Dialectical Behaviour Therapy (DBT)

Developed by Marsha Linehan in 1993, Dialectical Behaviour Therapy (DBT) describes borderline personality disorder (BPD) as an emotional dysregulation disorder arising from a combination of an invalidating early life environment and having a biological sensitivity.

A DBT practitioner works collaboratively with a person to increase their skills in mindfulness, inter-personal effectiveness, distress tolerance and emotional regulation. Together, these help the person to manage everyday challenges so that they can 'build a life worth living'. 

DBT is useful for significantly reducing anger, self-injurious and suicidal behaviours as well as increasing a person’s capacity to manage distress, regulate their emotions and improve the quality of their relationships.

Spectrum offers a comprehensive DBT Program for people experiencing BPD-related symptoms including emotional instability, interpersonal difficulties, impulsivity, and high risk and/or complex behaviours. DBT clients work with a specific clinician who co-ordinates their care in the program and conducts their weekly session, with a focus on increasing self-awareness, personalising the application of skills and increasing motivation to use these skills. 

The clinician may also provide phone coaching to trouble shoot skills in action. The client receiving DBT treatment also attends a weekly, interactive, two-hour group program in which they learn and practice DBT skills to help consolidate these in everyday living. 

Clients are contracted to the program in six-monthly blocks, including a full round of skills modules. If a client is able to engage with DBT and shows improvement in skill acquisition, they can be re-contracted for a further six-months of treatment to strengthen and broaden their skills. 

DBT is a team-based therapy; clinicians meet weekly for consultation to support each other to improve their capacity to provide DBT. In this way, DBT clinicians 'walk the walk' by applying the principles and approaches of DBT to themselves. Our DBT program is under the supervision of Prof Alan Fruzzetti from Harvard University’s McLean Hospital, and is in the process of being accredited with the DBT Certification Board.

DBT with Prolonged Exposure (DBT–PE) is a program for people who have experienced prolonged trauma and have a co-occurring or primary diagnosis of complex post-traumatic stress disorder (CPTSD). At Spectrum, clients can access the DBT-PE program to treat both conditions simultaneously. After completion of a full round of standard DBT treatment, the trauma is specifically targeted using an extra weekly individual exposure session for approximately six-months. Our clinicians have received training in DBT-PE from the treatment developer, Dr Melanie Harned.

Participation in the DBT skills group is the key to successful DBT treatment. Brief DBT programs have been shown to decrease anxiety and increase capacity for clients to manage distress, regulate emotions, and improve relationships. At regular intervals, Spectrum offers a 12-week DBT skills group-only program to assist in the treatment of moderate severity BPD, comprising a weekly 2-hour group session that teaches key DBT skills. Program suitability and the client’s readiness to participate is explored during a pre-commitment session.

DBT is not the best treatment option for everyone. Spectrum offers a range of similarly effective treatments that your therapist will discuss with you during assessment.