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Dialectical behaviour therapy (DBT)

What is dialectical behaviour therapy?

Dialectical behaviour therapy (DBT) is an evidence-based intervention for addressing self harm and suicidal behaviours in young people.

It was developed from cognitive behaviour therapy (CBT) and focusses on helping young people and their families learn skills to help with both acceptance and change.

We understand that young people entering into DBT are experiencing distress in their current lives, and so DBT is committed to supporting a young person to build a life worth living.

DBT is delivered over the course of 24 weeks and young people and their families attend a skills group for 2 hours once per week. Young people also attend an individual session each week.

DBT is a high intensity intervention. You will attend 3 hours of DBT each week for 24 weeks. A parent or carer is also required to attend the 2 hours skills group each week, for the 24 weeks.

What is covered in DBT?

You will attend a weekly group DBT skills session for 24 weeks, along with a parent or carer, where they will learn and practice skills such as:

  • mindfulness – how to become more aware and present in the moment
  • interpretational effectiveness – how to manage relationships
  • emotional regulation – how to reduce the intensity of strong emotions
  • distress tolerance – how to cope safely during a crisis
  • walking the middle path – how to manage conflict

You will attend a weekly 1 to 1 session with a DBT therapist where there is space to focus on practising and applying skills.

Young people in DBT will also have access to phone coaching. This is not for crisis calls or management.

Will I be considered for DBT?

You will be considered for DBT if you:

  • are aged 13 to 17 years old
  • self-harm or have suicidal behaviour:
    • at least weekly for a period of 3 months, or
    • at least 1 significant incident requiring emergency medical treatment in the last month such as steri-stripping, gluing, stitches, Parvolax, and so on, or
    • difficulties significantly impacting on your functioning such as attending school, engaging in services, daily activities, exploitation, involved with youth justice, and so on,
    • daily mood fluctuations

You will not be considered for DBT if you have:

  • acute symptoms of psychosis
  • acute issues with eating disordering needing specialist physical health intervention such as refeeding or hospitalisation
  • acute issues with substance dependence needing specialist intervention
  • moderate learning disability

Unfortunately as a service, we are unable to provide the intervention for individuals who need an interpreter.

What is DBT pre-treatment?

Once a referral accepted, you will be offered pre-treatment with a DBT therapist.

Pre-treatment is often around 4 sessions with a therapist and you parent or carer. You will be introduced to the model and expectations of DBT.

This does not mean you have been accepted onto the full DBT programme.

What about when DBT ends?

DBT is an intensive programme with 2 appointments weekly for 24 weeks. We have had feedback that if can feel like a ‘cliff edge’ ending the programme.

You case holder will be mindful about the ending of DBT, and will have a review session with you after the end of DBT.

If you are 17 years old, you may need to begin transition into adult services.

What if I do not want to go to a group?

Most young people do not want to do the group part of DBT.

Some young people and parents and carers end up enjoying the group part.

It is where skills are taught. It is not a process or therapeutic group in itself, and there is no discussion of self-harm.


We do not hold a waiting list for DBT as we aim to be responsive to need at the time.

When we have spaces in DBT, we will send an email out requesting referrals. Referrals with then be triaged based on need and risk.

If you would like to discuss anything further, please contact Rachel Johnson, our DBT lead for more information on rachael.johnson16@nhs.net

Referrals must have a case holder throughout the involvement of DBT.

If the referrals is accepted, you will be offered DBT pre-treatment. This does not meal you have been accepted onto the full DBT programme.

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Please note: this is a generic information sheet relating to care at Sheffield Children’s NHS FT. These details may not reflect treatment at other hospitals. This information is not intended as a substitute for professional medical care. Always follow your healthcare professionals’ instructions. If this resource relates to medicines, please read it alongside the medicine manufacturer’s patient information leaflet. If this information has been translated into another language from English, efforts have been made to maintain accuracy, but there may still be some translation errors. If you are unsure about any of the guidance in this resource or have specific questions about how it relates to your child, always ask your healthcare professional for further advice.

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