CAMHS Dialectical Behaviour Therapy Service

If it’s agreed at the assessment that you may benefit from DBT, you will be offered pre-treatment. Pre-treatment consists of 4 - 6 individual sessions where you will learn all about DBT and think together with your therapist to make sure it’s the right treatment for you. It’s where you will generate a list of goals, including identifying your ‘life worth living goals’. We like to think of it as a “try before you buy” period, and you only sign up to DBT if you want to – we know it can be a really effective treatment option but it is a big commitment and it’s important that you’re willing to throw yourself into it. 

You will have weekly 1-hour sessions with your therapist working on behavioural targets identified in your treatment hierarchy. The aim is to reduce some behaviours and increase others. For example, any self-injury or suicidal behaviours will be targeted first. You will work with your therapist to complete something we call a ‘chain analysis’ – a process where you learn to understand what led you to engage in a specific behaviour and how challenges and events in your life impact you.

These sessions are where you will practice various strategies to reduce or increase these behaviours, which includes rehearsing the skills you will learn in group. 

Our skills group will run for 6 months of your treatment and is where you learn DBT skills in a classroom-type setting with tables, pens, and notebooks. These groups will be in person and facilitated by two DBT therapists and will be attended by you and your parents/carers. You will be expected to practice the skills outside of the group between sessions.

We know that group can sometimes feel anxiety-provoking, and this is something we can talk about in more detail during pre-treatment. The group is a mandatory part of comprehensive DBT as it’s almost 50% of the treatment.  

The modules you will be learning are:

1. Mindfulness: practicing being in the present and acknowledging thoughts, feelings and behaviours as they happen, without trying to control them. This helps you understand yourself much more, and will give you more control in how you manage  

2. Distress tolerance: how to cope during distressing and crisis situations, and minimising impulsive responses. It's important to know that while these are helpful in these moments, as you move through DBT you’ll find that other skills are used to achieve your goals.

3. Interpersonal effectiveness: how to ask for what you need as well as how to say no to others, while focusing on keeping self-respect and maintaining relationships.  

4. Emotion regulation: how to manage emotions effectively so your actions aren’t ruled by emotion. This is not suppressing emotions, instead you are learning to regulate negative emotions to reduce how intensely you feel them.

5. Walking the middle path: skills and a way of thinking that finds the balance in different experiences and points of view, rather than seeing things as black and white.   

Once you've finished pre-treatment and sign up to our program, you can reach out via call and texts to your individual therapist for focused skills coaching. This is where your therapist will support you in identifying and implementing specific skills to manage the difficult situation you find yourself in.

This support is available Monday – Friday 9am– 5pm. We may not be able to answer straight away but will always get back to you. (You may notice that in the video it says you can contact your therapist 24/7, however we are NOT able to offer this within our service)

We also have a team mobile you can call to get support from if your individual therapist is on leave.

Parents/carers will receive an appointment with their allocated worker (this may be every 2 weeks or as agreed with them). These sessions focus on situations / issues that arise and developing skills/strategies to help manage. These sessions can take place in person or online.

Alongside 1:1, parent/carer and group sessions, DBT provides family based sessions. These sessions would take place in person. These sessions are facilitated together with your 1:1 therapist and parent/carer worker.

You and your parent/carer will be able to share items for the agenda, things that you want support with. These may be issues that keep coming up. For example, maybe you don’t feel you are being validated by them. Or a parent/carer may not feel their young person is respecting boundaries.

These can then be discussed in a supportive way with your DBT therapists.

This will be less directly obvious to you, but is a really important part of the DBT programme. All therapists attend a weekly DBT consult where they will have an opportunity to discuss cases, receive support around risk management, and supervision around the direction of therapy. They may feedback on their own levels of motivation and commitment, achievements towards goals, and risk management. This ensures all therapists within the team have an awareness of all the young people in the programme and their current position in therapy.