Dialectical Behavioural Therapy (DBT) is a cognitive-behavioural treatment originally developed by Marsha Linehan for suicidal and self-harming individuals. It was the first therapy to be effective for treating Emotionally Unstable Personality Disorder, previously known as Borderline Personality Disorder (BPD). It can also be used for a wide range of other mental health problems including Binge Eating, Bulimia, Self-Harm, Substance Abuse, Anger Management, BFRBs and ADHD.

DBT can be delivered in two ways:

• The Standard DBT Treatment Program – in the UK this is only delivered in private and NHS hospitals, involves a team of professionals including a psychiatrist and psychologist, and is a year-long treatment often involving in-patient care. There are four main components: Group Skills Training, Individual Therapy, Between-Session Coaching and Therapist Consultation. I am not able to offer this in private practice.

• DBT Skills Training Only – DBT Skills can be taught as a standalone treatment. There are four modules: Mindfulness, Emotional Regulation, Distress Tolerance and Interpersonal Effectiveness. Counselling underpins the delivery of DBT Skills Training, however, DBT Skills Training is significantly different to counselling in that the therapist is more of a teacher or coach rather than a therapist. I offer this service to individual, adult clients.

I conduct DBT in two phases:

• Phase One – Assessment: An assessment phase where you share and explore the difficulties you are facing in all areas of your life and I take a detailed personal history and risk assessment. This time gives you the opportunity to get to know me and decide if I am the right therapist for you. We’ll discuss your hopes for the training and determine whether it is right for you right now. Phase One consists of one 60-minute session per week for six weeks.

• Phase Two – DBT Skills Training in Mindfulness, Emotional Regulation, Distress Tolerance and Interpersonal Effectiveness. Phase Two consists of one 60-minute skills training session per week for approximately 9-12 months, depending on what you present with, how you learn, how much time you have and what is going on in your life at time of treatment. Whilst this training is based on a structured programme, it will be individualised to meet your specific needs.

The course is very intensive, highly structured, involves approximately an hour of homework each day and requires a weekly commitment for 7-8 months. For a successful outcome, full commitment and a determination to change is required. For those individuals that are ready to take this step, I will support you the whole way.

DBT Skills Training is useful for:

• Increasing self-observation and labelling of emotions, thoughts and behaviours.
• Improving communication skills.
• Increasing self-validation.
• Learning how to regulate emotions.
• Tolerating distress.
• Solving difficult life problems.
• Reducing dysfunctional or maladaptive behaviours
• Improving the quality of relationships.

DBT Skills Training can help with:

• Emotionally Unstable Personality Disorder (EUPD)
• Borderline Personality Disorder (BPD)
• Binge Eating
• Bulimia
• Self-Harm
• Substance Abuse
• Anger Management
• Body-Focused-Repetitive-Behaviours (BFRBs)
• ADHD Behaviours
• Trauma / Childhood Abuse
• Depression

Sometimes, clients find DBT after lots of unsatisfactory attempts at multiple other therapies. It teaches life skills that most people acquire in childhood, however, some people, whether through biological vulnerability, environmental invalidation (e.g. being told emotions are wrong/bad) or both, do not acquire these skills and develop dysfunctional ways of managing the stresses of life. DBT Skills Training is trauma-informed and can provide the foundation for trauma therapy at a later stage.