Dialectal Behavioural Therapy

Copy required for this page. Dialectal behavioural therapy (CBT) is a talking therapy that can help people of all ages, including younger children and teens. CBT focuses on how thoughts and emotions affect behaviour and how to break negative thought, feeling and behaviour patterns or cycles. While CBT is a type of talk therapy, it’s so much more than talk. It helps people recognize how to respond differently to every day situations or problems that cause stress or difficulty and provides tangible ways for individuals to take control and learn skills that can be put into practice immediately to improve mental health.

CBT is an evidence-based practice shown to be effective for a variety of issues and is recommended by the National Institute of Clinical Excellence (NICE).  View PDF.

Individuals can receive CBT alone or in combination with medications or any other therapies they might need.  It is usually delivered in a specified number of sessions, which can be as few as six sessions or as many as 30 or more, depending on the individual and the particular goals.

As part of any therapy a thorough risk assessment will take place in the initial assessment and will be reviewed each session.  Please see confidentiality and risk policy for further information on when information about risk will be shared.

Safeguarding is an integral part of therapy and the therapist should explain when they would need to share information in relation to child protection/safeguarding concerns.  Please see safeguarding policy for further information. 

CBT for children

CBT for kids has practical everyday applications. This therapy can help your child understand the negativity of their thought patterns and learn how to replace them with more productive ones. Through a range of different methods including role-playing, puppet work, games and art your child can learn and practice alternate ways of handling stressful situations. They will develop new skills that can follow them throughout their lives and help them maintain good mental health and improve overall wellbeing. Your child doesn’t need to have a diagnosed mental health condition to benefit from CBT.

CBT sessions can take place at school with the school’s agreement and at the child’s home when necessary for example when the young person is too anxious to leave the house.  

Family work

Particularly with younger children It’s recommend parents/carers are involved in the treatment as much as possible.   Children will be asked whether they want a parent/carer to attend the session, if they choose not to, then they will be encouraged to allow discussions to take place at the end of the session to ensure they can be appropriately supported at home.  

Parents/carers may also be offered psychoeducational or skills sessions to support the work of the therapist and improve treatment outcomes for their child. 

CBT can also be run as a group which includes the child, therapist, and other children who are dealing with the same or similar problems. Parent support and psychoeducation groups introducing CBT skills are also beneficial.

CBT techniques

  • Play therapy: Arts and crafts, dolls and puppets, or role-playing are used to help the child address problems and work out solutions. This can also help keep younger children engaged. See Article.
  • Trauma-focused CBT: This method is used to treat children/adults affected by traumatic events, including natural disasters. The therapist will focus on behavioral and cognitive issues directly related to trauma the child/adult has experienced.
  • Modeling: The therapist may act out an example of the desired behavior, such as how to respond to a bully or boss, and ask the child/adult to do the same or to demonstrate other examples.
  • Restructuring: This technique is a way for a child/adult to learn to take a negative thought process and flip it to a better one. For example, “I stink at football. I’m a total loser” can become “I’m not the best football player, but I’m good at a lot of other things.”
  • Exposure: The therapist slowly exposes the child/adult to the things that trigger anxiety.
  • Behavioural Experiments: An information gathering exercise, to test the accuracy of an individual’s beliefs (about themselves, others, and the world) or to test new, more adaptive beliefs.
  • Video Feedback: Helpful in social anxiety to adjust one’s perception to a more helpful and realistic appraisal.

DBT can help with:

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  • Impulsivity 
  • Tolerating boundaries 
  • Emotional distress 
  • Depression
  • Anxiety
  • Work/exam stress
  • Trauma
  • Disordered eating
  • OCD
  • Poor self-image
  • Sleep difficulties
  • Behavioural difficulties
  • Managing ADHD & ASD
  • School refusal

DBT can help develop the following:

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  • Problem-solving skills
  • More self-control
  • Distress tolerance
  • Mindfulness skills
  • Insight 
  • Alternative perspectives
  • Mood management skills
  • Social skills
  • Executive functioning skills
  • Self-efficacy
  • Assertiveness skills