Do you struggle with self-destructive thoughts and behaviours? Consider dialectical behaviour therapy.
Dialectical Behaviour Therapy (DBT) is a talk therapy adapted from Cognitive Behavioural Therapy (CBT). Its core goals are to help people overcome negative thought patterns and behaviours.
Clients achieve this by learning coping skills that encourage a healthy balance between:
- Acceptance – acknowledging that your thoughts, feelings and behaviours are valid, given your circumstances
- Change – learning to cope with stress and strong emotions to overcome self-destructive behaviours
4 Stages of DBT
In DBT, you will undergo four stages of treatment with your therapist:
- Stage 1: Addressing and overcoming behaviours that are life-threatening or may interfere with therapy.
- Stage 2: Treating mental and emotional distress such as past traumas or invalidating childhood experiences.
- Stage 3: Stabilising progress and improving self-esteem through reasonable goal-setting and effective communication with others.
- Stage 4: Enhancing quality of life by achieving a deeper sense of fulfilment in your career, relationships and school.
These stages are non-linear and may be revisited at various points during treatment.
Skills Taught in DBT
Comprehensive DBT focuses on incorporating the following four practical skills to improve the quality of your daily life. These skills are taught and reinforced throughout the stages of therapy.
Core Mindfulness
Mindfulness helps you become more aware of yourself and your surroundings. It encourages you to live in the present moment and be attentive to your:
- Internal world – your thoughts, emotions and impulses
- External world – your senses, what you can hear, see and touch
During sessions, you will be guided to observe these sensations without judging them.
This skill is useful during periods of strong emotional pain in everyday life. You will be better equipped to slow down, observe your feelings and use healthy coping techniques to overcome distress.
Distress Tolerance
Distress tolerance skills help you deal with difficult situations in a more objective manner while avoiding maladaptive behaviours. Its main aim is to help you accept the stressful situation as it is and manage strong emotional reactions before responding to the crisis.
In these sessions, you may learn crisis-handling techniques like:
- Self-soothing
- Distraction
- Figuring out how to improve the situation
- Listing out the pros and cons of ‘tolerating the distress’ versus ‘not tolerating the distress’
Emotion Regulation
Emotion regulation skills help you better recognise and label the emotions you are experiencing to gain greater control over them. You will learn to notice negative feelings, then make decisions that result in more positive emotional experiences.
In sessions, you may be taught exercises like identifying your emotions, then doing an opposite action. For example, if you feel angry, you may feel inclined to defend yourself or verbally attack someone. Instead, you can show kindness or walk away.
Interpersonal Effectiveness
Interpersonal effectiveness is learning to be assertive about your needs and boundaries to others in a tactful and positive way. You will learn how to communicate more effectively while maintaining healthy relationships with others through active listening.
This can potentially help you overcome stressful situations involving difficult people. It can also allow you to reach out to others about your struggles and needs better, so you can build a stronger, healthier support system.
What DBT Can Help With
DBT can help with self-destructive behaviour and mental health conditions that affect a person’s safety, emotional well-being, relationships and work performance. This includes people struggling with:
- Suicidal thoughts and behaviours
- Self-injury
- Post-traumatic stress disorder (PTSD)
- Substance abuse
- Borderline personality disorder (BPD)
- Eating disorders
- Depression
- Suicidal thoughts and behaviours
- Self-injury
- Post-traumatic stress disorder (PTSD)
- Substance abuse
- Borderline personality disorder (BPD)
- Eating disorders
- Depression
*The list above is not exhaustive.
Techniques Used in DBT
Techniques such as individual therapy and group training are used to help clients get accustomed to using DBT skills in their day-to-day lives.
Individual Therapy
During one-on-one sessions with your therapist, you get to discuss your thoughts, struggles and progress. You will also learn coping skills and how to apply them in daily situations.
Group Skills Training
In group sessions, you get to explore and practise DBT skills through role-playing and group discussions. You will get to talk through real-life scenarios with others and learn how to overcome them effectively.
Phone Coaching
Your therapist may open up a line of contact for additional support outside of therapy sessions. They can provide a listening ear and suggest ways to overcome overwhelming situations with skills you have learnt in session.
Self-Practice
‘Homework’ will be given to help you better understand the new skills you have learnt. An example for practising emotion regulation would be to track and note down a set number of emotions and behaviours experienced in your daily life.
Our Psychotherapists Trained in DBT
Our therapists Sophia and Alexandra are either certified or trained to provide DBT for clients who may benefit from it.
Alexandra Bohnen
M.A. in Counselling, Australia
Alexandra works closely with adults to dig deep and uncover their natural strengths and resources. Her key focuses include identity and sexuality issues, trauma, stress management and depression.
Why Choose Sofia Wellness Clinic?
Inclusive services
At Sofia Wellness Clinic, our services are inclusive to clients from all walks of life, covering a diverse spectrum of identities.
We believe in creating a compassionate, open environment for all our clients.
Qualified psychotherapists
All our psychotherapists are equipped with a minimum of a Masters degree in counselling.
Collectively, our reliable team of counsellors are trained and certified to treat a wide range of mental health issues.
Frequently Asked Questions
What is dialectical behaviour therapy and how does it work?
DBT is a type of talk therapy that advocates both acceptance and change when working through mental health issues like BPD and suicidal thoughts.
There are 4 stages of DBT that progress through different treatment goals, namely:
1. Reducing self-destructive behaviours
2. Overcoming overwhelming emotions
3. Improving self-esteem and stabilising progress
4. Enhancing quality of life
In DBT, a client undergoes individual therapy, group training, phone coaching and self-practice to learn the following skills:
- Core mindfulness
- Distress tolerance
- Emotion regulation
- Interpersonal effectiveness
How long does DBT therapy last?
DBT treatment typically lasts between 6 months to 1 year, depending on the individual client and the complexity of their mental health conditions.
What are the pros and cons of DBT?
Some pros and cons of DBT include:
| Pros | Cons |
|---|---|
When is DBT not appropriate?
DBT may not be not an appropriate treatment for clients with:
- Uncontrolled schizophrenia
- Intellectual disabilities
- Dissociative identity disorder (DID)
Sofia Wellness Clinic has DBT-trained therapists that can help you determine whether the treatment is recommended for you. Contact us for an assessment today!
What is the difference between CBT and DBT?
Although DBT is considered to be a modified version of CBT, they rely on different techniques to help clients overcome emotional and behavioural issues.
CBT equips clients with techniques to notice and change problematic thinking patterns and behaviours. It is largely used to treat depression, anxiety and Obsessive Compulsive Disorder (OCD).
On the other hand, DBT focuses on helping clients accept painful emotions. Troublesome behaviours and thoughts are overcome through skills like mindfulness and emotional regulation. It is usually an effective treatment for BPD and maladaptive behaviours like suicide ideation and self-harm
