If you or your loved one have received certain types of mental health diagnoses, such as BPD or EUPD, Dialectical Behavioural Therapy (DBT) may have been recommended to you.  DBT is a specialised approach designed to help people who have challenges with their emotions and/or find themselves engaging in behaviours that may be causing them harm.  That said, it is incredibly effective overall and, amongst other things, it is now also often used to help with conditions such as depression, anxiety, and disordered eating. There are many studies available online to show it is clinically proven to be effective, and I personally believe when it is used well, with understanding and compassion, it is a powerful and life-changing therapy. However, as with most types of therapy, it is not suitable for everyone. 

 

There are a number of key points that are worth knowing if you are looking to access this type of therapy.

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OPTION 1: Full-Service DBT

 

For DBT to be experienced as it was originally designed by its founder, Marsha Linehan, it needs to be delivered as part of a ‘full service’.  It may help to think of a full service as being the ‘gold standard’ of DBT. It can vary, but it will often take upwards of a year to complete the programme. Therapy includes taking part in a highly structured therapy that includes weekly group sessions and homework tasks where you might develop your existing skills around distress tolerance, interpersonal effectiveness, mindfulness, and emotional regulation. As well as that, you’ll have 1:1 individual weekly sessions with a DBT therapist who is part of that service. These sessions are designed to help you integrate the skills you’ve learnt in the group and problem-solve any difficulties that arise from that. Your primary therapist will then be involved in something we call ‘consultation’, where they discuss DBT principles and share ideas around this problem-solving. Crisis support via brief phone calls is also provided in the full service. In short, engaging in a full DBT programme can be very effective but requires an intense commitment from all involved. Because of that, you can expect it to cost significantly more than individual therapy.

 

If this is something you think would be helpful for you, I would recommend taking a look online at https://rhcp.org.uk/ where there is a little more information on accessing this through private practice, and with a professional and experienced team.

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OPTION 2: DBT Informed Therapy (DBTi)

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The reality is, lots of people are unable to afford this first option/level of therapy or be able to commit to that amount of time. However, I believe the skills that are taught in DBT are, in effect, life skills. This means they can be useful for absolutely anyone, regardless of any formal diagnosis. As such, DBT skills therapy can be utilised in a number of ways, depending on an individual's personal circumstances.

 

To make the DBT principles more accessible, I offer DBT ‘informed’ therapy where we can work together to use the skills taught in the full programme. Following a discovery session where we catch up and see what is going on for you, we will decide if this is an appropriate way to access DBT. As mentioned, this condensed version of DBT may not be appropriate for everyone so just as with the full service, an assessment and crisis plan session is required before therapy can begin. 

 

Assuming we decide to work together, from the outset, we will devise a bespoke programme that will likely be based on 20-25 sessions. However, as always with Self Made, there is never a requirement to financially commit to more than your next session. The content of your programme will be made up of the core skills that DBT offers and what you’d like to specifically focus on. With DBT, most of the work occurs outside of the session as you begin to develop your existing skills. This means there will often be small homework tasks where you will consider or put into action what you’ve learned. We will then review how that went in the next session.

 

These sessions can be once a week for 1 hour, 1.5 hours, or split over 2 x 1-hour sessions. While there is room to flex the sessions, especially if cost is a factor, there is still a significant amount of structure to allow for skills teaching and a mixture of regular therapy. 

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Even with the condensed version of DBT, for this type of therapy to be effective, you will probably notice there is a significant amount of structure to the sessions and a continued commitment to the program is required.

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OPTION 3: DBT Lite -  Blending Skills with Integrative Therapy.

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Some people do not want to have such structured sessions but feel they would still like to learn some DBT skills and principles that would be valuable in helping them reach their personal goals. As mentioned, DBT skills are life skills and that means they can be useful for everyone! This is why it can be really effective to use those skills and principles in an integrative way. Although we can still create a bespoke programme for you, DBT Lite is far less structured and leaves room to include other ways of working.

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UNSURE OF WHERE TO GO NEXT?

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This may all seem like a lot of information (because it is!) and you may be unsure of what you are looking for or what might suit you best. The reality is, it depends, and deciding what is right for you or your loved one will likely require a bigger conversation. If that is the case, please send me a message and we can work together to figure out what might be appropriate.

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