Dialectical Behaviour Therapy

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 Question mark: This treatment has not been properly researched. It is not possible to say whether they are useful or not.

What is it?

Dialectical Behaviour Therapy (DBT) is a type of psychological treatment. DBT was originally developed to treat other psychological disorders but can also be used to treat depression. DBT is similar to cognitive behavioural therapy (see more on cognitive behaviour therapy) and also includes mindfulness strategies. DBT involves both individual sessions with a therapist and group therapy sessions.

How does it work?

DBT teaches people a number of skills to help cope with difficulties they face. These skills include mindfulness (being aware of situations or thoughts without judgement), impulse control, interpersonal skills, and how to manage emotions and cope with feeling distressed. Improving these skills allows people to better cope with everyday life events in an effective and positive way. 

Is it effective?

There is very little scientific evidence on DBT for the treatment of depression. Two small studies found that both adults and older adults who were treated with DBT and antidepressant medication showed more improvement in their depression symptoms compared to those who simply took antidepressant medication. In one study these positive effects lasted for six months after treatment.

One meta-analysis found that DBT may be able to reduce depression symptoms in adolescents, but the studies included in the analysis were very small and not all participants had a primary diagnosis of depression. There are no randomised controlled trials looking at the effectiveness of DBT for children and adolescents.

While these results are promising, most of the research on DBT has looked at its effectiveness in treating other disorders such as borderline personality disorder. More studies of better quality, such as large randomised controlled trials, are needed to understand how DBT might help people with depression.

Are there any disadvantages?

DBT may involve seeing a therapist weekly for several months which can be expensive. In Australia Medicare provides rebates for visits to trained therapists (see below).

Where do you get it?

DBT is generally provided by therapists such as clinical psychologists, psychologists or counsellors who have been specially trained to provide this therapy (see Psychologists and other therapists). In Australia, Medicare provides rebates for visits to some therapists under the Better Access to Mental Health Care scheme. DBT may also be covered by some private health insurance funds.

Recommendation

DBT is a promising alternative to other psychological therapies but more evidence is needed to be sure it works. It may be combined with antidepressant medication to treat depression.

Key references

  • Cook, N. E., & Gorraiz, M. (2016). Dialectical behavior therapy for nonsuicidal self-injury and depression among adolescents: preliminary meta-analytic evidence. Child and Adolescent Mental Health, 21(2), 81-89.
  • Harley, R., Sprich, S., Safren, S., Jacobo, M., & Fava, M. (2008). Adaptation of dialectical behavior therapy skills training group for treatment-resistant depression. Journal of Nervous and Mental Disease, 196(2), 136-143.
  • Lynch, T. R., Morse, J. Q., Mendelson, T., & Robins, C. J. (2003). Dialectical behavior therapy for depressed older adults: a randomized pilot study. American Journal of Geriatric Psychiatry, 11(1), 33-45

Last reviewed and updated: 18 January 2018