What is DBT?

Dialectical Behaviour Therapy was developed by Dr Marsha Linehan. She was interested in finding a treatment that worked for people with ongoing problems of self harm, suicidal thoughts, and suicidal behaviour.

Dr Linehan had direct personal experience of these problems as well as professional training and experience in well-researched behavioural therapies (see link re: Linehan’s personal history with this).  When she found that traditional behavioural treatments did not seem to work for certain clients she started incorporating Eastern psychological theory and practices into her treatment. Through feedback from clients and observers about what worked in the treatment she developed DBT.  The resulting treatment was shown to be highly effective in reducing hospitalisations, helping people stay in treatment (preventing drop out) and reducing suicidal and self harm behaviours.

Initially the treatment was researched as an effective treatment for Borderline Personality Disorder. Over time, however, DBT has been shown to be effective for other groups, such as adolescents with complex, multiple problem behaviours, binge eating, substance abuse and gambling. In general DBT tends to be applied when the core problem seems to be emotion regulation.  In DBT ongoing life threatening and quality of life threatening behaviours are viewed as a person’s best attempt in the moment to solve the problem of painful emotions.

At present researchers are trying to work out which bits of DBT make it work and who is it most effective for. In Australia and around the world there are both comprehensive DBT programs and programs that have incorporated some of the principles of DBT into their treatment. Similarly there are clinicians who have extensive, formal training in DBT, and those who incorporate some ideas from DBT in their work.