A career in dialectical behaviour therapy

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DBT is an innovative and unique treatment model for Borderline Personality Disorder (BPD), developed by Professor Marsha Linehan at University of Washington, Seattle.

Dialectical behaviour therapy (DBT) is designed to help people change patterns of behaviour that are not helpful, such as self-harm, suicidal thinking, and substance abuse. This approach works towards helping people increase their emotional and cognitive regulation by learning about the triggers that lead to reactive states and helping to assess which coping skills to apply in the sequence of events, thoughts, feelings, and behaviours to help avoid undesired reactions.

DBT assumes that people are doing the best they can but are either lacking the skills or influenced by positive or negative reinforcement that interfere with their ability to function appropriately.

Standard comprehensive DBT comprises 4 components:

  • Individual therapy (approximately 60 minutes/week)
  • Group educational skills training (approximately 120 minutes/week)
  • Team meeting (approximately 90 minutes/week)
  • Unscheduled telephone calls (average duration approximately 6 minutes)

The most consistent observation from research published to date is that the application of standard out-patient dialectical behaviour therapy (stage 1) reduces the rate of suicidal behaviour compared with treatment as usual.

Dialectical behaviour therapy is a four-stage treatment including:

  • decreasing life-threatening suicidal behaviours
  • decreasing therapy interfering behaviours
  • decreasing quality-of-life interfering behaviour
  • increasing behavioural skills

DBT seeks to build upon the foundation of CBT, to help enhance its effectiveness and address specific concerns that the founder of DBT, psychologist Marsha Linehan, saw as deficits in CBT.

DBT is offered on the NHS in some places. There is currently no official, comprehensive register of DBT therapists in the UK, but specialist organisations such as British Isles DBT Training or Refer self counselling psychotherapy practice (RSCPP) provide details of some DBT teams and therapists on their websites.