Dialectical behaviour therapy (DBT)

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

Who can benefit from DBT?

DBT was originally developed as a treatment for borderline personality disorder (BPD) and you are most likely to be offered DBT through the NHS if you have a diagnosis of BPD.

Some NHS services also offer DBT to children and adolescents, people with drug and alcohol problems, eating problems and offending behaviour. Research shows that DBT can be also helpful in tackling problems such as:

What's it like to receive DBT treatment?

Watch Debbie talk about her experience of DBT as treatment for her BPD diagnosis.

"Before DBT, I felt like the only solution was suicide... Now that I have completed my treatment I am now able to look forward. My thoughts and emotions used to control me; now I can control them. Of course, I have my bad days, but through learning various skills from DBT I can ride the waves of my depression rather than letting them swallow me."

What factors should I consider?

Some people can find DBT difficult in the beginning, as it requires accepting your problems and working hard to change them. However, after a while you might come to feel that your efforts were worthwhile.

If you are wondering whether DBT is right for you, it might be helpful to think about these questions:

  • Is DBT relevant to me? If you’re mainly interested in talking about your problems in general and trying to understand where they came from, then DBT might not seem relevant to you. In this case, there are various other talking therapies you might like to consider. (See our pages on talking treatments for more information.)
  • Is changing my behaviour my priority? DBT therapists focus very much on enabling you to change your problematic behaviour. If changing your behaviour isn’t the main thing you want to get out of treatment, then you might feel that your therapist doesn’t accept you, or is being critical of you.
  • Am I able to put the work in? DBT can sometimes be hard work, and you will be asked to do homework between your individual sessions. If you don’t like doing homework or feel that you don't have the time, you might find a course of DBT too rigid or demanding, which might be demoralising.
  • Is group therapy right for me? Group therapy can be really helpful for some people and you may find it helps to work alongside people who are experiencing similar problems. Group therapy is not for everyone though as it can be quite daunting and sometimes triggering. It is important that you think about whether group therapy is right for you or whether you prefer to just work with a therapist one-to-one.

In some areas, you may be offered DBT pre-treatment to help you decide whether it is the right therapy for you.

"My personal experiences of DBT were very mixed. At first it was really tough, and I wondered what the point of it was going to be. Some of the DBT skills seemed silly to me, but I had committed myself to the process and as time passed, it started to make more sense."

What if DBT doesn't work for me?

It's important to remember that everyone experiences therapy differently. Some people may find DBT helpful, but others may find it isn't right for them. If you don't get along with DBT then you could:

  • talk to your therapist about any changes that can be made to make you feel more comfortable with the therapy.
  • talk to your doctor about different treatment options that might be better suited to you.

"DBT isn’t for everyone. There is very definitely a right time and a wrong time to do it. Its something you have to be ready for because it’s very hard work... It’s not a short term thing... you have to work at it every single day. It’s hard to do, and even now, some 2 years after I completed the therapy, I’m still having to work at it."

(See our pages on seeking help for a mental health problem for more information about how to access treatment.)

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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