07/09/2025
Dialectical Behaviour Therapy Explained:
Is It Right for You and Is It DBT or DBT-Informed?
Lorna Wykes, CEO of Home Counties Therapy
www.homecountiestherapy.co.uk
Have you ever had the feeling that your emotions are dictating the game and you cannot get it under control? There are also overwhelming feelings, weak relationships, and lapses of self-destructive behaviour that most people know quite well. It is at this point that Dialectical Behaviour Therapy (DBT) comes in. DBT is an evidence-based and structured therapy that aims to support individuals in controlling their intense emotions, finding healthier coping mechanisms, and improving their relationships. The only question is whether you should use DBT. And what is the difference between it and “DBT-informed therapy”?
In this guide, we will simplify DBT. We will discuss its structure, advantages, and disadvantages, as well as a comparison with approaches based on DBT knowledge. As a client seeking treatment or a professional seeking clarity, you will find this article helpful in making decisions that best fit your needs.
What is Dialectical Behaviour Therapy?
Dr. Marsha Linehan initially developed Dialectical Behaviour Therapy (DBT) in the late 1980s. It was meant to treat Borderline Personality Disorder (BPD) sufferers, who were described as being unable to control or manage emotional changes, impulsiveness, and relationship turbulence. Research over the years has demonstrated that DBT is not specific to BPD only. Adaptation has been done successfully with individuals with bipolar disorder, ADHD, depression, anxiety, post-traumatic stress disorder, and autistic adults.
In its essence, DBT is a combination of two essential aspects:
1. Cognitive Behavioural Therapy (CBT) skills to deal with unhelpful thoughts and behaviour.
2. Mindfulness to enhance awareness, acceptance, and balance.
The word “dialectical” implies the balancing of opposites. In DBT, this is often coupled with the elements of acceptance and change. To clarify, an individual can accept themselves as they are and simultaneously work towards changing some unhelpful behaviours.
The uniqueness of DBT is that it has a highly structured programme. DBT is skills-based, unlike traditional talk therapy. It educates you in practical skills to manage stress and control emotions, as well as navigate relationships. It is not about continuously examining the past: it is about developing the present and future competencies.
DBT offers simplicity and promise to those seeking therapy. To those in the profession, it adds an organised framework that is clearly supported by substantial evidence of sense.
Who Can Benefit from DBT?
You may ask yourself:
Do I really need DBT?
The reality is that DBT can benefit a diverse range of individuals. It is highly effective for those who are experiencing intense emotions that interfere with their everyday living and conversely for those who are experiencing a significant impact on their daily life without understanding the emotions that are causing the difficulties. .
The following groups are among those who access DBT the most:
• People with Borderline Personality Disorder (BPD): DBT is regarded as the gold-standard approach to BPD. It supports regulating self-harm, suicidal thoughts and management of relationships.
• Individuals with mood disorders: People with depression or bipolar disorder may also, upon stabilisation with medication, utilise the tools of emotion regulation and distress tolerance offered in DBT.
• Those with ADHD or Autism: DBT is useful in emotional regulation (even when combined with alexithymia), interpersonal relationships and management of distress, which neurodivergent individuals often view as in written in a foreign language. Yes, the reality is, often all of this is written in a foreign language – the neurotypical language, but more on that in the next article
• Addiction recovery: DBT techniques are now utilised in many rehabilitation programmes to enable clients to develop relapse prevention coping strategies.
• Adolescents: DBT skills can be a life changer in teens who are impulsive, self-destructive or overwhelmed with feelings.
However, there is a twist to it:
DBT is not a universally applicable therapy. It requires commitment: months of organised learning and practice are necessary to complete a full programme. This is why it pays to know how full DBT and DBT-informed therapy are different.
The Difference Between Full DBT and DBT-Informed Therapy
This is where confusion usually arises. Most therapists claim to offer DBT, but not all of them give the full DBT programme. Instead, a few provide DBT-informed therapy. What is the difference, and why does it matter?
