Dialectical Behavioural Therapy (DBT) is a research-based, cognitive-behavioural treatment originally developed by Marsha Linehan at the University of Washington, to help clients with the suicidal and self-harm behaviours often seen in Borderline Personality Disorder.

DBT has since then been modified as a treatment for other complex and challenging mental disorders that involve emotional dysregulation, such as dual diagnoses, PTSD, eating disorders and severe mood disorders. Clients with these disorders often have great difficulty managing the emotional and relational crises of their lives because they lack the needed behavioural coping skills.

Using both acceptance and change strategies, DBT asks both patient and therapist to find a balance between accepting reality as it is, and maintaining a strong commitment to change. Such treatment is ideally offered in an environment that is warm and validating, while attempting to offer enough challenge and guidance to effect behavioural change and reduction of harmful behaviours. The goal is to help clients create “a life worth living.”

The DBT session format includes four sets of skills: Mindfulness, Interpersonal effectiveness, Emotion regulation, and Distress tolerance.

Mindfulness: The ability to take control of your mind instead of having your mind controls you. Mindfulness helps direct your attention through the process of observing, describing and participating from a non-judgmental perspective. This allows for more objective, effective, and meaningful experiences in the here and now.

Interpersonal Effectiveness: The ability to communicate and express yourself effectively while maintaining an understanding and a commitment to your objectives, your relationship to the person(s) and your self-respect.

Emotion Regulation: The ability to regulate your emotions by understanding the relationship between thoughts, feelings, body sensations and behaviours. As well as, being aware of vulnerability factors related to emotional states such as: adequate sleep, balanced eating, appropriate medication usage, self-care, exercise and incorporating positive experiences in your daily life.

Distress Tolerance: The ability to get through an already difficult time without making it worse. Self-destructive behaviours are often a result of ineffective ways of dealing with painful emotions. Distress tolerance teaches the use of distraction, radical acceptance and pros/cons as alternatives.

Research shows that DBT leads to improvement in various problems related to Borderline Personality Disorder, such as self-harming, suicide attempts, depression, eating problems and feelings of hopelessness.

Research has shown that DBT treatment is most effective when it includes 1. Individual therapy, 2. A weekly skills training group and 3. Help with skills application by phone with the individual therapist between sessions. For information about individual DBT therapy and skills application, please contact us.

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