Care & Treatments, Mood disorders, Mental health and wellbeing

26 November, 2024

Understanding Dialectical Behaviour Therapy at St Patrick’s Mental Health Services

This blog explores the Dialectical Behaviour Therapy (DBT) at St Patrick's Mental Health Services (SPMHS), highlighting its effectiveness in helping people build emotional resilience and healthier coping strategies.

What is Dialectical Behaviour Therapy (DBT)?

DBT is a type of psychological therapy that helps people manage emotions and improve their overall wellbeing. It is particularly helpful for those who experience intense emotions and may act impulsively, such as engaging in self-harm, substance abuse, or lashing out at others. While these actions may offer temporary relief, they can make life harder in the long run.

The main goal of DBT is to help individuals build a “life worth living.” It provides tools and strategies to help people to develop skills that help them to work through and manage intense emotions and move away from destructive or unhelpful behaviours. DBT focuses on teaching four key skills: mindful awareness, distress tolerance, emotion regulation, and effective communication with others.

Who can benefit from DBT?

DBT is useful for people who find it hard to control their emotions or thoughts, find it difficult to cope with distress, and have trouble setting boundaries or expressing their needs in relationships. DBT helps them find better ways to manage these challenges.

How DBT started at SPMHS

At St Patrick’s, there was a growing recognition of the need for a programme that could help people with self-harming behaviours. This led to the creation of the Living Through Distress (LTD) programme. This was a DBT-informed, group-based intervention. The programme aimed to provide essential DBT skills to individuals who had problems with emotional control and often engaged in self-harming behaviours.

The first LTD programme was launched in June 2008, offering one-hour sessions four times a week for a four-week period. The programme initially focused on the DBT skills of mindfulness, distress tolerance, and emotion regulation. Over time, the programme expanded to include additional skills and aftercare support.

While there were doubts about the effectiveness of a skills-only approach at first, research conducted within the department showed significant improvements in participants. Studies found reductions in self-harming behaviours and increased distress tolerance, along with improvements in anxiety, mindfulness, and emotion regulation (Booth et al., 2014; Looney & Doyle, 2008). We remain committed to measuring the impact of the programme and we are currently investigating our service users experience of hope.

The growth of the DBT programme

Over the past 10 years, the DBT programme at SPMHS has continued to evolve and improve, with input from leading DBT experts. Today, it offers a more comprehensive and structured approach, still focused on the goal of helping people build a life worth living.

The DBT programme at SPMHS is now available to outpatients of SPMHS. It is a stage one psychology programme. This means it focuses on helping individuals better understand and manage their emotions and behaviours and get in control of out-of-control behaviours.

The programme is divided into two main groups: the DBT Comprehensive Group and the DBT Skills-Only Group.

DBT Comprehensive Group: This in-person group is designed for people with a recent history of self-harm or suicidal behaviour. It includes group and individual therapy sessions.

DBT Skills-Only Group: This group focuses solely on teaching DBT skills and is available both in person and online. It is for people who have difficulty managing emotions and behaviours but do not have a recent history of self-harm or suicidal behaviour.

Both groups run twice a week for three months. They each teach essential DBT skills, such as:

  • Mindfulness: Helps people gain better control over their attention and become more aware of their emotions, thoughts, and urges to engage in unhelpful behaviours.
  • Emotion regulation: Focuses on how the individual experiences and expresses emotions and reducing the intensity of unwanted emotions.
  • Distress tolerance: Help people how to manage highly uncomfortable emotions or thoughts.
  • Interpersonal effectiveness: Helps people build and strengthen relationships, supporting them to learn to ask for what they want clearly and firmly.

Where the DBT programme is now

Since its launch, the DBT programme at SPMHS has continued to expand and grow. The service now runs three groups per year for each of the DBT streams (comprehensive, in-person skills-only, and online skills-only). In total, SPMHS runs nine DBT groups per year and has helped hundreds of individuals develop DBT skills.

The programme is continuously evolving, and SPMHS remains dedicated to providing the best possible care to its service users.

One service users experience

Read about one service users experience with the DBT programme at SPMHS below.

“Attending Dialectical Behaviour Therapy (DBT) was a transformative experience that reshaped my understanding of myself and my emotions. Initially, I was hesitant. I didn’t understand what I would be walking into. I was very closed off and felt like it was a waste of time. I had no experience with anything concerning my emotions. I felt as if I only had two – sadness and happiness. Throughout my journey, I could label different emotions and understand what they were and how I felt.”

They continue, “When I would hit my lowest point, I would see no other options at the time other than negative coping mechanisms, With the help of DBT I was able to stop that completely and find other healthy coping mechanisms that I still use every day.

As the weeks went by, I noticed significant changes within myself. I became more aware of my emotional triggers and learned how to respond rather than react.

My DBT experience was not just about individual growth it was about embracing the journey as a whole and learning that healing is not linear, and setbacks are a part of the process. Looking back, attending DBT was one of my best decisions. I left each session feeling more grounded, more capable, and above all, more connected to myself and others. I wouldn’t be where I am today without it.”