Dialectical Behavioural Therapy (DBT)

If you know much about cognitive behavioural therapy (CBT), you may also be familiar with dialectical behavioural therapy (DBT) which is a modified, behaviour-centric version of CBT. DBT was created to help people tackle more complex behavioural patterns that haven’t benefited from traditional psychotherapies. 

In DBT, you and your therapist will work closely to bring about positive change in your life because ultimately, DBT helps us to express and manage intense negative emotions in more positive ways. It can be tailored to meet your unique needs and has been shown to be highly effective in improving the quality of life.

So, what is the main difference between DBT and CBT?

What makes DBT unique is its ‘dialectical’ component. DBT brings together two opposites in therapy — acceptance and change — to optimise therapeutic results. While it was originally developed to treat Borderline Personality Disorder (BPD), DBT has since been used to treat acute and high-risk individuals with self-harming or suicidal tendencies, binge-eating, alcohol and substance abuse, chronic anxiety, and gambling. 

Comprehensive DBT allows your therapist to help you move away from unhelpful or harmful coping behaviours and towards a more meaningful life. 

What are the 4 principles of DBT?

The are 4 main goals of DBT that are used to develop healthy ways to cope with distress, emotion regulation, and improving relationships.

1. Mindfulness

Mindfulness teaches us how to live in the moment, and to accept our thoughts, feelings, and behaviours as they occur without judgement or the desire to control them. By practicing mindfulness, we learn to distance ourselves from thoughts that can cause distress.  

2. Distress tolerance

Distress tolerance skills help us learn how to manage and cope during a crisis. Crisis survival, acceptance, and self-soothing skills are practiced, and can be especially helpful when we feel as if we may not be able to control an uncomfortable or distressing situation.

3. Emotion regulation

Emotion regulation skills are important for better managing our emotions. Why? Because it helps us understand how our emotions work. Emotion regulation skills typically centre around naming and understanding our emotions, decreasing the frequency of unwanted emotions, and effectively managing and problem solving in order to increase our mental health.

4. Interpersonal effectiveness

Struggling with emotions can take a toll on our relationships. DBT focuses on improving our interpersonal skills to help us build and maintain meaningful, quality relationships. Approaching conversations with more conscious intention and thoughtfulness — rather than reacting impulsively due to distressing or intense emotions — is likely to bring us more satisfaction in our interactions with others. Learning to set boundaries, be more assertive and ask for things when appropriate are taught in DBT to enhance our interpersonal skills.

DBT can be used to treat a number of issues, including:

• Borderline personality disorder (BPD) 
• Self-harming or suicidal tendencies
• Binge-eating
• Alcohol/substance abuse
• Chronic anxiety
• Gambling
• Emotional and behavioural dysregulation