Dialectical behaviour therapy (DBT)

Dialectical Behaviour Therapy (DBT) represents a sophisticated and highly effective adaptation of Cognitive Behavioural Therapy (CBT), meticulously crafted to aid individuals in navigating the present moment, fostering robust coping mechanisms for stress, regulating emotions, and enhancing interpersonal relationships. Originally developed to treat those with Borderline Personality Disorder (BPD), DBT has evolved to address a wide spectrum of mental health conditions, providing invaluable support to those grappling with emotional regulation challenges or engaging in self-harming behaviours, including eating disorders and substance use disorders. Moreover, DBT has found application in treating Post-Traumatic Stress Disorder (PTSD).

At the heart of DBT lies a harmonious blend of acceptance and change, underpinned by four key principles: mindfulness, interpersonal effectiveness, emotion regulation, and distress tolerance. This approach has been rigorously refined and is now supported by substantial empirical evidence, demonstrating its efficacy across various settings and conditions.

DBT session

DBT Approach at Southern Hill Hospital

Southern Hill Hospital integrates DBT into our comprehensive mental health programmes, tailored to each patient's unique needs. Our multidisciplinary team of therapists, psychiatrists, and mental health professionals collaborates closely to deliver personalised care. DBT is offered in both outpatient and inpatient settings, ensuring continuous support throughout different stages of recovery.

DBT sessions at Southern Hill Hospital are structured as follows:

  • Group Therapy Sessions: Patients participate in group sessions where they are taught behavioural skills in a supportive communal environment.

  • Individual Therapy Sessions: These are personalised sessions with qualified professionals, focusing on integrating behavioural skills into the patient's specific life challenges.

  • Phone Coaching Services: Patients can access their therapists between sessions for guidance on navigating real-time challenging situations.

Core Techniques in DBT

Mindfulness

DBT instructs individuals to observe and describe their experiences without judgement, cultivating an acute awareness of thoughts, feelings, and sensations in the present moment.

Distress Tolerance

Patients learn strategies to endure distressing emotions without resorting to harmful behaviours. Techniques include distraction, self-soothing, and improving the moment.

Emotion Regulation

This aspect helps individuals understand and manage intense emotions by identifying triggers, increasing emotional awareness, and adopting healthier ways to express and regulate feelings.

Interpersonal Effectiveness

Patients acquire skills to manage relationships more effectively, including assertiveness, setting boundaries, and balancing priorities while maintaining self-respect and respect for others.

Conditions Treated with DBT

DBT has proven effective in treating a variety of mental health issues, including but not limited to:

  • Borderline Personality Disorder (BPD)

  • Mood disorders such as depression and bipolar disorder

  • Anxiety disorders

  • Post-Traumatic Stress Disorder (PTSD)

  • Eating disorders

  • Substance abuse and addiction

  • Self-harming behaviours

  • Suicidal ideation and behaviours

Benefits of DBT

  • DBT equips individuals with skills to manage and regulate their emotions effectively, leading to reduced emotional volatility and impulsivity.

  • Through interpersonal effectiveness training, patients learn to navigate social interactions skilfully, express needs assertively, and cultivate empathy and understanding in relationships.

  • DBT teaches alternative and healthier ways to cope with distressing emotions, fostering resilience and adaptive coping strategies.

  • Mindfulness practices help individuals develop greater self-awareness and clarity of mind, enabling intentional responses to situations rather than impulsive reactions.

  • DBT effectively reduces behaviours such as self-harm, suicidal ideation, and impulsive actions by addressing underlying emotional dysregulation.

  • Research supports DBT's efficacy in promoting long-term stability and well-being by addressing the root causes of emotional dysregulation and providing ongoing support.

  • DBT aims to improve the overall quality of life, empowering individuals to lead more fulfilling, meaningful, and balanced lives.

Is DBT Effective?

Numerous studies affirm the effectiveness of DBT in treating various mental health conditions. Research indicates significant improvements in symptom severity, interpersonal functioning, and overall quality of life for individuals undergoing DBT. Additionally, DBT has been shown to reduce hospitalisation, self-harm, and suicidal behaviour among those with BPD and other high-risk populations.

Considerations Before Pursuing DBT

  • Commitment to Treatment: DBT requires a significant time commitment, including weekly therapy sessions, group skills training, and homework assignments. Prospective clients should be prepared to dedicate the necessary time and effort.

  • Openness to Change: A willingness to engage in self-reflection, learn new skills, and implement behavioural changes is crucial for benefiting fully from DBT.

  • Finding the Right Therapist: It is essential to work with a trained and experienced DBT therapist who can provide guidance, support, and structure throughout the treatment process.

