DBT – dialectical behavioural therapy

Colette Adrian 2012

Specifically designed for those with borderline personality disorder

• BPD is considered one of the most difficult disorders to treat

• People with this diagnosis often present with – suicide attempts, suicide threats, displays of hostility

• DBT is a form of CBT specifically for this group

Targets of skills training in DBT

• Mindfulness

• Distress tolerance

• Interpersonal effectiveness

• Emotion regulation techniques

Core skill of the therapist

• Validation validation validation• The essence of validation is communicating

that his or her private responses (emotions, thoughts, assumptions, actions) are understandable and reasonable.

• Has a number of benefits – the biggest being validation balances the therapist’s push for change

Validation strategies

• Emotional validation strategies– Opportunities for expression, naming emotions,

feelings are valid• Behavioural validation strategies– Accepting behaviour in non-judgemental manner

• Cognitive validation strategies– Finding the kernel of truth• Cheerleading strategies• You are doing your best

Levels of validation

1. Active observing- attentive, AWAKE2. Reflecting the observed – not judging merit or

encouraging “is this how it is for you right now?”3. Articulating the unobserved – perceptively

understand what is meant without the person having to explain things.

4. Validation in terms of past – describe how behaviour makes sense given that in the past….

5. Validation in terms of present – this behaviour makes sense given what’s happening right now

Level 6 of validation

• Radical acceptance – you are what you are and I can handle it, and you can handle it.– What’s done is done, and I’m still here, lets move

forward together.