Dialectical Behavioural Therapy (DBT)

What is DBT? 

Dialectical behaviour therapy (DBT) is a psychological treatment to assist people diagnosed with borderline personality disorder or those displaying borderline personality traits in learning and applying skills to improve their life. It consists of both individual therapy and group skills training.

Alternatives to DBT 

DBT is an evidence based treatment for borderline personality disorder that is explicitly recommended by the National Institute for Health and Clinical Excellence (NICE). However, there may be other psychological therapies that may be effective and you should discuss these with your referrer or assessor. 

Risks 

As with many other therapies, DBT is not without risk and you may experience a slight worsening of your condition as you begin to address some difficult issues. There is, however, a very good support network in place to help you deal with these difficulties if and when they arise and your therapist will discuss this with you. 

Benefits 

The evidence base for DBT shows that it is effective in reducing self-harm and self-destructive behaviours. However, as we address a variety of problems it may be that you benefit from it in lots of other ways.

How long does therapy last and what is expected of me? 

DBT groups are usually held weekly in your local area. They normally last approximately 2 hours, will have 8-12 members at most, and are run by professional therapists. The whole programme is one-year long and you will be expected to commit for this length of time. 

In addition to the weekly group sessions you will have regular one-to-one sessions with a therapist. You will be asked to put into practice what you learn in the groups and fill in diaries. 

How do I know if I am suitable for the group? 

Individuals who are referred for DBT will be offered an individual assessment with a therapist. This will allow you to assess whether this would be for you or not.

Real Life Experience

When I was first referred to my dialectical behaviour therapist by a nurse from the local community mental health team, I felt both relieved and anxious. Relieved because after over a decade of struggling, somebody in a position of power had listened to my story and believed there was a treatment out there that could teach me the skills I so desperately needed to turn my life around. Anxious because, not only had other treatments I had explored in the past not worked for me, I was also becoming increasingly aware of the stigma faced by those with a diagnosis of borderline personality disorder such as myself.

As an undergraduate psychology student, who had transferred from one university to another due to several traumatic events, self-harm, and suicide attempts, I knew I had the drive to dedicate a year of my life to gaining a greater insight into my symptoms; specifically, why I had them and what I could do to manage them. If I had come this far and survived, surely, I would be able to push myself a little further? I’d seen close friends go to counselling and cognitive behaviour therapy and knew their lives had been transformed for the better by those decisions, so I thought to myself that there would be no harm in me doing the same and giving it a go. Fortunately, I was right!

Despite the fact that the pandemic was happening when I had reached the top of the waiting list, and I was asked to participate in both the individual and group sessions over video calls, I truly believe my experience was as effective as it would have been in person, quite simply because of the amazing people on the specialist psychotherapy team who held the space for me to express what was on my mind, simultaneously validating my thoughts and feelings, and challenging them. They challenged them through four core modules: mindfulness, interpersonal effectiveness, distress tolerance and emotion regulation; all of which helped me to find balance and wisdom when making decisions and to cope with any crisis I might confront in the future. In short, these skills have set me up for a life worth living.

Overall, attending dialectical behaviour therapy has changed both my approach to myself and to my relationships with others. Whilst I had always wanted to work for the National Health Service, I was never quite sure which career path to follow, until I discovered occupational therapy. I want to empower others to play an active role in their recovery and overcome any obstacles that might come in between them and fulfilling their dreams, and improving their own quality of life and independence, in the way my dialectical behaviour therapist did for me. Growing from whatever darkness may be in your past is tricky, but I now know that it is possible because there is something I can learn each day. I can remind myself that I am a work in progress just like everyone else, and that in my opinion is one of the most beautiful aspects of being human. Being taught this philosophy in dialectical behaviour therapy made me the woman I am today, and for that I am grateful.