Practical skills for intense emotions.
Dialectical Behaviour Therapy (DBT) is a structured, skills-based therapy for difficulty regulating emotions, impulsivity and unstable relationships -delivered directly by a psychiatrist.
Understanding and regulating intense emotions
Dialectical Behaviour Therapy (DBT) is a structured, skills-based therapy originally developed for people who experience very intense, rapidly shifting emotions and difficulty tolerating distress. It combines acceptance of where you are now with practical strategies for change, and has strong evidence for reducing impulsivity, self-harm and relationship difficulties.
Sessions focus on four skill areas -mindfulness, distress tolerance, emotion regulation and interpersonal effectiveness -with concrete techniques to practise between appointments. Because it is delivered by a psychiatrist, medication and therapy can be considered together, in one coordinated plan, when that's the right fit.
Difficulties DBT is commonly used for
DBT was developed for intense emotional experiences and is now used more broadly. Some of the most common reasons patients start DBT include:
Intense, rapidly shifting emotions
Emotional reactions that feel overwhelming, arrive quickly, and are hard to bring back down.
Impulsivity & self-harm urges
Impulsive behaviours or urges to self-harm used to cope with distress.
Unstable relationships
Patterns of intense, unstable relationships, and difficulty maintaining a stable sense of connection with others.
Difficulty regulating anger
Frequent, intense anger or irritability that feels difficult to control.
Chronic feelings of emptiness
A persistent sense of emptiness or an unstable sense of identity.
Distress intolerance
Difficulty tolerating distress without resorting to avoidance or harmful coping strategies.
How a course of DBT is structured
A clear, skills-based process from the first session onward.
Assessment & formulation
Understanding your difficulties in detail and building a shared picture of the patterns keeping the problem going.
Skills focus
Working through the four DBT skill areas -mindfulness, distress tolerance, emotion regulation and interpersonal effectiveness -chosen to fit your goals.
Structured sessions
Regular sessions, each with a clear focus, plus practical exercises and skills practice to try between sessions.
Review & relapse prevention
Reviewing progress regularly and building a plan to maintain your gains once regular sessions end.
DBT shares roots with CBT and is often considered alongside it, or alongside medication management for mood and anxiety disorders.
DBT session fees
DBT sessions are billed as standard psychiatric consultations -there is no separate rate.
Fees
DBT therapy -your questions
How is DBT different from CBT?
DBT is a specific, structured form of CBT, developed specifically for very intense emotions and impulsive behaviour. It places more emphasis on distress tolerance, mindfulness and emotion regulation skills, alongside a balance between acceptance and change.
Can DBT be combined with medication?
Yes -because DBT is delivered by a psychiatrist here, medication and therapy can be planned and adjusted together as part of one coordinated approach, if that's the right fit for you.
Do you offer DBT online?
Yes, DBT sessions can be carried out by secure video call, with the same structure and quality as in-person sessions.
How many sessions will I need?
This varies by individual and difficulty. DBT is generally a longer-term, skills-based therapy than standard CBT -we'll agree a plan together and review it regularly as skills are built up.