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Underlying principles of Dialectical Behavioural Therapy

Informed by the Buddhist philosophy, Third wave models of Cognitive Behaviour Therapy such as Acceptance and Commitment Therapy, Dialectical-Behaviour Therapy and Compassion-Focused Therapy hold a common view that emotional suffering occurs when creative means of surviving difficult life events become repeated and fixed, and are no longer of service to the client. The psychotherapist works with the client to identify and validate the impact of significant life events, and the role that inhibiting or destructive ways of coping have helped the client to endure adverse experiences. Within a warm and transparent therapeutic relationship, Third wave approaches value using mindfulness, acceptance and compassion to cultivate flexibility in order to foster change, wellbeing and increased autonomy. Acceptance and Commitment Therapy, Dialectical-Behaviour Therapy and Compassion-Focused Therapy are also unique in their approach, more information about each approach is given below. Depending on how the client views their struggles, needs and hopes for the therapeutic process, the therapist can work from one approach or draw upon beneficial aspects from each approach.

Dialectical-Behaviour Therapy adopts a directive approach that aims to help clients learn and develop specific skills to enhance self-acceptance, self-care, resilience and improve relationships. These skills include mindfulness, understanding overwhelming emotional experiences, developing healthy means of tolerating intense periods of distress, as well as skills to improve assertiveness, self-expression and understanding others. Dialectical-Behaviour Therapy is typically delivered in a group format with additional one-to-one sessions. However, this approach can be applied within one-to-one sessions where the psychotherapist can work directly with the difficulties that you bring.

Evidence for efficacy of Dialectical-Behaviour Therapy

Dialectical-Behaviour Therapy has been found to help individuals improve emotion regulation, reduce suicidal thoughts, harmful behaviours and improve interpersonal skills (Linehan et al, 1999; Neacsiu et al, 2014; Verheul et al, 2003). The research suggests that this skills-based approach leads to continued improvements to general and social well-being following the end of treatment (Linehan et al, 1999).

Issues Dialectical Behaviour Therapy can help with:

  • Managing intense periods of emotional distress
  • Feeling out of control
  • Reactive and impulsive behaviours
  • Substance abuse
  • Self-harm
  • Suicidal ideation
  • Difficulties with developing and maintaining relationships
  • Being in unhealthy relationships
  • Anxiety
  • Depression
  • Anger

Benefits of Dialectical Behaviour Therapy:

  • To understand the reasons for using harmful behaviours
  • To understand the role of different emotions
  • To understand how interpretation of events leads to subsequent feelings and behaviours
  • To find healthy ways of managing intense periods of distress
  • To improve self-care and resilience
  • To develop mindfulness skills and active acceptance of events beyond control
  • To improve ways of relating and connecting to others
  • To improve communication skills

Individuals Dialectical Behaviour Therapy is suited to:

Dialectical Behaviour Therapy is useful for individuals who are sensitive to their thoughts and feelings, and who currently use alcohol, self-harm or other coping behaviours they feel are having a negative impact on their life. This approach is suited to individuals who feel they would benefit from learning skills that can help to increase control over intense emotional experiences, reduce harmful behaviours and improve relationships with others.

Therapists who practice using this model

Dr Sophia Gazla (BSc, MRes, DCounsPsych, CPsychol)

Dr Gazla’s therapeutic approach is best described as pluralistic. Rooted in Humanistic and Existential psychotherapy values, Dr Gazla places a great importance on developing a trusting and collaborative therapeutic relationship to work with clients’ hopes and needs for the therapy process. This may include offering a safe space for clients to express and explore their difficulties confidentially, to work relationally to better understand how past relationships have influenced present ways of interpreting and relating to others and the world, or to focus on developing helpful strategies and skills to improve wellbeing. Dr Gazla draws upon contemporary ‘Third Wave’ Cognitive Behavioural Therapy techniques that can help to understand and reduce harmful behaviours and improve relationships with oneself and others, as well as foster psychological health and valued living. Dr Gazla applies these approaches to work effectively with issues such as anxiety, depression, eating issues, addiction, intrusive thoughts, harmful behaviours, medically unexplained symptoms, relationship problems, as well as general life challenges, in short-term or long-term therapy.

References

Linehan, M. M., Schmidt, H., Dimeff, L. A., Craft, J. C., Kanter, J., & Comtois, K. A. (1999). Dialectical behavior therapy for patients with borderline personality disorder and drug‐dependence. The American journal on addictions8(4), 279-292.

Neacsiu, A. D., Eberle, J. W., Kramer, R., Wiesmann, T., & Linehan, M. M. (2014). Dialectical behavior therapy skills for transdiagnostic emotion dysregulation: A pilot randomized controlled trial. Behaviour research and therapy59, 40-51.

Verheul, R., van den Bosch, L. M., Koeter, M. W., De Ridder, M. A., Stijnen, T., & Van Den Brink, W. (2003). Dialectical behaviour therapy for women with borderline personality disorder. The British Journal of Psychiatry182(2), 135-140.

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