Dialectical Behavioural Therapy (DBT) was developed for clients with borderline personality disorder (BPD), who felt invalidated when practitioners of the then-predominant Cognitive Behaviour Therapy (CBT) challenged their thoughts. This page introduces you to Dialectical Behavioural Therapy, and provides you with a curated collection of DBT courses, articles, videos, and other resources.
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What is Dialectical Behavioural Therapy?
Dialectical Behaviour Therapy, or DBT, was developed in 1991 by U.S. psychologist Marsha Linehan for use specifically with clients diagnosed with borderline personality disorder (BPD), who cope with distressing emotions and situations by using self-destructive behaviours such as suicide and self-harm, eating disorders, and substance abuse. Linehan’s assessment of the therapies available to BPD clients at the time was that traditional treatments were “woefully inadequate” (1993, p 3).
DBT has nearly three decades of research behind it and is considered the “gold standard” for the treatment of BPD (Fraga, 2021). Investigations have shown that DBT is effective at reducing the harmful behaviours that go with BPD diagnosis. As an example, a randomised controlled study (RCT) within a routine Australian public mental health service was conducted in which adult patients with BPD were provided with outpatient DBT for six months. Patient outcomes were compared to those obtained from patients in a wait list group receiving treatment as usual. After six months, the DBT group showed significantly greater reductions in suicidal and non-suicidal self-injury, emergency department visits, psychiatric admissions, and bed days. On self-report measures, the DBT patients demonstrated significantly improved depression, anxiety and general symptom severity scores compared to the treatment-as-usual group. Average treatment costs were significantly lower for those patients in DBT than those receiving treatment as usual (Pasieczny & Connor, 2011).
Increasing numbers of investigations since that 2011 study have found similar results – that is, that DBT is superior to “treatment as usual” and to other therapies used to treat BPD. Thus, researchers and clinicians began to ask if it could be used to help with other disorders. By the turn of the millennium, a burgeoning number of studies saw it successfully adapted for use with domestic violence, in forensic settings, for substance abuse, and in the treatment of elderly individuals with depression (Miller & Rathus, 2000; MacPherson, Cheavens, & Fristad, 2013). The myriad randomised trials conducted in the two decades since then have seen DBT’s star shine even more brightly as researchers, clinicians, and consumers alike are captivated by its sound research backing with a multimodal, principle-based treatment conceptualising emotional dysregulation as the core of myriad emotional difficulties. Its compassion-engendering stance, based on Linehan’s biosocial theory, has endeared it to all parties (Miller, 2015).
Source: What is Dialectical Behaviour Therapy?
Featured DBT Training & DBT Courses
Following is a curated list of Mental Health Academy DBT training and DBT courses. Click the links to learn more about each course, and enrol (enrolment is available for MHA members only – if you’re not a member, click here to learn more about membership):
- Dialectical Behaviour Therapy (learn more). This DBT course provides an introduction to Dialectical Behaviour Therapy (DBT), with a specific focus on its applications with clients with Borderline Personality Disorder.
- Dialectical Behaviour Therapy for At-risk and Suicidal Adolescents (learn more). In this DBT course, those who work with adolescents and would like to work in a DBT-informed way are shown the theoretical assumptions, principles, and skills/techniques with which they must work if they are to implement successful DBT-A (dialectical behaviour therapy for adolescents) with their clients.
- Dialectical Behaviour Therapy for At-risk and Suicidal Adolescents: Specific Considerations (learn more). In this DBT course, we look into treatment differences between five common presentations for DBT-A therapy, including the theoretical dialectics, case conceptualisation, goal setting, and ongoing assessment tools and change strategies.
- Dialectical Behaviour Therapy for Eating Disorders (learn more). In this DBT course, focusing on DBT adapted for eating-disordered client populations, attendees briefly review standard DBT, examine the DSM-5 definitions of binge-eating disorder and bulimia nervosa, and proceed through detailed sessions showing how to use DBT skills for those with BED and BN. The DBT course framework is based on a 20-session program which has demonstrated efficacy at reducing binge-eating and compensatory behaviours such as purging.
