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Dialectical behaviour therapy (DBT)

Disclaimer:

This publication is based on a Mind UK publication and the original version may be found here: https://www.mind.org.uk/information-support/a-z-mental-health/

Thank you to Mind UK for sharing their valuable content with us. Content included in Mental Health A-Z is made available free of charge and does not form part of any commercial activity. The adaptation has been done independently by Mind HK and is intended for general information purposes only.

What are DBT sessions like? 

DBT can vary between different services. See below for an outline of what DBT treatment might look like and entail: 

DBT pre-treatment 

Some therapists may offer you an assessment or pre-treatment phase of DBT. This is where the therapist will look at how suitable DBT is for you. They might offer you several sessions where you will learn about the DBT model. Then if you decide it is the right therapy for you, they will ask you to make a commitment to the treatment. 

Individual therapy 

Individual therapy usually involves weekly one-to-one sessions with a DBT therapist. Each session might last approximately 45–60 minutes. 

The individuals sessions have a hierarchy of goals: 

  1. To help keep you safe by reducing suicidal and self-harming behaviours. 
  2. To reduce behaviours that interfere with therapy. 
  3. To help you reach your goals and improve your quality of life by addressing what’s getting in the way. This might be other mental health problems like depression or hearing voices. Or it might be things in your personal life like employment or relationship problems. 
  4. To help you learn new skills to replace unhelpful behaviours and help you achieve your goals. 

Your DBT therapist is likely to ask you to fill out diary cards as homework, and bring them to sessions. This is for you to track your emotions and actions, and look for patterns and triggers in your life. You then use this information to decide together what you will work on in each session. You can find some sample diary cards on the DBT Self Help website. 

“I’ve learned that emotions are not the enemy. They are useful and have functions. I still feel emotions intensely, but I can now identify them and  know how to manage them without using harmful behaviours.” 

Skills training in groups 

In these sessions DBT therapists will teach you skills in a group setting. This is not group therapy, but more like a series of teaching sessions. 

There are usually two therapists in a group and sessions might be weekly. The room is sometimes arranged like a classroom where your skills trainers will be sat at the front. The aim of these sessions is to teach you skills that you apply to your day-to-day life. 

There are typically four skills modules: 

  • Mindfulness. This is a set of skills that focus your attention on the present, rather than worries about the past or the future. You might have a mindfulness module running between other modules. DBT sessions may often also start with a short mindfulness exercise. See our resource on mindfulness for more information.
  • Distress tolerance. This means learning to deal with crises without harmful behaviours, like self-harm. 
  • Interpersonal effectiveness. This means learning to ask for things and say no to other people, with respect for yourself and others. 
  • Emotion regulation. This is a set of skills you can use to understand, be more aware, and have more control over your emotions. 

In group sessions your therapist might ask you to do group exercises and use role-play. You are also given homework each week to help you practise these skills in your day-to-day life. 

Telephone crisis coaching 

DBT often uses telephone crisis coaching to support you in your day-to-day life. This means that you might be able to call your therapist for support between sessions. For example: 

  • when you need help to deal with an immediate crisis (such as feeling suicidal or wanting  to self-harm) 
  • when you are trying to use DBT skills but want some advice on how to do it
  • if you need to repair your relationship with your therapist. 

But you need to check with your therapist whether this is something that is available to you, and it’s expected that your therapist will set some clear boundaries around this. For example: 

  • calls are usually brief 
  • calls should only take place between the hours you agree with them
  • in particular circumstances, they might ask you to wait 24 hours before calling them. 

“If I had a meltdown or crisis, she’d help me understand what may have contributed.” 

During sessions DBT therapists will use a balance of acceptance and change techniques. 

Acceptance techniques 

Acceptance techniques focus on: 

  • understanding yourself as a person 
  • making sense of why you might do things such as self-harm or misuse drugs. 

For example, a DBT therapist might suggest that this has been your only way of coping with intense emotions. So even though it’s damaging in the long-term, and may alarm other people, your behaviour makes sense.

“Finally someone is saying ‘yes it makes sense’ rather than ‘no that’s wrong’.” 

Change techniques 

Change techniques focus on replacing behaviours that harm you with behaviours that help you. This  may mean your therapist: 

  • challenges your unhelpful thoughts 
  • encourages you to find new ways of dealing with distress. 

“It’s not a short term thing… you have to work at it every single day. It’s  hard to do, and even now, some 2 years after I completed the therapy, I’m still having to work at it.”

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What is iACT Service?