Full DBT Programme
A full DBT programme is very organised. It typically includes:
• A programme lasting 26 weeks (usually a year).
• Weekly skills training session, during which clients are taught and practice the following DBT modules: mindfulness, distress tolerance, emotion regulation, and interpersonal effectiveness.
• Individual psychotherapy sessions are held weekly, during which the skills are applied to personal issues by the clients.
• Team consultation, in which therapists gather to consult and promote treatment fidelity.
• Phone coaching clients have access to support between sessions and during times of crisis.
• Family education, to assist family members to learn and applying DBT concepts.
• A DBT-trained team, usually with other professional training.
This organisation provides a safety net. Clients do not learn skills in isolation but instead practice them in various environments with complete support. Studies indicate that the model yields optimal results, especially in cases where an individual has complex or high-risk concerns.
Complete DBT is resource-intensive. It needs a trained team, work and time commitments. It means that it is usually more expensive and more demanding than other treatments.
DBT-Informed Therapy
DBT inspires DBT-informed therapy and does not provide the full programme. A therapist may illustrate some DBT skills during individual sessions, and may not conduct group skills classes. Or a rehabilitation facility may apply DBT techniques in a larger treatment programme without providing the framework.
DBT-informed therapy may have the following appearance:
• Individual therapy sessions with a counsellor on DBT skills.
• Skills-only group without individual treatment.
• Discussion of a small number of modules, such as mindfulness or emotion regulation.
It can be effective for people with less severe problems, those who cannot follow the entire programme or for rehabilitation clinics where time is limited. It can be cheaper and is very flexible, hence appealing to many people.
But it has downsides. Clients are unlikely to be supported to the same extent without team consultation and a full structure. There are risks of burnout for individual therapists, and clients are not able to have the full benefits of DBT.
Why the Difference Matters
This is a crucial distinction for clients seeking therapy. You may need a full DBT programme to receive complete and systematic assistance. On the other hand, DBT-informed therapy may be suitable if you are seeking short-term support or skill trainings.
Key Components of a Full DBT Programme
What constitutes a full DBT programme?
1. Skills Training Group
They are typically weekly, two/two and half-hour-long sessions during which clients are taught modules of DBT. The group is a maximum of eight individuals and can incoprorate role-play, practice, and peer support.
2. Individual Psychotherapy
Clients also see a therapist (one-to-one) every week. This will help transfer DBT skills to real-life situations and track progress.
3. Phone Coaching
This is an exclusive characteristic as the clients can see their therapist outside of a session. To illustrate this point, by the time one feels like engaging in self-harm, the therapist can be called, and they can get advice in real time.
4. Therapist Consultation Team
DBT therapists do not operate alone. They regularly discuss cases with one another as a team to encourage each other and prevent burnout. This means quality and consistency of care.
5. Family Support
DBT principles are taught to family members. This provides a home-based rehabilitative atmosphere and enhances the effectiveness of treatment.
By combining all these elements, DBT is not just therapy anymore but a system of life skills training. Among its clients, it translates to full service. To industry leaders, it is a gold-standard model of mental health care.
Advantages and Disadvantages of Full DBT vs DBT-Informed
The issue of full DBT vs. DBT-informed therapy is a matter of weighing the benefits and costs.
Full DBT Advantages
• Evidence-based with strong research backing.
• Comprehensive support system.
• Effective for complex or high-risk cases.
• Structured and consistent across settings.
Full DBT Disadvantages
• High time commitment (often 6–12 months).
• More expensive than other therapies.
• Limited availability in some regions.
DBT-Informed Advantages
• More flexible and accessible.
• Shorter treatment times.
• Cost-effective compared to full DBT.
• Useful for mild-to-moderate difficulties.
DBT-Informed Disadvantages
• Limited access to the full range of DBT benefits.
• Higher risk for both client and therapist due to a lack of team support.
• Not be suitable for individuals with severe or complex conditions.
