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What is Dialectical Behaviour Therapy (DBT)?

Dialectical Behaviour Therapy is a form of psychological therapy which was developed for the treatment of Borderline Personality Disorder (BPD), particularly those individuals with self harm and/or suicidal urges. DBT has been shown by research to be an effective psychological treatment for Borderline Personality Disorder. While the treatment of BPD remains probably the most common use of Dialectical Behaviour Therapy, the DBT treatment approach is increasingly being applied to a range of other psychological disorders and problems, particularly disorders that include issues of emotional dysregulation such as bulimia.

Dialectical Behaviour therapy was developed by psychologist Dr Marsha Linehan (1993). DBT developed out of the recognition that traditional Cognitive Behaviour Therapy (CBT) techniques, while of some assistance for symptoms of BPD, seemed to have limited impact on the core problems in BPD.

Dialectical Behaviour therapy combines traditional CBT with techniques such as mindfulness and acceptance, which are often associated with newer or “third wave” behavioural strategies. These extra techniques focus particularly on teaching people with DBT emotion regulation skills to assist them in dealing with the sometimes overwhelmingly intense negative emotions which occur periodically in BPD and hinder sufferers from being able to progress in therapy.

By acquiring effective DBT emotion regulation skills, BPD sufferers frequently feel empowered able to be able to tackle the wide range of other issues in their lives which otherwise hem them in and frequently prevent them from reaching their full potential.

As well as the inclusion of some novel therapy techniques, Dialectical Behaviour Therapy differs from traditional CBT in the typical time frame for therapy. CBT is generally considered 'brief therapy' because clients are typically seen for somewhere between 6 and 20 visits (although there is obviously substantial variation. By contrast, because Borderline Personality Disorder is a chronic condition which involves very significant emotion coping difficulties, Dialectical Behaviour Therapy can be conducted in weekly or twice weekly visits over a year or more. Nonetheless the skills building group programme is designed to be run over

There are two forms of Dialectical Behaviour Therapy, Individual DBT and Group DBT. While based on the same underlying principles, DBT Group Therapy tends to focus on teaching practical coping skills, while individual DBT focuses on addressing issues specific to the individual client and assisting the client to put DBT skills into practice in everyday life. Click here for more information on group verses individual DBT.

What is involved in Dialectical Behaviour Therapy (DBT)?

DBT Group programs which follow Linehan's program closely involve training in 4 key areas:

(1) Mindfulness techniques – techniques designed to increase the ability of clients to stay 'present focussed' and to overcome

the mental wrestle over unwanted intrusive thoughts, images & emotions.

(2) 'Interpersonal Effectiveness Skills' – skills at negotiating interpersonal challenges, especially confrontation and conflict.

(3) Emotion Regulation Skills – skills designed to replace unhelpful and/or destructive emotion coping approaches

(4) 'Distress Tolerance' Skills – skills to tackle the extreme emotional pain, often associated with crises.

In practice many therapist use DBT skills as part of their treatment approach, particularly in the early stages of treatment for BPD, but may use other treatment techniques such as Schema Therapy and traditional CBT, in their treatment programs.

In fact it is possible to attend DBT Group Skills Training while receiving individual treatment by a therapist using an entirely different treatment approach. This is not usually problematic provided the individual therapist does not use a contradictory treatment approach and the individual therapist is aware of what is occurring in then DBT skills training program.

What is Borderline Personality Disorder (BPD)?

Borderline Personality Disorder (BPD) is a chronic psychological condition which is characterised by difficulties with emotion regulation. While symptoms vary from person to person, some of the symptoms experienced by people with BPD include: feelings of emptiness, volatile relationships, self-harm, depression, suicidal thoughts or attempts, dissociative symptoms, nightmares, insomnia, a tendency toward emotional volatility and subjective sense of difficulty controlling emotions, impulsive behaviour, fears of and/or irrational perception of abandonment by significant others, and intense feelings of anger which may be externalised or internalised.

While a large proportion of people with BPD report a history of some form of abuse, a significant minority of BPD sufferers do not identify abuse experiences in their childhoods.

The condition typically develops in adolescence or early adulthood and has a chronic course. Recent research suggests that many people with BPD improve over time provided they receive appropriate treatment.

The name, “Borderline Personality Disorder”, is very misleading and there is a lot of discussion about changing the label of this disorder in the near future.

For more information on Borderline Personality Disorder the following sites may be of assistance: www.BorderlinePersonalityDisorder.com.au

or the following US site: www.borderlinepersonalitydisorder.com


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