Dialectical Behaviour Therapy Programme

DBT skills manual

Click to buy it!

DBT is a comprehensive programme which involves weekly one-to-one therapy, skills group and access to skills coaching on the phone. It was developed for intensely-feeling individuals who experience difficulties in regulating their emotions.

Whilst this includes people whose challenges get described in the medical world with the “borderline personality disorder” label, DBT skills can help those with or without a formal diagnosis who want to cope more effectively with “roller-coaster” emotions, impulsivity, eating difficulties, self-harm, substance misuse, chronic shame and guilt, ADHD/ADD and forming and maintaining functional relationships. 

If unmanageable distress and disproportionate reactions to events interfere with the quality of your life, for example in the context of relationships, DBT can be helpful and ultimately support you in building a fruitful, satisfying life.

Where and When?

THE SATURDAY 10AM and 12:15PM GROUPS ARE NOW OFFERED IN-PERSON NEAR KING’S CROSS. THE REMAINING CLASSES ARE CURRENTLY AVAILABLE ONLY ONLINE VIA ZOOM. TIMINGS REMAIN THE SAME.

KING’S CROSS, ISLINGTON, LONDON: We hold two in-person DBT skills groups at Barnsbury Community Centre, 12 Jays Street, London, N1 0FE on Saturdays from 10am to 12pm* and from 12:15pm to 1:45pm. Nearest stations are King’s Cross (12 minutes walk), Caledonian Road & Barnsbury (14 minutes walk), Angel (15 minutes walk) or Caledonian Road (22 minutes walk).

  • The next entry point to the Saturday classes is on 27th April 2024 when we begin the 12-week module in Emotion Regulation Skills. The fee is £1,020 (£85 x 12 sessions). This class will be followed by modules in Core Mindfulness & Middle Path (3rd August 2024), Distress Tolerance (21st September 2024) and Interpersonal Effectiveness (16th November 2024). Please note that sessions will not be held on Saturdays that fall on or close to Bank Holidays, i.e. 30th March, 4th and 25th May, 24th August and 21st and 28th December 2024. 

ANGEL, ISLINGTON (CURRENTLY ONLY AVAILABLE ONLINE): We hold two DBT skills groups in Islington on Wednesdays from 6pm to 8pm* and Thursdays from 5:30pm to 7:30pm* at Brighter Spaces, 2A Prebend Street, Islington, London, N1 8PT.

  • The next entry point to the Wednesday 6pm group is on 27th March 2024 when the 8-week module in Interpersonal Effectiveness Skills is scheduled to begin. The fee is £680 (£85 x 8 sessions). It will be followed by classes in Core Mindfulness & Middle Path (22nd May 2024), Distress Tolerance (3rd July 2024) and Emotion Regulation (28th August 2024).
  • The next entry point to the Thursday 5:30pm group is on 7th March 2024 when the 8-week class in Distress Tolerance Skills is scheduled to begin. The fee for this class is £680 (£85 x 8 sessions). It will be followed by modules in Emotion Regulation (2nd May 2024), Interpersonal Effectiveness (25th July 2024) and Core Mindfulness & Middle Path (19th September 2024).

ONLINE VIA ZOOM: The online skills groups are available on Mondays from 5:45pm-7:15pm, Tuesdays at 4pm-5:30pm and 6pm-7:30pm and Wednesdays at 3:30pm-5:30pm.

  • The next entry point to the Monday 5:45pm group is on 11th March 2024 when the 12-week class in Emotion Regulation Skills is scheduled to begin. The fee is £1,020 (£85 x 12 sessions). It will be followed by modules in Interpersonal Effectiveness (24th June 2024), Core Mindfulness & Middle Path (19th August 2024) and Distress Tolerance (7th October 2024). Sessions are not held on Bank Holiday Mondays, i.e. 1st April, 6th and 27th May, 26th August and 23rd and 30th December 2024. 
  • The next entry point to the Tuesday 4pm and 6pm groups is on 16th April 2024 when the 12-week module in Emotion Regulation Skills is scheduled to begin. The fee is £1,020 (£85 x 12 sessions). It will be followed by classes in Interpersonal Effectiveness (9th July 2024), Core Mindfulness & Middle Path (3rd September 2024) and Distress Tolerance (15th October 2024).
  • The next entry point to the Wednesday 3:30pm group is on 27th March 2024 when the 8-week module in Interpersonal Effectiveness Skills is scheduled to begin. The fee is £680 (£85 x 8 sessions). It will be followed by classes in Core Mindfulness & Middle Path (22nd May 2024), Distress Tolerance (3rd July 2024) and Emotion Regulation (28th August 2024).
  • The next 10-week Advanced Relationship Skills in Action module will begin on 3rd April 2024 and be held weekly on Wednesdays from 6pm to 7:30pm via Zoom. The fee is £85 per session (£850). 

