Joanne Regina, M.A., MBABCP, MBACP, EMDR (UK & IRE)
Counselling and Psychotherapy
Dialectical Behaviour Therapy: An Informed Approach
Creating a Life Worth Living
Dialectical behaviour therapy (DBT) is a modified form of cognitive behaviour therapy that is based on the Biosocial Model which proposes that individuals develop according to a complex set of interactions between their unique biological temperament, the demands and features of their immediate environment, and the broader social context in which they exist. It is an effective treatment for people who struggle with intense/fluctuating emotions, stress, episodic depression, feelings of emptiness, relationships difficulties, and impulsive behaviours.
One of the main principles of DBT involves identifying and resolving natural tensions (dialectic) between acceptance and change. That is, both developing an acceptance that oneself/life/people/situations are as they are, whilst also identifying the need and opportunity for change. A fundamental assumption of DBT is that due to their particular biosocial conditions, some individuals do not have the opportunity to learn the skills necessary for tolerating distress, regulating their emotions, or being able to communicate and interact in ways that are effective for attaining their goals.
DBT Skills training is made up of four modules: core mindfulness, distress tolerance, emotion regulation, and interpersonal effectiveness. They are designed to specifically assist individuals in better managing behaviours, emotions and thoughts.
Mindfulness is considered a foundation for the other skills taught in DBT, because it helps individuals accept and tolerate the powerful emotions they may feel when challenging their habits or exposing themselves to upsetting situations.
Involves learning how to recognise and reduce situations that elicit distress, assessing those aspects of a distressing situation where change may be possible, and acting skilfully to effect those changes – or accepting situations where change is not currently possible and learning to skilfully tolerate the associated distress, and learning to tolerate distressing situations and emotions without taking action that may ultimately increase distress (i.e. self-harm or self-destructive behaviour).
Involves learning to reduce emotional vulnerability and emotional suffering through increased understanding about what emotions are, what purposes they serve, and how they function. It also involves learning ways to observe and experience emotions in a more objective way, in addition to skilfully acting to reduce the likelihood of experiencing distressing emotional states.
Teaches skilful ways to increase the likelihood of achieving one’s objectives with others, in ways that enhance and maintain self-respect. This may include learning to ask for one’s needs to be met, setting limits with others or saying “no”, and having one’s opinions taken seriously. It also involves skills training in identifying, strengthening and maintaining supportive relationships, and ending or managing conflict in hopeless or unsupportive relationships.
I offer an informed approach which incorporates DBT skills and principles into therapy to enhance the therapeutic process in order to meet the individual needs of a client rather than moving through specific stages. My goal is to assist clients in learning effective skills to deal with emotional disturbance, to tolerate emotional intensity, and maintain stability in their lives outside of therapy.
**I strongly recommended comprehensive DBT for individuals presenting with chronic and severe symptoms (e.g. severe mood changes, impulsivity, current self harm and/or suicidality). Comprehensive DBT is an intensive therapy delivered by specialist teams and comprising of individual therapy, group skills training, telephone skill coaching, and weekly team consultation meetings.
For information about services which offer comprehensive DBT, speak to your GP or visit http://personalitydisorder.org.uk/services/.
© Joanne Regina Counselling and Psychotherapy