Dialectical Behavioural Therapy (DBT) is a type of therapy that is tailor-made for Borderline Personality Disorder, though it can also be used for many other conditions.
DBT runs on the basis that an individual is emotionally vulnerable, and that the individual grew up in an environment where emotions were dismissed by caregivers/teachers.
These factors cause an individual to feel guilty or ashamed for having upsetting emotions, which leads to further upset,
DBT aims to change this system, using a range of techniques to help, with a focus on acceptance and problem-solving.
The Science Behind Dialectical Behavioural Therapy
This type of therapy is intended for use in the treatment of Borderline Personality Disorder, though it can be beneficial for other conditions too.
DBT is based on the idea that two key factors contribute towards a person developing a mental health condition.
These factors are the assumption that a person is very vulnerable emotionally and that the person grew up in an environment where they were neglected, or where their emotions were roundly dismissed.
This supposedly leads to an individual having negative emotions due to their vulnerability, yet feeling worthless and guilty at the same time for having such emotions.
This continues with low mood and other problems, and so the cycle goes on. DBT aims to break up this cycle through a range of techniques.
Just some of the areas looked at by DBT include interpersonal relations, regulation of emotions and managing distress.
How Does Dialectical Behavioural Therapy Work?
DBT is a therapy that requires time and will facilitate change gradually. As mentioned above, the patient will normally enter therapy in an emotional state, yet feeling guilty for having such feelings.
DBT introduces two key ideas. Firstly – validation. This means that a person will recognise over time that their emotions are justified, and that they also should’ve been accepted during childhood.
Secondly – dialectics. This is where a therapist will teach the patient about how it is important to not see things in “black and white”, and that it is important to be open to any new ideas.
DBT will typically last between 10 and 30 sessions and will often be in a group setting. Emotional regulation is ultimately the aim with DBT, with improvements in interpersonal events and relaxation also strived for. Tolerating moments of crisis are also important, and coping techniques are taught as well during DBT.
Homework will also often be involved – with the aim of the patient putting into practice the techniques that they have learned. Therefore, commitment towards DBT is important.
Most people finish DBT with an improvement in symptoms, and with new techniques to help them in the future. While relapse is common, the techniques taught should help prevent this.
When is Dialectical Behavioural Therapy Useful?
DBT was specifically designed to treat Borderline Personality Disorder – which is also known as Emotionally Unstable Personality Disorder.
DBT tends to help with stopping dangerous behaviour, and can help change harmful actions like self-harm or substance abuse.
Besides Borderline Personality Disorder, DBT can also help conditions such as Bipolar Disorder, Eating Disorders, Substance-Related Disorders, other Personality Disorders and even some cases of Depression.
Anyone with a mental health condition can feasibly benefit from DBT. DBT is primarily focused on the present-day, and finding ways of combatting unhelpful thoughts and beliefs – which may touch on some part of a person’s past.
How effective is Dialectical Behavioural Therapy?
DBT appears to be mostly effective. A journal article that reviewed several studies into DBT found that the therapy has a “moderate effect” on those with Borderline Personality Disorder .
A large study conducted in 2009 found that DBT was much more effective than general therapies in terms of lowering suicidal ideation – which is a common symptom in Borderline Personality Disorder .
Research that pitted DBT against Mentalisation based Therapy found that DBT was more effective for patients with BPD . The study found that DBT was excellent for lowering incidents of self-harm and emotional dysregulation .
Research into DBT’s use in treating other mental health conditions has produced mixed results, including for Depression and Bipolar Disorder. However, a 2001 study did find that DBT produces positive results or those suffering with Eating Disorders .
While many people will find that their symptoms lessen due to DBT, it also isn’t a one-size fits all approach to mental health.
How to find a therapist?
It is recommended that you contact your GP and inform them of your problems. They will refer you to the relevant mental health team.
If you are aiming to use the private sector, you could ask your GP or someone you know for a recommendation. You can also look online – the British Association for Counselling and Psychotherapy have a therapist directory on their site.
- Therapy Home
- Everything You Need To Know About Talking Therapy
- FAQ’s About Talking Therapy
- Dialectical Behavioural Therapy: Everything You Need to Know
- The Advantages and Disadvantages of Dialectical Behavioural Therapy
- 8 Things You Should Know About Dialectical Behavioural Therapy
- What Conditions Can Dialectical Behavioural Therapy Treat?
- Which Is More Effective for Borderline Personality Disorder: DBT or MBT?
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 Kliem, S., Kröger, C., & Kossfelder, J. (2010). Dialectical behavior therapy for borderline personality disorder: A meta-analysis using mixed-effects modeling. Journal of Consulting and Clinical Psychology. 78(6): p936–951.
 McMain, S. (2009). A Randomized Trial of Dialectical Behavior Therapy Versus General Psychiatric Management for Borderline Personality Disorder. American Journal of Psychiatry. 166(12): p1365–1374.
 Barnicot, K., & Crawford, M. (2019). Dialectical behaviour therapy v. mentalisation-based therapy for borderline personality disorder. Psychological Medicine,49(12), p2060-2068.
 Telch, C. F., Agras, W. S., & Linehan, M. M. (2001). Dialectical behavior therapy for binge eating disorder. Journal of Consulting and Clinical Psychology. 69(6): p1061–1065.