Dialectical behaviour therapy (DBT)
Dialectical behaviour therapy (DBT) is a type of talking therapy offered by the complex emotional need pathway that helps people learn how to replace impulsive, risky, or harmful ways of coping with healthier, more effective ones. It is designed for people who feel emotions very intensely.
Dialectical behaviour therapy is often used to treat people who engage in life-threatening behaviours like self-harm and suicidal thoughts. The goal is to help a person develop a life worth living.
The aims of dialectical behaviour therapy are to help you:
- understand and accept your difficult feelings
- learn skills to manage them
- make positive changes in your life
Dialectical means trying to understand how two opposite things can be true at the same time, like accepting yourself while also changing your behaviour. Dialectical behaviour therapy teaches you that it is possible to achieve both. During DBT, the therapist will use a mix of acceptance and change techniques.
What to expect
You will be offered an assessment or pre-treatment phase of DBT. This is where the therapist will see if DBT is suitable for you. You will be asked to commit to the treatment.
The dialectical behaviour therapy treatment has four elements:
Individual therapy
- Weekly sessions with a therapist to help you achieve a life worth living.
- You will complete weekly diary cards to monitor problem behaviours, emotions, and urges. This helps decide what to work on in each session
Skills training
Weekly teaching sessions that cover four modules. The group is like a class where the leader teaches skills, and you have weekly homework and skills practice.
The four modules are:
- mindfulness, focusing on the present
- interpersonal effectiveness, learning to work with and respond better to others
- emotion regulation, understanding, increasing awareness, and better controlling your emotions
- distress tolerance, dealing with crises without harmful behaviours
Phone coaching
- Offered by individual therapists to help you use your new skills in real-life situations.
- Provides in-the-moment coaching on coping effectively between sessions.
- Support is available during distress, when you need advice on using the skills, or to repair your relationship with the therapist.
- Calls are usually brief, and there are clear boundaries, like not calling again for 24 hours.
Therapist Consultation team
- Therapists work in teams and meet weekly for supervision.
- The team helps therapists discuss issues, treat people more effectively, stay motivated, and share responsibility.
- You will not attend these meetings, but they are part of your overall treatment.
Questions and answers
What medications will I be given?
At the moment, there is no medication proven to treat emotionally unstable personality disorder or personality difficulties. You might be taking medication for other related problems. If so, it’s best to have these reviewed by a psychiatrist or your GP.
You may be encouraged to talk about any medications you are using to see how they work and if they have any side effects. It might be necessary to stop or reduce any medications that are not helpful.
What about hospital treatment?
The best way to treat emotionally unstable personality disorder or complex emotional needs is usually in the community.
If you need to go to the hospital, it should be for a short time and with a clear goal. For example, you might go to the hospital to understand what’s causing your current problems or to help manage a serious crisis, like setting up or reviewing a plan for your care and safety.
What happens in the first session?
The first group session helps you understand how the group works. You will talk about your goals, the problems you want to work on, and the rules that keep everyone safe. You will get handouts to help you with this.
What if I don’t like it?
You might not like someone in the group or find others too talkative or critical. This is normal and happens in everyday life too. You will be encouraged to solve any problems during your one-on-one sessions. If you think the treatment isn’t helping, discuss it in your one-on-ones.
Many people feel nervous about group sessions and prefer one-on-one treatment, but studies show that group treatment works best for shared learning and support. If you need help joining the group, we have occupational therapists and support workers who can assist you.
What is good about a group?
Everyone in the group is trying their best to learn and deal with life problems in a better, healthier way. You all share similar experiences and get to practice new skills in a safe environment. Then, you can try these skills in the outside world to improve your life there too.
Do I have to tell everything about myself and my experiences in the group?
No, many people worry about this. You are not expected to talk about childhood experiences, past traumas, or anything you are uncomfortable with. We also encourage everyone to be mindful of how much they share, as it can affect others. The group focuses on skills and problem-solving, so you only need to share what you are comfortable with.
Plan your journey
If you use public transport, the Traveline journey planner provides information about what services and times are available.
Page last reviewed: March 05, 2025
Next review due: March 05, 2026
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