The 101 on DBT

What is DBT?

The origins

Dialectical Behaviour Therapy (DBT) was developed by Dr Marsha Linehan in the 1980’s. At

the time, Dr Linehan was a behavioural Psychologist with a background in researching

suicide. She was very interested in researching treatments that were effective for people

experiencing these thoughts and associated behaviours. Interestingly, at the time many

research studies would exclude people if they experienced suicidal thoughts and so, it

wasn’t clear what was effective. Most of the clients that Dr Linehan worked with had

complex presentations – they had multiple mental health difficulties with specific challenges

with regulating their emotions. Dr Linehan found most people met criteria for borderline

personality disorder (BPD).

The Model

DBT stems from cognitive-behavioural therapy (CBT). It draws on CBT strategies to help

people change and it also adds parts of acceptance, based in modified Zen practices. It was

found that when working with clients living with BPD, they benefited from addressing both

their need for change and their need to be accepted and understood. DBT includes four

skills training modules including: Core mindfulness, distress tolerance, emotion regulation

and interpersonal effectiveness. When working with young people and families, there is a

fifth module – walking the middle path. Comprehensive DBT includes four integral

components: skills training group, individual therapy, phone coaching (support for clients to

use skills outside of therapy) and consultation group (a support space for therapists).

Is it effective?

Since it has been developed comprehensive DBT has been very well researched. Studies

indicate that DBT reduces suicidal behaviour (by 50%), visits to emergency departments for

suicidality (by 53%), self-harm and hospitalisations (by 73%). It also leads to an increase in

overall functioning and increase in self-esteem. Many studies have also demonstrated a

reduction in cooccurring substance misuse, eating difficulties, anger, hopelessness,

impulsivity and depression. We know that DBT is considered a gold start treatment for BPD.

We also know from the research that DBT can be an effective treatment for post-traumatic

stress disorder (PTSD), depression and young people experiencing suicidal thoughts.

Variations of DBT

In addition to the standard DBT model, there have many several adaptations made to cater

to different groups of people. These include:

- DBT-A (DBT was adolescents – also known as multi-family DBT)

- DBT-PE (prolonged exposure – for PTSD)

- DBT-C (children)

- DBT-E (for an eating disorder – excluding anorexia)

- Abridged DBT (either stand-alone individual session or stand-alone skills group

training)

How do I access DBT?

There are several practitioners that provide DBT, both in the public and private sector.

Ideally, look for a therapist that has a special interest in the area, has completed intensive

training in how to provide the treatment, such as through Behavioural Tech – Dr Linehan’s

training group and who has experience in providing the treatment.

Wanting to book an appointment with me? Connect with me via my email here: hello@lifeworthlivingpsychology.com.au