Dialectical Behavioural Informed Therapy (DBT)
This is a summary of some of the core elements of DBT. Please don't hesitate to contact me for an informal chat and/or signposting to other resources if you would like further information about DBT
NB- Full DBT treatment consists of both being part of a skills group for psychological education and individual therapy. Within the skills group the individual would be taught the four main modules of treatment which are listed below. As the therapy will be conducted only by myself as an individual this is not recognisised as full DBT treatment; it is a DBT informed approach. It also means that the therapy takes longer as the skills are being taught within individual therapy at the same time as dealing with here and now issues. Due to this; and other issues regarding effectively managing risk within private practice; I regret that I cannot see individuals who are presenting as a high suicidal risk or having excessive suicidal thoughts and/or intent into my private practice in Seaford.
DBT was originally devised by Marsha Linehan as a treatment for Borderline Personality Disorder (BPD). It is an extremely effective approach for individuals who struggle to find coping strategies or resources to manage extreme distress, regulate emotions; and manage the complexity of interpersonal relationships and may resort to Self Harming or extreme risk taking behaviour to manage these difficulties. It is a bio social approach and theory in that it recognises the combination of pre-existing genetic emotional vulnerability and an invalidating or traumatic early environment as causing an individual to be potentially vulnerable to developing symptoms of BPD.
Stage One of DBT informed treatment focusses on helping individuals to develop coping strategies and resources for managing distress. The skills taught in order to develop such resources come under the four main headings of;
- Distress Tolerance
- Emotion Regulation
- Interpersonal Effectiveness
Stage One will also involve devising a target hierarchy of behaviours to address with the support of the therapist. These will include first and foremost any life threatening and/or self harming behaviours. Once these are addressed, and skills are learned and are able to be put successfully into practice to manage urges for life threatening behaviours, the next target will be behaviours that may be impacting on the clients quality of life and well being. The client will also be supported in recognising and challenging, and changing behaviours that may interfere with their engagement in therapy.
Stage Two addresses the underlying causes of distress such as past traumatic events/childhood trauma/PTSD.
Stage Three helps the individual to begin to address other life issues and to re invest energy into creating a meaningful life for themselves.
A core element of DBT is Mindfulness.
Mindfulness is a particular way of focussing attention and awareness, based on the concept of mindfulness in Buddhist Meditation. Mindfulness however is not inherently a religious practice, and and is often taught independently of religion. I teach Basic Mindfulness Skills as an integral part of my therapy work overall. It is an extremely beneficial skill to have and can be used in a variety of situations, i.e., when feeling anxious; as a way of dealing with intrusive thoughts, and as a general overall practice to enhance well being.