Exploring Dialectical Behaviour Therapy

In the history of mental illness and psychology, there have been many proposed forms of treatment. However, the most effective are those that are evidence-based, such as cognitive behavioural therapy (CBT) and dialectical behaviour therapy (DBT). Here, we’re going to explore what DBT is, who it helps, and how you can access this treatment for yourself or loved ones.

What is Dialectical Behaviour Therapy?

Dialectical Behaviour Therapy (DBT) is a method of talk therapy that aims to help patients regulate their emotions and improve their relationships. The word “Dialectical” comes from the idea of opposites existing together. In therapy, it refers to the theory that acceptance and change can be required at the same time.

In the 1980s, Dr Marsha Linehan and her team created DBT when they noticed that cognitive behavioural therapy wasn’t as effective for some patients, specifically those living with Borderline Personality Disorder. 

Today, DBT is used to treat a variety of mental illnesses. These illnesses may involve conflict in relationships, risk-taking or violent behaviour, and severely low moods, such as:

  • Borderline Personality Disorder
  • Eating Disorders
  • Substance Use Disorders
  • Depression
  • Post-Traumatic Stress Disorder
  • Bipolar Disorder

What’s the Difference Between DBT and CBT?

Both forms of therapy use a trained mental health professional to conduct one-on-one talk therapy sessions. Since CBT was created first, DBT is strongly influenced by it. However, DBT has a few other distinguishing features that make it more suitable in the treatment of certain mental illnesses. 

DBT aims to teach patients how to accept themselves while also working towards changing aggressive or dangerous behaviour. It also focuses heavily on teaching patients new skills for coping with emotions and having safe and healthy relationships. 

In addition to one-on-one talk therapy sessions, DBT also includes group sessions where patients can learn and practice interpersonal skills with others and find support. Some treatment programs will also include in-the-moment telephone coaching. There are also excellent workbooks available for individuals to learn more about DBT. 

The 4 Key Skills Learned Through DBT

Each DBT program aims to teach patients four key skills to help them live a full life:

  • Emotion Regulation – the ability to observe feelings without letting them control one’s behaviour.
  • Distress Tolerance – the ability to cope with distress and crises, focusing strongly on acceptance.
  • Mindfulness – the ability to notice thoughts and feelings in the present and decide intentionally how/if they will be acted on. 
  • Interpersonal Effectiveness – the ability to set boundaries and respect the boundaries of others to foster respectful relationships. 

Where to Access DBT

If you are seeking DBT for yourself or someone else in Ontario, know that DBT provided by a medical doctor is covered under OHIP and you do not need a referral. However, it may require waiting on a lengthy waitlist.  

This download from University Health Network lists some of the facilities in Toronto offering DBT. It also includes a list of therapists and DBT providers who are not covered by OHIP.

The Linehan Institute also has a Find a Therapist tool for finding providers who are certified in DBT in Canada. 

Across Canada, the Sashbear Foundation is offering virtual group courses in DBT, known as Family Connections. These free courses (there is a nominal fee for resources) are facilitated by trained group leaders many of whom have experience with emotional dysregulation themselves or within their families. During Covid, these courses are being offered virtually. The Family Connections program is coordinated internationally by the National Education Alliance for Borderline Personality Disorder (NEABPD

If you’d like to learn more about DBT without seeking a therapist, CAMH has a web resource on it, as does the Canadian Mental Health Association.

Interested in Learning More About Treatment for Mental Illness?

Eli’s Place will be a much-needed treatment option for adults aged 18-35 in need of treatment for serious mental illnesses. Until our doors open, learn more about the efficacy of a farm-based therapeutic community for those with serious mental illness here

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