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Explains what dialectical behaviour therapy is, who it can help, what happens during therapy and how to access it.
The way that DBT is delivered can vary between different providers and across different areas. However, there are typically three different types of DBT sessions that you might have and these are likely to be run alongside each other:
Individual therapy typically involves weekly one-to-one sessions with a DBT therapist. Each session lasts approximately 45–60 minutes.
The individuals sessions have a hierarchy of goals, including:
Your DBT therapist is likely to ask you to fill out diary cards as homework which you can use to monitor your emotions and actions. You will be asked to bring these cards with you to your therapist each week to help you look for behaviour patterns and triggers that occur in your life. You then use this information to decide together what you will work on in each session. You can find some sample diary cards on the DBT self-help website.
"I’ve learned that emotions are not the enemy. They are useful and have functions. I still feel emotions intensely, but I can now identify them and know how to manage them without using harmful behaviours."
In these sessions DBT therapists will teach you skills in a group setting. This is not group therapy, but more like a series of teaching sessions. There are usually two therapists in a group and the sessions typically occur every week. The room is sometimes arranged like a classroom where your skills trainers will be sat at the front. The aim of these sessions is to teach you skills that you apply to your day-to-day life.
There are typically four skills modules:
In these group session you may be asked to do group exercises and use role-play. You are also given homework each week to help you practise these skills in your day-to-day life. By completing the homework weekly, you might find that these skills gradually become second nature and you become better at dealing with difficult situations.
"I was really nervous about the group aspect of DBT. When I started group I wouldn’t speak or make eye contact, but everyone was supportive and by the end I was much more confident and even taught a skill session to the other group members."
DBT often uses telephone crisis coaching to support you in using new skills in your day-to-day life. This means that you can call your therapist between your therapy sessions when you need help the most, such as in the following situations:
However, you can expect your therapist to set some clear boundaries. For example, calls are usually brief and the hours that you can call them will be agreed between you and your therapist. They may also agree some other rules with you where, in particular circumstances, you may be asked to wait 24 hours before contacting your therapist.
"At first I didn’t think DBT was for me, but I quickly learnt you really do get out of it what you put in, and after a few months I found that although how I felt and a lot of my symptoms did not change, I was managing them all so much better. I could actually get through days without a crisis and without the support of the crisis coaching."
(To find out more about how DBT is delivered you can visit the official DBT website, BehavioralTech.)
This information was published in April 2017. We will revise it in 2020.
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