What is dialectical behaviour therapy (DBT)?

Dialectical behaviour therapy (DBT) is a type of cognitive behaviour therapy or 'talking therapy'. It is useful for people with borderline personality disorder (BPD) or who have trouble controlling their emotions.

People with BPD have difficulty regulating their very strong emotions. This may cause troubled relationships and a disturbed sense of self. They may experience self-harm or have suicidal thoughts.

DBT helps people change unhelpful ways of thinking and behaving, and to accept themselves as they are. They learn skills to build a satisfying and meaningful life.

Dialectical behaviour therapy involves learning both 'acceptance-oriented' and 'change-oriented' skills — seemingly 'dialectical' (opposite) skills. In DBT, your therapist will accept you as you are, and help you do the same, while also accepting the need for positive changes to help you recover and progress towards your goals.

When is DBT used?

DBT is used to treat problems related to borderline personality disorder, such as:

• feeling a sense of emptiness or hopelessness
• low self-esteem or feelings of self-hate
• strong emotions or intense mood swings
• risk-taking or impulsive behaviour
• unstable relationships
• self-harm
• suicidal thoughts or suicide attempts

Therapists offer DBT for other mental health conditions as well, including:

• alcohol or drug problems
• depression
• eating disorders, such as binge-eating or bulimia
• post-traumatic stress disorder (PTSD)

What can I expect from DBT?

With DBT, you learn to:

• accept yourself as you are
• build skills to regulate your emotions
• improve interpersonal relationships

DBT usually involves:

• sessions with a therapist
• skills training in groups
• telephone coaching sessions with a therapist, if you have a crisis

A typical course of DBT involves weekly sessions. These may continue for up to a year, but will depend on the needs of the person.

How does DBT help?

DBT helps you learn to manage your behaviour and emotions. It teaches you new skills to cope with day-to-day life and to replace harmful coping behaviours with healthier ones. It helps you understand why you struggle with the things you do.

There are 4 main skills you will learn during DBT:

• Mindfulness is being self-aware and present in the moment (the 'here and now'). When you are mindful, you are aware of what's going on around you and stop worrying about the past or the future. It helps you notice the present, rather than automatically reacting to it.
• Distress tolerance is learning to accept your emotions in difficult or stressful situations and manage them without using harmful behaviours.
• Emotional regulation is being more aware of your emotions. By understanding your emotions, you have more control over them.
• Interpersonal effectiveness is learning how to ask for what you need. It involves setting boundaries whilst being respectful towards yourself and others.

Where can I find a therapist or get help?

To find a therapist in your area, visit the healthdirect mental health services page.

There are also many organisations that you can contact for help.

If you are having a personal crisis, contact:

• Lifeline call 13 11 14 or chat online
• Suicide Call Back Service call 1300 659 467

Resources and support

• Beyond Blue helps anyone feeling depressed or anxious — call 1300 22 4636 or chat online.
• Black Dog Institute helps anyone affected by mood disorders — visit their online clinic.
• Jean Hailes for Women's Health has fact sheets on a range of health issues, including anxiety.
• SANE Australia helps people living with a mental illness — call 1800 187 263 or chat online.
• This Way Up Clinic helps anyone with stress, anxiety or depression — find an online program that best suits your needs.
• Healthdirect also offers a list of mental health helplines.

Looking for information for Aboriginal and/or Torres Strait Islander people?

• 13Yarn is a free and confidential crisis support service run by Aboriginal and/or Torres Strait Islander People — call 13 92 76.