* Should a lower number of participants sign up for (or attend) the 2-hour group we reserve the right to make alterations to the group structure, e.g. we will remove the break between the homework review and teaching part of the group and shorten the group to 90 minutes. This is because in smaller groups less time is required for mindfulness and homework review. The group might also be facilitated by one facilitator at a time instead of two. 

What is Dialectical Behaviour Therapy?

Dialectical Behaviour Therapy (DBT) is one of the most researched treatments for people with difficulties in regulating their emotions. DBT is a comprehensive team-based programme which entails weekly individual therapy, skills class, access to phone skills coaching available seven days a week and DBT team consultation*. DBT was originally developed in the late 1980s by Dr Marsha Linehan for self-harming individuals whose difficulties were described in the medical world as “borderline personality disorder” (BPD), also known as “emotion regulation disorder” or “emotionally unstable personality” (EUPD). Research finds that up to 77% of people no longer met the criteria for BPD after one year of treatment with DBT. It was also proven helpful for ADHD, bipolar disorder, eating disorders, post-traumatic stress and depression.

Clients who are unable to commit to the comprehensive DBT programme can opt to attend the skills classes alone without ongoing individual therapy (depending on the outcome of assessment or a referral letter). However, we recommend that arrangements are made for external one-to-one support should any aspects of engaging in the skills group become challenging. Please note that the programme is offered on a rolling basis and that group participants will be at various stages of their skills training.

* Individual therapists and group facilitators meet on a weekly basis and work as a DBT consultation team to ensure that they are all applying DBT appropriately and to assist you in getting the maximum benefit from the programme.

What will I learn?

There are four core DBT modules which are offered on a rolling basis and can be attended as part of the full DBT programme or on a module-by-module basis. It takes 34 weeks to complete them all once. If your goals revolve particularly around enhancing relationships you can also attend the advanced 10-week module called ‘Relationship Skills in Action’. Subject to individual circumstances and the review offered by our team it might be indicated to repeat the modules and/or extend your place on the programme to solidify your use of skills.

  • 6-week Core Mindfulness and Middle Path module is designed to teach you how to increase your awareness levels, decrease reactivity, habitual behaviour and judgmentalness, train your attention, allow current moment experiences instead of suppressing, avoiding or constantly changing them, and how to be more compassionate towards yourself. This module will also teach you how to avoid taking extreme positions and instead acknowledge the validity of different positions and perspectives.
  • 8-week Distress Tolerance module is centred on accepting difficult situations and emotions and finding ways to survive and tolerate the moment without engaging in problematic behaviours such as self-harm, conflict, substance misuse or other impulsive behaviours. You will learn how to respond to stressful and overwhelming emotions by engaging both your body and mind in the process. This module will cover both strategies of change and acceptance.
  • 12-week Emotion Regulation module involves learning to recognise and label current emotions, identify obstacles to changing emotions, reduce emotional vulnerability and reactivity, increase positive emotions and harness a more positive long-term outlook, and change emotions that are unhelpful or unwarranted. This module will also teach you how to gradually decrease avoidance of feelings and become more comfortable experiencing emotions.
  • 8-week Interpersonal Effectiveness module teaches strategies aimed at improving your communication in order to foster healthy relationships. You will learn skills to ask for what you need, say no, set boundaries and cope with interpersonal conflict in a way that influences others whilst enhancing the relationship and your self-respect. This module is of particular relevance to individuals who experience their relationships as chaotic, intense and unstable, and those who feel that their needs are never met in relationships.
  • 10-week Advanced Relationship Skills in Action is a module for people who have attended the Interpersonal Effectiveness DBT module and want to enhance their interpersonal skills further. In this module you will learn about social engagement system and how interactions affect your nervous system and that of the other person, the theory and practice of dialectical thinking, balancing opposites, how to balance intense desire to influence someone with acceptance of the moment, validation of self and others and its impact on conflict resolution and emotion regulation, recovering from invalidation, building new relationships, getting people to like you and strategies for relational reinforcement. There will also be two practice sessions to immerse yourself in the application of the skills. You will be able to bring your own real life scenarios and receive suggestions from the group trainer on how to approach them skilfully.

