Dialectical behaviour therapy (DBT)
Learn about DBT, including what it can treat, what happens in DBT sessions, and how to access it.
What is DBT?
Dialectical behaviour therapy (DBT) is a type of talking therapy. It's based on cognitive behavioural therapy (CBT). But it's specially adapted for people who feel emotions very intensely.
The aim of DBT is to help you:
- Understand and accept your difficult feelings
- Learn skills to manage these feelings
- Become able to make positive changes in your life
'Dialectical' means trying to understand how two things that seem opposite could both be true. For example, accepting yourself and changing your behaviour might feel contradictory. But DBT teaches that it's possible for you to achieve both of these goals together.
Through learning various skills from DBT, I can ride the waves of my depression rather than letting them swallow me.
Experiences of DBT
Watch Debbie and Lechelle talk about getting a BPD diagnosis, and their experience of DBT as treatment.
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.
What does DBT treat?
DBT was originally developed for borderline personality disorder (BPD). But research shows that DBT can also help with problems like:
But everyone experiences therapy differently. Whatever your diagnosis or problems, DBT might not be right for you.
DBT is more likely to work for you if:
- You feel able to do homework between sessions
- You're ready to focus mostly on your present and future, rather than your past
- You feel able to do some sessions in a group with others
Some people like group work, but others find it harder. You might prefer to work with a DBT therapist one-to-one. But unfortunately this is not always offered as an option.
You can talk to your doctor or mental health team about what you would find most helpful. But the options in your local area may be limited.
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.
How can I get DBT?
The main ways to seek DBT are:
- Through the NHS, with a referral from your doctor or mental health team
- With a private therapist
But accessing DBT can be difficult. It isn't available everywhere.
NHS waiting lists can also be very long in some areas. Especially if there is high demand for the service. And many of us can't afford to pay for a private therapist.
If you'd like to access DBT, these pages may help:
- If you want to access DBT on the NHS, our information on how to find NHS therapy explains how to ask your GP for a referral.
- If you want to find private DBT, our information on paying for private therapy has links to directories where you can search for private therapies.
- Some therapy directories include filters for types of therapy or mental health problems. The Counselling Directory includes a filter specifically for DBT under 'type of therapy'.
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.
During DBT sessions, therapists will use a balance of acceptance and change techniques:
Acceptance techniques
Acceptance techniques focus on:
- Understanding yourself as a person
- Making sense of why you might do certain things, such as self-harm or misusing drugs
For example, a DBT therapist might suggest that this behaviour has been your only way of coping with intense emotions. So your behaviour makes sense, even if it might cause damage or alarm other people.
Finally someone is saying 'yes it makes sense' rather than 'no that's wrong'.
Change techniques
Change techniques focus on replacing behaviour that harms you with behaviour that helps you. This may mean your therapist:
- Challenges your unhelpful thoughts
- Encourages you to find new ways of dealing with distress
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.
Can I do DBT by myself?
It can be difficult to learn DBT techniques by yourself. It can also be overwhelming when you start doing DBT. So doing it by yourself doesn't usually work as well as going to sessions run by trained therapists.
Doing a formal course of DBT can help you:
- Stay motivated if you feel like giving up
- Find situations where you can practise DBT skills
- Feel supported and less alone, as others in the group are going through the same process
But you may be able to find DBT self-help materials online, such as on the DBT Self Help website. This might include diary cards, exercises and behavioural analysis sheets.
You could use these to work on your DBT training alongside a formal course, or after finishing one.
This information was published in January 2024. We will revise it in 2027.
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