Dialectical Behaviour Therapy an Introduction

Published Categorised as Psychology


As an Organisational Psychologist, I spend most of my time thinking about how people impact organisations and vice versa. However, my reading of Freud and Adler has made the world of Clinical Psychology increasingly interesting to me. How individuals have the power to remake themselves with the help of an effective therapist. To satiate my interest in the world of Clinical Psychology I have been undertaking various training in the area. I started with a course on Dialectical Behaviour Therapy run by The Psych Collective. This blog is a summary of the key takeaways from the course. Whilst this therapy is focused on support individuals with Borderline Personality many of the skills are applicable across a range of mental health difficulties.

Who would I recommend this training to? For me, this short course was a perfect introduction and gave me the insight I desired at an appropriate level. Anyone interested in expanding their toolkit of therapeutic techniques would benefit. For people interested in delivering Dialectical Behaviour Therapy (DBT) group workshops, this course will serve as a strong foundation. However, a deeper knowledge from reading the DBT Guidebook would be necessary to translate this foundation into the recommended 16 weekly group sessions.

Overview of Dialectical Behaviour Therapy:

Created by Marsha M. Linehan in the 1970’s Dialectical Behaviour Therapy got its name from the philosophical discussions people have with differing opinions (A dialectic). Or as Wikipedia puts it “Two or more people holding different points of view about a subject but wishing to establish the truth through reasoned argumentation.” Dilemmas in life can be hard to reconcile, for example, how should we behave when something bad happens? Do we become completely emotional when things go wrong or coldly and practically work through our problems? The emotional route may work when you are supporting someone who is grieving but cold rationality may not be helpful in such circumstances. If for example, you are planning a funeral, being able to put your emotions aside to get the job done may be helpful. These ‘dialectics’ are wide varying and even a healthy adult can find it hard to figure out how to respond to various circumstances. However, those with Borderline Personality Disorder can find these dilemmas particularly difficult to navigate. Many grew up being told not to show any emotion or not having their emotions validated. Because of this, they find it very hard to walk the line in the middle where they use their emotional mind and logical mind in a balanced way. What DBT calls the “Wise Mind”. For more information on the specific characteristics of BPS see the Australian BPD Foundation’s website.

DBT was designed to give individuals an answer to the dialectic of “how do I both accept what is, as well as change for the better.” It does this by teaching people four key skills which when implemented help with navigating daily life, finding a balance of healthy emotionality and practical action.

Below is an overview of the four core skills that participants are expected to learn and the various sub-skills within them. You will notice that there are many acronyms within this form of therapy. This is because it was designed to be more easily absorbed by learners in a group setting.

You will notice I have put the information behind dropdown toggles. This will help with learning the acronyms as you can use them to test yourself on the content of a section before revealing the answer (Once you have absorbed the content first of course). Active recall is a proven effective way to improve learning, for more evidence-based revision tips I highly recommend Ali Abdaals youtube videos on the topic.


Distress Tolerance

Emotional Regulation

Interpersonal Effectiveness

Monitoring for Change

Where do these techniques fit in with Cognitive Behavioural Therapy?

For many Australian Psychologists who are most experienced with Cognitive Behavioural Therapy you may be wondering, how can incorporate these methods and skills within my existing framework for individual therapy with my clients?

If the situation is the problem employ Structured Problem Solving Skills

If the thoughts are the problem Check the Facts and Challenge the thoughts (CBT cognitive distortions)

If the feelings are the ‘problem’ Use LEAN and RESPOND skills

If there’s an urge to engage in regrettable behaviour or the wrong behaviour employ Opposite Action.

Additional Resources:

If any of the topics above might prove useful for your clients I highly recommend diving deeper with one of the Psych Collectives Training Courses. They also have a whole suite of free resources for mental health professionals. Their Distress Survival Guide is particularly useful as a handout.

The DBT Tools website below summarises many of the tools available in DBT in a similar fashion to what I have constructed above. It is a great reference tool as you learn more about this topic.

Further Reading:

If you are ready to start creating your own group therapy sessions for BPD based on the DBT methodology, the next step is to grab a copy of the manual and supporting worksheets by Marsha Linehan.

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