Improving Access to Community Therapies (iACT®) is one of the services from Mind HK. Trained Wellbeing Practitioners will offer initial assessment and early intervention for people dealing with mild to moderate symptoms of depression, anxiety, or other emotional difficulties.

 

The service includes 6-8 sessions of low-intensity psychological support, the flexibility of the service allows individuals to receive free and timely support when needed.

If you’re aged between 18 – 65 and are facing some emotional challenges, we would like to invite you to take an online assessment for us to gain a better understanding of your current emotional struggle.

 

If you’re eligible, we’ll get you connected with a Wellbeing Practitioner within two weeks to sort out the next steps.

The service runs for about 3 months and includes 6-8 support sessions, tailored to your needs.

 

We encourage you to attend all sessions and actively practice the tips and exercises provided by your Wellbeing Practitioner.

We take your privacy seriously. Your chats with the Wellbeing Practitioner are confidential.

 

We won’t share any of your info unless you’ve provided consent or if there are risks detected.

This programme isn’t suitable for people facing emergencies, major setbacks, or those diagnosed with serious or complex mental health conditions.

 

If you’re having thoughts of suicide or self-harm, this programme might not meet your needs, so please seek help right away. You can check out Mind HK’s “Find Help Now” page for immediate information and services.

Most of our Wellbeing Practitioners have backgrounds in psychology or counselling and are passionate about mental health. They’ve gone through about 140 hours of intensive training and completed at least 120 hours of supervised clinical practice over 9 months to ensure the quality of service.

 

They’re trained by accredited local experts in the mental health field, including clinical psychologists, counselling psychologists, counsellors, and psychiatrists. Plus, we regularly check how effective our services are. All service outputs and performances are subject to consistent monitoring.

Who is suitable for participating in this programme?

This programme welcomes anyone between the ages of 18 and 65 who may be feeling lost or facing emotional difficulties. Please note that this programme is not suitable for individuals diagnosed with severe or complex mental health conditions.

This programme is not suitable for individuals diagnosed with severe or complex mental health conditions, but suitable for those who experience mild to severe moderate anxiety, mild to moderate depression, or other emotional challenges. If you are currently experiencing a major setback or even having thoughts of suicide or self-harm, please visit the “Find Help Now” page on our Mind HK’s website for immediate information and services.

After signing up, our Wellbeing Practitioner will contact you within two weeks to schedule a convenient time for a 45-minute conversation, either via video or phone call, according to your preference. During the conversation, the Wellbeing Practitioner will understand your current situation and help you gain a better understanding of your emotional state based on the questionnaire you filled out during application. Additionally, they will provide recommendations for appropriate community resources based on your needs, helping you take an important first step in taking care of your mental health.

Although the intervention procedure is mostly standardised, Wellbeing Practitioners will work flexibly with clients to address individual presenting problems and unique characteristics.

Our Wellbeing Practitioners are trained to support people who experience mild to moderate mental health difficulties primarily. This programme is not suitable for the situations mentioned above. If you are currently experiencing a major setback or even having thoughts of suicide or self-harm, please visit the “Find Help Now” page on our Mind HK’s website for immediate information and services.

Your conversations with the Wellbeing Practitioner are absolutely confidential. Any information about you will not be shared with anyone without your consent unless you or others are at immediate risk or the Wellbeing Practitioner has reason to believe that you may be in imminent danger.
Supervisors will monitor trainees’ development throughout the placement to ensure that they are meeting the required level of competency to pass the training course at the end of the placement.

Yes, it is necessary to book an appointment in advance by filling out the form. Additionally, you can select one of the five stores yourself. We will allocate clients to different Wellbeing Practitioners based on their chosen location.

Before having the conversation, we will ask you to fill out a basic questionnaire for preliminary screening assessment. This screening process aims to ensure that the training received by the Wellbeing Practitioners is sufficient to meet the needs of the individuals receiving the service. If it is determined after the screening assessment that the service is not suitable for you, Mind HK will provide alternative recommendations to ensure your safety and support.

For adults who are suitable for this service, all Wellbeing Practitioners have received training on how to identify and respond to safety and risk issues. If you have any concerns about the support process, the Wellbeing Practitioners have appropriate measures in place and will develop response plans based on the urgency of the situation. They can also access support from clinical practitioners from Mind HK or participating organisations.

What private training does Mind HK provide?

Mind HK provides 4 themes of mental health training, including: Supporting Self, Supporting Others, Family Wellbeing and DEI (Diversity, Equity and Inclusion).

 

Check out the brochure here for more information.

