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Dialectical-Behavioural Therapy (DBT)

Overview of Dialectical-Behavioural Therapy:

DBT was derived from CBT (link) techniques but tailored to better treat individuals with Borderline Personality Disorder. DBT's key feature is the use of acceptance strategies alongside CBT techniques (behavioural analysis, group skills training and homework) used to address and change the problem behaviour. CBT focuses on changing behaviour, however, some individuals with BPD need acceptance and validation of their intense emotions before they are ready to change the behaviour. Acceptance strategies enable this by seeking a balance between acceptance and change. Dialectics refers to the simultaneous 'holding' of opposing ideas and DBT seeks this as a therapeutic step away from rigid or 'black and white' thinking common amongst BPD clients.

Who uses it?

Dialectical Behaviour Therapy is used by DBT-trained psychotherapists and counsellors.

Clinical Partners trained in DBT include: Alan Bore, Alison Hunt.

Why would someone use it?

DBT was developed to meet the specific needs of individuals with Borderline Personality Disorder and has been found more effective than CBT techniques for this client group. It has been found effective in treating issues such as self-harm and suicidal thoughts which are also common amongst individuals with BPD.

DBT, ACT, and MBCT are sometimes referred to as 'third wave' behaviour therapies which are all based on CBT, but incorporate acceptance and mindfulness in their treatment techniques. Third wave treatments focus on specific behaviour changes and achievement of specific goals.

Whilst the CBT elements offer a more directive approach than some other therapies, such as person-centred therapy, or psychodynamic psychotherapy, Dialectical Behaviour Therapy also provides a less directive space for clients to explore and eventually accept intense feelings or emotions.

DBT is used to treat Borderline Personality Disorder (BPD), self-harm behaviours, suicidal ideation and, more recently, some eating disorders.

Strengths of the approach:

DBT is a short-term treatment, and is focused on the achievement of specific goals, as defined and agreed between the therapist and client. DBT typically comprises 4 stages. Depending on geographic location, the first stage of treatment is usually free on the NHS. Whilst the other 3 stages are not compulsory, those wishing to complete these stages may need to pay a fee.

Limitations:

DBT treats specific symptoms in the short-term, and whilst intense emotions may be examined, additional, deeper therapeutic work may be needed to fully address the underlying feelings.

 

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