- Dialectical Behaviour Therapy: Case Studies (learn more). In this DBT course, case studies are presented of Sandy, a 39-year-old woman with bulimia nervosa and Aidan, a 20-year-old man who experienced sexual abuse as a child. Both clients go through a DBT program adapted for their needs: eating disorders in Sandy’s case and complex PTSD in Aidan’s. The contents of each program are outlined and highlighting vignettes detailed as the two clients undergo demanding but life-changing therapy programs.
For more courses, visit https://www.mentalhealthacademy.com.au/catalogue
Recommended Dialectical Behaviour Therapy Resources
Following is a curated list of Dialectical Behaviour Therapy resources, including DBT articles, DBT videos, and popular DBT books. Click the links to learn more about each resource.
- What is Dialectical Behaviour Therapy? (read article)
- Dialectics, DBT and the Therapeutic Process (read article)
- Integrating DBT Group Training Skills to Other Approaches (read article)
- Case Study: DBT and Bulimia Nervosa (read article)
- How Marsha Linehan Learned Radical Acceptance (watch video)
Assessment Tools in Dialectical Behaviour Therapy
Dialectical Behaviour Therapy assessment tools are essential for clinicians and therapists to assess and monitor their clients’ progress in DBT treatment. Here are some commonly used DBT assessment tools:
- Diary Cards: Diary cards are daily tracking tools used by clients to record their emotions, behaviors, and skills usage. They help individuals become more aware of their thoughts and behaviours.
- Dialectical Behaviour Therapy Ways of Coping Checklist (DBT-WCCL): This self-report questionnaire assesses the frequency and effectiveness of DBT skills usage in various situations.
- Dialectical Behaviour Therapy Adherence Scale (DBT-AS): This tool helps therapists evaluate their adherence to DBT principles and assess whether they are delivering treatment as intended.
- Suicide Ideation Questionnaire (SIQ): SIQ is used to assess and monitor suicidal thoughts and behaviours in clients undergoing DBT treatment.
- Beck Depression Inventory (BDI): Although not specific to DBT, the BDI is often used to measure the severity of depressive symptoms in DBT clients.
- Beck Scale for Suicidal Ideation (SSI): SSI is used to assess the intensity and severity of suicidal ideation in individuals, which is relevant to DBT treatment.
- Sheehan Suicidality Tracking Scale (S-STS): This tool helps assess and monitor suicide risk and self-harming behaviors in individuals receiving DBT therapy.
- Difficulties in Emotion Regulation Scale (DERS): DERS is used to measure emotional dysregulation, which is a central target of DBT treatment.
- Behavioral Tech’s DBT Prolonged Exposure Protocol for PTSD: This is a structured protocol for assessing and treating post-traumatic stress disorder (PTSD) within the context of DBT.
Please note that the use of these assessment tools should be conducted by trained mental health professionals as part of a comprehensive DBT treatment plan. They are not intended for self-assessment or diagnosis.
References
- Linehan, M. (1993). Skills Training Manual for Treating Borderline Personality Disorder. United States: Guilford Publications.
- Fraga, J. (2021). Treating Borderline Personality Disorder (BPD). PsychCentral. Retrieved on 5 April, 2024, from: https://psychcentral.com/disorders/borderline-personality-disorder/treatment#treatments
- Miller, A.L., Rathus, J.H., & Linehan, M.M. (2017). Dialectical behaviour therapy with suicidal adolescents. New York/London: The Guilford Press (paperback version). www.mhca.org.au.
- Pasieczny, N. & Connor, J. (2011). The effectiveness of dialectical behaviour therapy in routine public mental health settings: An Australian controlled trial. Behaviour Research and Therapy, 2011, Jan; 49(1) 4-10. Doi: 10.1016/j.brat.2010.09.006. Epub2010 Oct 1.