Dialectical behaviour therapy

Dialectical behaviour therapy is a type of therapy that helps you understand and change patterns of behaviour that might be holding you back from living the life you want. It focuses on identifying any unhelpful behaviors, emotions, and thoughts you might have, working with you to replace them with healthier ones.

One of the key ideas is called "dialectics," which is about finding a balance between two seemingly opposite ideas. For example, it encourages you to both accept yourself as you are and work towards making positive changes. Dialectical behaviour therapy helps you find a middle ground between extreme ways of thinking or acting.

This therapy emphasises understanding and validating your feelings while also encouraging you to grow and make changes. It’s about working together to help you build a life that feels meaningful and fulfilling.

Dialectical behaviour therapy may be a good fit for you if you are dealing with some of the following behaviours:

• Persistent thoughts or attempts of suicide and previous suicide attempts and self-harm behaviours.
• Frequent, intense, and rapid mood swings. Emotional ups and downs that feel out of control.
• Challenges within relationships and connecting with others, feelings of abandonment.
• Impulsive and risky behaviours leading to life-changing consequences.
• You may also find you have an additional mental health condition, like eating disorders, substance use disorders, trauma and post traumatic stress disorder (PTSD), and attention deficit hyperactivity disorder (ADHD).

If you want to learn new ways to cope with these challenging behaviours, dialectical behaviour therapy could be helpful for you.

Our programme has four key parts:

1. Pre-treatment:

You’ll start by meeting with an individual therapist to talk about your goals and the behaviours you want to work on. This usually takes four to six sessions. If you and your therapist agree that dialectical behaviour therapy is a good fit, you’ll then move onto the full 12-month programme.

2. Skills Group:

In this weekly group, you’ll learn practical skills to help you understand your reactions and manage your emotions. The skills group covers four main areas:

• Mindfulness - paying attention to the present moment without getting caught up in thoughts about the past or worries about the future. It means being fully aware of what’s happening around you and inside you—like your thoughts, feelings, and sensations—without judging them.
• Emotion regulation - understanding and managing your emotions, so they don't overwhelm you. It involves recognizing what you're feeling, knowing why you're feeling that way, and figuring out how to respond. It’s like having a remote control for your feelings, so you can turn down the intensity or change the channel when needed.
• Interpersonal effectiveness - learning how to interact with others clearly and respectfully. It involves knowing how to ask for what you want, how to say "no" when necessary, and how to handle conflicts without damaging relationships. It’s about balancing your needs with the needs of others.
• Distress tolerance - learning how to handle and cope with difficult situations or strong emotions without making things worse. It will help you get through tough moments without losing control or making decisions you might regret later. It’s like having tools to get through the storm until it passes.

3. Individual sessions:

You’ll also have weekly one-on-one sessions with a therapist. During these sessions, you'll both work closely together to better understand your behaviours and what might be causing them. This is done through something called behaviour analysis, which helps you look at what happens before and after a behavior to figure out why it happens and how to change it.

These sessions focus on motivating you, helping you put your new skills into practice, reducing life-threatening behaviours, and setting goals to build a life that feels worth living.

4. Telephone coaching:

Outside of your sessions, your therapist will be available at certain times to support you through challenging situations and help you use the skills you’ve learned.

You can be referred to our dialectical behaviour therapy service by the community mental health team, secondary care psychology therapies, or structured clinical management teams in your area.

If you’re a health professional or part of a team working with someone who has these behaviours, we also offer consultation and supervision to support your work.