.
- Emotion Regulation – clients develop awareness, understanding, and control over emotions.
DBT is typically run as a 24-week program, often taken twice to create a one-year program. In its standard form, there are three ways you receive DBT during the program. There are also shorter versions of DBT such as 12 week courses depending on the setting, and some versions do not include telephone coaching. DBT has been adapted for different needs.
Programs typically run over 24 weeks and clients are often encouraged to attend 2 programs to create a one-year intervention. However, shorter courses have also shown efficacy and may be available in some settings.
Best practice also recommends clients receive individual support in one-on-one sessions with a psychologist and phone consultations between group sessions.