How will I learn?

DBT classes are designed to be interactive, not where you passively listen to the facilitator. You can expect to be challenged by the didactics, demonstrations and discussions. The aim of this approach is to encourage you to help you maximise your use of the tools that you will be learning. New skills are presented each week and homework tasks are assigned for participants to practice during the week. Homework is reviewed at the next class. To enhance learning and effective application of newly acquired knowledge and skills people who commit to the full DBT programme will have access to phone skills coaching, which can be accessed at times of heightened distress seven days a week. The goal of this is for people to get better at using the skills when they are needed most, such as during times of intense emotion, crisis or conflict.

Who should join the programme?

There is no specific diagnostic requirement for participation in our programme. If any of the following challenges interfere with the quality of your life, whether you were given a formal diagnosis or not, DBT can help.

  • Emotional sensitivity and difficulties returning to a calm emotional baseline
  • Episodes of extreme emotional pain and attempts to stop it with self-harm, alcohol, substances or sex
  • Enormous fear of abandonment and trying to avoid it at all costs
  • Rapidly changing moods, anger, recurrent depression, feelings of guilt and shame and high stress
  • Chaotic relationships where you either frantically pursue or impulsively cut others off
  • Intense emotions and unmanageable distress which lead you to behaving in ways that you don’t understand
  • Impulsive urges and behaviours that lead to feelings of shame, regret or self-hate
  • The skills classes are also suitable for people who are on the DBT for Complex Trauma programme with our team, and for those who are engaging in the stabilisation and safety stage of trauma-focused therapy outside of our team
  • The skills classes can be adjunct to outside care or a part of a larger treatment plan and can be applied as a treatment for some eating and mood difficulties, bipolar disorder, post-traumatic stress and substance misuse, and is now the go-to treatment for improving emotional regulation skills in those diagnosed with ADHD and ADD

Exclusion criteria

  • Uncontrolled psychosis
  • Severe developmental delay or intellectual disabilities
  • Cognitive impairment
  • Active addictions
  • Certain narcissistic personality presentations
  • Behaviours and presentations which might impact on group learning
  • DBT focuses a lot on finding coping methods to stop impulsive behaviour and learning to appropriately respond to stressful events. If changing behaviour and increasing your repertoire of skills aren’t the main thing you want to get out of treatment, DBT might not be right for you

How to begin?

All individuals interested in joining the full programme will be assessed by a member of our team. To find out more about our team please visit the About Us section of this website and if you have a preference let us know which therapist you wish to be assessed by. Following the assessment we meet as a team to carefully consider your therapy plan.

If you would like to attend the skills classes without committing to the comprehensive programme, you can provide a letter of recommendation from your psychiatrist or therapist describing your mental health and developmental history. The letter needs to provide a detailed account of patterns of dysregulation in emotion and behaviour, history of risk (including self-harm, suicide attempts and hospitalisations), current and/or previous engagement with other services and therapeutic endeavours.

Following this you will be offered three one-to-one orientation sessions which will introduce you to some fundamental DBT theories, tools and crisis skills (in some circumstances these sessions might be optional). We will also talk you through a roadmap of your treatment going forward, answer your questions and agree on a start date in the skills group.

Fees

Fees for the comprehensive DBT programme (individual therapy, skills class and phone skills coaching) range between £185 and £220 a week. For the breakdown of fees please click here. It is also possible to commit to attending the DBT skills groups alone for which the fee is £85 per class. We offer a small number of concessionary places in the DBT groups to people on low income. 

To formally reserve a place in the skills group 50% of the module fee must be paid at the time of booking which is non-refundable. The remaining part of the fee is due a week before the official start date of the module. It is only possible to commit to a full module and the fee is payable for all of the sessions. This includes sessions that are not attended, missed or cancelled for any reason.

Fees and Booking