  • Cost and Accessibility: Factors such as cost, insurance coverage, and availability of DBT programmes may impact access to treatment. Prospective clients should explore these factors to determine feasibility.

Combining DBT Therapies at Southern Hill Hospital

Dialectical Behaviour Therapy (DBT) is a versatile and comprehensive approach to mental health treatment that can be effectively combined with other therapeutic modalities to enhance overall patient outcomes. At Southern Hill Hospital, we recognise the value of integrating DBT with various other therapies and treatments to create a robust and multifaceted treatment plan tailored to each patient's unique needs.

The Importance of an Integrated Approach

Combining DBT with other therapies can offer a more holistic approach to mental health care, addressing multiple facets of a patient's condition and providing a broader range of tools and strategies for recovery. This integrated approach can enhance the effectiveness of treatment, promote long-term well-being, and support patients in achieving their recovery goals.

Therapies Commonly Combined with DBT

1. Cognitive Behavioural Therapy (CBT)

While DBT is a modified form of CBT, integrating traditional CBT techniques can further reinforce the cognitive restructuring component of treatment. CBT focuses on identifying and challenging unhelpful thoughts and beliefs, which can complement DBT's focus on emotion regulation and mindfulness.

2. Medication Management

For many individuals, medication can play a crucial role in managing symptoms of mental health conditions. Combining DBT with pharmacotherapy ensures that patients receive comprehensive care that addresses both the psychological and biological aspects of their condition. Psychiatrists at Southern Hill Hospital work closely with therapists to monitor and adjust medication as needed, ensuring optimal treatment outcomes.

3. Acceptance and Commitment Therapy (ACT)

ACT shares similarities with DBT, particularly in its emphasis on mindfulness and acceptance. Combining DBT with ACT can enhance patients' ability to accept and commit to changes in their behaviour and thought patterns, further supporting their emotional and psychological well-being.

4. Psychodynamic Therapy

Integrating psychodynamic therapy with DBT allows patients to explore underlying unconscious processes and early life experiences that may influence their current behaviours and emotions. This deeper exploration can provide valuable insights that complement DBT's skills-focused approach.

5. Interpersonal Therapy (IPT)

IPT focuses on improving interpersonal relationships and social functioning. When combined with DBT's interpersonal effectiveness training, this approach can help patients develop stronger, healthier relationships and improve their overall social support network.

6. Trauma-Focused Therapies

For patients with PTSD or a history of trauma, combining DBT with trauma-focused therapies such as Eye Movement Desensitisation and Reprocessing (EMDR) or Trauma-Focused CBT can be particularly beneficial. These therapies address the specific impact of trauma, while DBT provides tools for managing the associated emotional dysregulation and distress.

7. Family Therapy

Family therapy can be an important addition to DBT, especially for adolescents and individuals whose family dynamics significantly impact their mental health. This approach involves working with family members to improve communication, resolve conflicts, and create a supportive home environment.

8. Art and Expressive Therapies

Art therapy and other expressive therapies can be integrated with DBT to provide patients with additional outlets for expressing and processing emotions. These therapies can enhance mindfulness and emotion regulation by engaging patients in creative activities that promote self-awareness and emotional expression.

Dialectical Behaviour Therapy (DBT) at Southern Hill Hospital offers a holistic approach to mental health treatment, addressing core issues such as emotion dysregulation, interpersonal difficulties, and maladaptive coping behaviours. By emphasising mindfulness, distress tolerance, emotion regulation, and interpersonal effectiveness, DBT equips individuals with practical skills to navigate life's challenges more effectively and cultivate greater resilience and well-being. Whether used as a standalone treatment or as part of a comprehensive care plan, DBT empowers individuals to lead more fulfilling and meaningful lives. Through dedicated and personalised care, Southern Hill Hospital ensures patients receive the support and tools needed for long-term recovery and improved quality of life.

Frequently Asked Questions

  • While DBT can be beneficial for many, it may not be the most appropriate treatment for everyone. Factors such as diagnosis, treatment goals, and readiness for change should be considered when determining DBT’s suitability.

  • The timeline for seeing results varies based on factors such as symptom severity, engagement in treatment, and consistency in practising DBT skills. Some individuals may notice improvements within weeks, while others may require longer-term treatment for significant changes.

  • Encountering challenges when learning new skills is normal. Approach the process with patience and self-compassion. Therapists can provide guidance, support, and encouragement to help overcome difficulties and develop proficiency in DBT skills over time.

  • Yes, DBT can be integrated with other therapeutic approaches and medication management as part of a comprehensive treatment plan. The treatment team will collaborate to determine the most effective combination of interventions based on individual needs and preferences.

  • While initially developed for specific mental health disorders, DBT’s principles and techniques can benefit anyone seeking to improve their emotional well-being, interpersonal relationships, and overall quality of life.