Mind HK provides a wide range of standardised mental health training, which can be tailored to different circumstances. Chat with our team to explore more! 

Our trainers come from a diverse, accredited pool of clinically experienced professionals. Check out our trainers’ biographies here.

Yes, the Mental Health First Aid class of Mind HK is internationally accredited by the MHFA International. The content and certification is delivered by trainers certified from the Mental Health Association of Hong Kong. You can find out our trainers accreditation here.

We are here to support your mental health education journey! Reach out to us and chat with our team.

What are DBT sessions like? 

What are DBT sessions like? 

DBT can vary between different services. See below for an outline of what DBT treatment might look like and entail: 

DBT pre-treatment 

Some therapists may offer you an assessment or pre-treatment phase of DBT. This is where the therapist will look at how suitable DBT is for you. They might offer you several sessions where you will learn about the DBT model. Then if you decide it is the right therapy for you, they will ask you to make a commitment to the treatment. 

Individual therapy 

Individual therapy usually involves weekly one-to-one sessions with a DBT therapist. Each session might last approximately 45–60 minutes. 

The individuals sessions have a hierarchy of goals: 

  1. To help keep you safe by reducing suicidal and self-harming behaviours. 
  2. To reduce behaviours that interfere with therapy. 
  3. To help you reach your goals and improve your quality of life by addressing what's getting in the way. This might be other mental health problems like depression or hearing voices. Or it might be things in your personal life like employment or relationship problems. 
  4. To help you learn new skills to replace unhelpful behaviours and help you achieve your goals. 

Your DBT therapist is likely to ask you to fill out diary cards as homework, and bring them to sessions. This is for you to track your emotions and actions, and look for patterns and triggers in your life. You then use this information to decide together what you will work on in each session. You can find some sample diary cards on the DBT Self Help website. 

"I’ve learned that emotions are not the enemy. They are useful and have functions. I still feel emotions intensely, but I can now identify them and  know how to manage them without using harmful behaviours." 

Skills training in groups 

In these sessions DBT therapists will teach you skills in a group setting. This is not group therapy, but more like a series of teaching sessions. 

There are usually two therapists in a group and sessions might be weekly. The room is sometimes arranged like a classroom where your skills trainers will be sat at the front. The aim of these sessions is to teach you skills that you apply to your day-to-day life. 

There are typically four skills modules: 

  • Mindfulness. This is a set of skills that focus your attention on the present, rather than worries about the past or the future. You might have a mindfulness module running between other modules. DBT sessions may often also start with a short mindfulness exercise. See our resource on mindfulness for more information.
  • Distress tolerance. This means learning to deal with crises without harmful behaviours, like self-harm. 
  • Interpersonal effectiveness. This means learning to ask for things and say no to other people, with respect for yourself and others. 
  • Emotion regulation. This is a set of skills you can use to understand, be more aware, and have more control over your emotions. 

In group sessions your therapist might ask you to do group exercises and use role-play. You are also given homework each week to help you practise these skills in your day-to-day life. 

Telephone crisis coaching 

DBT often uses telephone crisis coaching to support you in your day-to-day life. This means that you might be able to call your therapist for support between sessions. For example: 

  • when you need help to deal with an immediate crisis (such as feeling suicidal or wanting  to self-harm) 
  • when you are trying to use DBT skills but want some advice on how to do it
  • if you need to repair your relationship with your therapist. 

But you need to check with your therapist whether this is something that is available to you, and it’s expected that your therapist will set some clear boundaries around this. For example: 

  • calls are usually brief 
  • calls should only take place between the hours you agree with them
  • in particular circumstances, they might ask you to wait 24 hours before calling them. 

"If I had a meltdown or crisis, she’d help me understand what may have contributed." 

During sessions DBT therapists will use a balance of acceptance and change techniques. 

Acceptance techniques 

Acceptance techniques focus on: 

  • understanding yourself as a person 
  • making sense of why you might do things such as self-harm or misuse drugs. 

For example, a DBT therapist might suggest that this has been your only way of coping with intense emotions. So even though it’s damaging in the long-term, and may alarm other people, your behaviour makes sense.

"Finally someone is saying 'yes it makes sense' rather than 'no that's wrong’." 

Change techniques 

Change techniques focus on replacing behaviours that harm you with behaviours that help you. This  may mean your therapist: 

  • challenges your unhelpful thoughts 
  • encourages you to find new ways of dealing with distress. 

"It’s not a short term thing... you have to work at it every single day. It’s  hard to do, and even now, some 2 years after I completed the therapy, I’m still having to work at it."