This is a client decision that depends on their specific needs, available resources, and level of preparedness. As a professional, it emphasises the need to speak honestly about what is being presented.
Choosing the Right DBT Approach for You
However, in choosing between full DBT and DBT-informed therapy, you do need to take into account your personal needs, situation and the extent of your problems. The full programme would offer the systematic, holistic help needed by some people who may be struggling with high-risk behaviours like self-harm or suicidal ideation to help them stay safe and experience effective change. DBT-informed therapy is another option that can be offered to other individuals as a convenient and not too expensive alternative for those with fewer challenging concerns: relationship problems, emotional regulation problems, or fear.
The best place to begin is with specific questions to potential therapists or services:
• Does that include the full DBT programme or DBT-informed therapy?
• Which parts of DBT does your service contain (skills classes, individual treatment, telephone coaching, etc.)?
• What do you do to train your staff in DBT, and do you consult as a team?
• How long and how much would it cost?
By asking such questions, you become well-informed, and the treatment you receive is the kind you need.
Accessing DBT in England
How to access DBT in the UK will rely on whether you are dealing with the NHS or the private sector.
• NHS Services: Many NHS trusts offer DBT, but eligibility criteria often restrict access. Waiting lists are usually long, and programmes may also differ based on location. You are more likely to be referred if you are determined to be a high-risk (say, with a BPD diagnosis). Not all people, however, will be eligible due to a lack of resources.
• Private Providers: There is an increasing trend of people referring to private DBT services. They are not typically funded, but may offer more flexibility and shorter waiting lists, along with occasionally a more intensive level of support. Commercial providers can also provide full DBT programs, changes, and DBT-informed interventions, such as online teams, which can simplify access in cases of challenging travel situations or time constraints.
Those who may seek private treatment would want to enquire whether the practitioner adheres to the Linehan Institute or has therapists trained using an established programme of DBT. This will assure you that you are receiving care that is professionally appropriate.
Is DBT Right for You?
You may be one of those people who feel flooded and depleted and have difficulties with relationships or use negative coping behaviours that result in self-destruction. DBT can give you a new perspective. It is skill training-based, which means that you not only talk about problems but also learn strategies and practice to change them.
Honesty about your needs is the key for therapy seekers. If your problems are long-term and complicated, the full DBT programme can offer the security and format you need. DBT-informed therapy might be sufficient when your difficulties are not very severe and when you need to acquire some essential skills.
To the professionals and leaders of the industry, the lesson learnt is obvious: transparency is important. It is in the best interest of clients to understand whether they are getting full DBT or a DBT-informed approach. They are both important, but for different ends.
Conclusion
Dialectical Behaviour Therapy is not like any other talking therapy. It is an evidence-based, practical system that has transformed the lives of people throughout the UK, USA and beyond.
DBT comes with a cost, though, to many individuals; the life-changing outcomes compensate for that cost. Right now, when you are seeking therapy, ask questions, explore your choices, and choose a way that is sustainable and helpful to you.
FAQs About DBT
1. How long does DBT take?
The full DBT programme would typically be 6-12 months in duration. The amount of time spent in DBT-informed therapy can be adjusted based on individual needs. (Usually a minimum of 12 months).
2. Can I get DBT on the NHS?
Yes, but access varies. There are NHS trusts and other facilities covering DBT in limited quantities, with rigid requirements and extensive waiting lists.
3. Is private DBT worth the cost?
There is flexibility, the waiting time is reduced, and the support is more intensive in private DBT. The investment is worth it according to our clients at Home Counties Therapy
4. What’s the main difference between DBT and DBT-informed therapy?
Full DBT consists of a comprehensive programme with many elements, and DBT-informed therapy applies DBT methods without the complete programme.
5. Can DBT help with conditions other than BPD?
Absolutely. DBT supports management of ADHD, autism, bipolar disorder (along with medication stabilisation), anxiety, depression and substance misuse.
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