Dialectical Behaviour Therapy (DBT)
What is Dialectical Behaviour Therapy, or DBT?
DBT is an evidence-based therapy and has been adapted for different populations, age ranges and clinical settings. It has become a flexible treatment approach that assists a wide range of people.
DBT is based on the concept of the dialectic – a principle which emphasises the contradictions or opposites inherent in the world. In DBT, these opposites are made clear, and the client and clinician work to resolve them by forging a middle path.
Examples of dialectics in the context of DBT include:
the client’s need for autonomy versus their desire for connection
the contradiction between the clinician’s acceptance of clients as they are and their motivation to help them change
the experience of intense emotional pain versus detachment or numbing
the desire to live versus the desire to die
being sensitive to criticism versus self-invalidation.
DBT also differs from traditional CBT in its emphasis on acceptance and balance. The western psychological tradition is complemented with elements of eastern philosophical traditions. As a result, DBT includes approaches associated with Buddhist practices such as mindfulness meditation.
What conditions can be treated with DBT?
DBT was developed to help people manage emotional problems such as those experienced in borderline personality disorder.
These problems involve rapidly changing and distressing mood states, such as anxiety, irritability and depression.
They are often also associated with concerning behaviours such as self-harm, relationship difficulties, and impulsive or risky actions.
These problems had proven resistant to traditional cognitive behavioural treatment.
DBT emerged as an alternative in the 1990s when Marsha Linehan adapted cognitive behavioural therapy to improve its effectiveness in people experiencing these conditions.
Why do we practice DBT at Peter Walker & Associates?
DBT is an evidence-based treatment approach which aligns with the ethos of our practice.
All of our clinical psychologists have experience delivering DBT treatment and we have seen it work for a lot of clients to help them manage distress and build a more satisfying life.
How our clinicians use DBT for treatment
Treatment sessions in DBT have a set structure and cover the following four areas:
1. Core Mindfulness
This involves learning to focus your awareness on the present, along with the ability to observe things as they’re unfolding and disengage from reactive responses. It is considered the most important skill and this module is reinforced throughout treatment.
2. Emotion Regulation
In this module, you learn how to reduce your vulnerability to distress and tame emotions you’d like to experience less.
3. Distress Tolerance
These skills help you get through a distressing situation without making it worse. This module involves building your capacity to tolerate and allow unwanted experiences.
4. Interpersonal Effectiveness
This module teaches relationship and communication skills to help you develop more satisfying relationships.