At the DBT Centre of Vancouver, we offer a variety of evidence-based psychological treatments, including Dialectical Behaviour Therapy (DBT), Cognitive Behavioural Therapy (CBT), Mindfulness and Acceptance Based Treatments, among other modalities.

What is DBT?

Dialectical Behaviour Therapy (DBT) is a treatment developed by Dr. Marsha Linehan at the University of Washington. Dr. Linehan originally developed DBT to help people who were suffering so intensely that they had tried (sometimes many times) to end their own lives. Over time, DBT has been adapted and used to help people with a variety of complex emotional problems, such as those with borderline personality disorder (BPD), people with eating or substance related disorders, suicidal adolescents, people struggling with treatment-resistant depression, among many other difficulties. DBT is especially helpful for people who have difficulty understanding and managing their emotions. Through more than two decades of scientific research, DBT has been established as an effective treatment. In fact, following comprehensive reviews of all available treatments for BPD, both the Australian National Health and Medical Resource Council and the United Kingdom’s (UK’s) National Collaborating Centre for Mental Health concluded that DBT has the largest evidence base and currently holds the most empirical support (NHMRC, 2013; NICE, 2009).

DBT normally involves a weekly individual therapy session (usually 50 minutes) and a weekly group therapy session (usually 1.5-2 hours) that involves learning important new skills in the areas of managing your attention (mindfulness skills), managing and coping with your emotions (emotion regulation skills), dealing effectively with interpersonal situations (interpersonal effectiveness skills), and tolerating emotional distress (distress tolerance skills). DBT is based on the idea that, for people to build a better life and reach important goals, they need to make some important changes (such as reducing suicide attempts, self-injury, relationship problems, impulsive behaviour), and also need to learn to accept themselves. In addition, DBT is a community of therapists helping a community of clients. As such, DBT is a team-oriented approach, and all members of the DBT team view each others’ clients as their own. DBT therapists meet weekly to discuss cases, and to provide the supervision, training, and support required to be effective therapists.

DBT is especially effective for people with the following problems:

  • Borderline Personality Disorder
  • Suicidal thinking or behaviour (e.g., suicide attempts)
  • Self-injury and other self-destructive behaviours
  • Difficulties with anger and anger management
  • Problems with other emotions (such as intense sadness or recurrent fear)
  • Impulsive behaviours that can be dangerous (such as reckless driving, recurrent unsafe sex, etc.)
  • Difficulty building and maintaining healthy relationships
  • Chronic feelings of emptiness
  • Depression among older adults
  • Problems with alcohol & drug use
  • Eating disordered behaviour, such as bingeing and purging

We are grateful to the Mood Disorders Association for creating the following video on DBT (interview with Dr. Chapman).

Dr. Wagner met with Baylie McKnight from the Borderline Personality Disorder Society of BC in May 2021 for a BPD Awareness Day Event.

What is CBT?

Cognitive-behavioural therapy (CBT) is a type of treatment used to help people with a variety of different health and mental health problems. CBT is based on the idea that psychological difficulties often result from the interplay of thinking patterns, emotions, actions, and situations. Thoughts, beliefs, actions, emotions, and life situations are all related. For example, when people are depressed, they often have hopeless or negative thoughts, thinking there’s no point in doing anything. When they, for example, stay in bed and avoid people or going out, they feel even worse, and when they feel worse, they’re more likely to think that everything is pointless or hopeless. This same type of pattern happens with people who struggle with anxiety and other disorders. As a result, CBT involves learning to (a) identify patterns of thinking, emotions, and actions, (b) change behaviours and develop new coping skills, (c) think more flexibly, and (d) reach important goals and enhance well-being and fulfillment. Over the past several decades, scientific research has shown that CBT effectively helps people with a variety of different psychological problems. CBT is particularly effective for depression, anxiety disorders, bulimia, problems with anger, and general stress. There is also evidence that CBT is helpful for people struggling with substance use problems, symptoms of psychosis (such as schizophrenia, involving hallucinations and delusions), chronic pain, and other problems.

What are Mindfulness & Acceptance Based Treatments?

Mindfulness involves paying attention to your experience of the present moment. Some people practice mindfulness by sitting and focusing on their breathing (like meditation), whereas others bring mindfulness into their daily lives by awakening their minds and paying attention to experiences, such as walking, eating, talking with others, washing dishes, experiencing emotions, and so on. Back in the 1970s and 1980s, people started to realize that the practice of mindfulness was beneficial for people suffering from medical problems and pain. As a result, Dr. John Kabat-Zinn and others began to develop treatments that involve practicing mindfulness. Around the same time, Dr. Marsha Linehan also began to develop mindfulness skills as part of DBT. Over the years, there has been a lot of scientific research on mindfulness. The findings have shown that practicing mindfulness can be beneficial for your mental health and well-being. Practicing mindfulness can help you learn how to accept yourself and your experiences, to experience freedom and peace more often, and to live life more fully.

Acceptance, much like mindfulness, involves being aware of and acknowledging your experiences. Often, our attempts to deny, escape, or get rid of unwanted feelings or thoughts contribute to some of the misery we experience in life. As a result, acceptance-based treatments aim to help you learn how to be open to reality and acknowledge things as they are. Acceptance is a bit of a loaded word for many people, and it may sound like you’re supposed to approve of or like the terrible things you might have experienced in life. That’s not what we mean by acceptance. Instead, acceptance simply involves being open to and acknowledging the way things are – not approving, liking, or wanting things to stay the same. In fact, often accepting the way things are can open the door for change. If you accept, for example, that you feel sad, you might be more likely to find ways to cope with sadness or change it.

Both acceptance and mindfulness based strategies are used in DBT and other forms of evidence-based psychotherapy, including Mindfulness Based Stress Reduction, Mindfulness Based Cognitive Therapy, and Acceptance and Commitment Therapy.

If you’re interested in finding out more about our clinical services, please visit clinical services or contact us directly at 604-569-1156.