for better mental health

Dialectical behaviour therapy (DBT)

Explains what dialectical behaviour therapy is, who it can help, what happens during therapy and how to access it.

What is DBT?

Dialectical behaviour therapy (DBT) is a type of talking treatment. It's based on cognitive behavioural therapy (CBT), but has been adapted to help people who experience emotions very intensely.

It's mainly used to treat problems associated with borderline personality disorder (BPD), but it has also been used more recently to treat a number of other different types of mental health problems (see Is DBT right for me?).

What's the difference between DBT and CBT?

  • CBT focuses on helping you to change unhelpful ways of thinking and behaving.
  • DBT also helps you to change unhelpful behaviours, but it differs from CBT in that it also focuses on accepting who you are at the same time. DBT places particular importance on the relationship between you and your therapist, and this relationship is used to actively motivate you to change.

"I had bounced in and out of mental health services for a long time and nothing had helped, my condition had just worsened... Then I started DBT. Now I know what helps me, I have strategies when life is tough. Not everything is plain sailing, but when things go a bit wrong, I bounce back rather than spiralling."

What are the goals of DBT?

The goal of DBT is to help you learn to manage your difficult emotions by letting yourself experience, recognise and accept them. Then as you learn to accept and regulate your emotions, you also become more able to change your harmful behaviour. To help you achieve this, DBT therapists use a balance of acceptance and change techniques.

What does ‘dialectics’ mean?

In a nutshell, ‘dialectics’ means trying to balance opposite positions and look at how they go together. For example, in DBT, you will work with your therapist to find a good balance between:

  • Acceptance – accepting yourself as you are.
  • Change – making positive changes in your life.

You might eventually come to feel that these goals are not as conflicting as they first seem. For example, coming to understand and accept yourself, your experiences and your emotions, can then help you learn to deal with your feelings in a different way.

Acceptance techniques

Acceptance techniques focus on understanding yourself as a person, and making sense of why you might do things such as self-harm or misuse drugs. A DBT therapist might suggest that this behaviour may have been the only way you have learned to deal with the intense emotions you feel – so even though it’s damaging to you in the long-term, and may be alarming to other people, your behaviour actually makes sense.

"Finally someone is saying 'yes, it makes sense' rather than 'no, that's wrong’."

Change techniques

DBT therapists use change techniques to encourage you to change your behaviour and learn more effective ways of dealing with your distress. They encourage you to replace behaviours that are harmful to you with behaviours that can help you move forward with your life. For example, you can learn to start challenging your unhelpful thoughts and develop a more balanced way of looking at things.

"To get the most out of DBT requires a certain leap of faith and willingness to have your thinking and behaviours challenged. It is totally different to any other type of therapy I have ever had. It's hard work, but over time and with effort, life starts to get better."

(You can find out more about the development of DBT on the official DBT website, BehavioralTech.)

My DBT journey

"I see a future for myself now that I didn’t see before the therapy."

This information was published in April 2017. We will revise it in 2020.

References are available on request. If you would like to reproduce any of this information, see our page on permissions and licensing.

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