Comprehensive Dialectical Behaviour Therapy (CDBT) is an evidence-based treatment that works to provide a balance of acceptance and change using validation, problem solving, and behaviour change strategies. The program is intended for people who experience severe and pervasive emotion and behaviour dysregulation. CDBT strives to help people acquire, strengthen, and generalize new skills. CDBT is a 24- to 48-week program which consists of weekly individual therapy sessions, weekly skills group, availability of coaching calls to assist with skills development, and a consultation team for therapists.

CDBT was originally developed to treat suicidal behaviors in individuals who met criteria for Borderline Personality Disorder (BPD). It has since been adapted for many other populations, including children and adolescents, eating disorders, anxiety, depression, PTSD, substance use, and in corrections. CDBT is now widely accepted as a treatment for severe and persistent emotional and behavioural difficulties.

Individuals who benefit from using CDBT often experience:

  • Confusion about self (not always knowing what you feel, who you are, or why you get upset).
  • Impulsivity (acting without thinking it all through).
  • Emotional instability (fast, intense mood changes with little control or steady negative emotional state).
  • Interpersonal problems (pattern of conflict/difficulty getting along with others, pattern of difficulty keeping relationships, difficulty asking for what you want, or keeping your self-respect; frantic efforts to avoid abandonment)

Dialectical thinking means:

  • Balance between acceptance and change
  • There is always more than one way to see the situation, and more than one way to solve a problem
  • All people have unique qualities and different points of view
  • Moving away from all or nothing thinking to more dialectical both-and ways of thinking
  • For example: ‘I love being close to you and I also need space’
  • Mindfulness Skills (focusing and awareness skills)
  • Distress Tolerance (crisis survival skills and radical acceptance)
  • Emotion Regulation Skills (de-escalation skills)
  • Interpersonal Effectiveness Skills (people skills)
    Mindfulness will help with:

    • Reducing rumination (overthinking)
    • Decreasing impulsivity (increasing awareness)
    • Increasing enjoyment and positive experiences
    • Increasing effective behaviours and decision making
    • Increasing control of attention
    • Managing the impacts of illnesses such as cancer, arthritis, anxiety, chronic pain, etc.
    Distress Tolerance helps with:

    • Surviving Crisis
    • Accepting Reality

Emotion Regulation will help with:

  • Understanding emotions being experienced

• Identifying and describing emotions
• Understanding what emotions do

  • Reducing emotional vulnerability

• Decreasing vulnerability to Emotional Mind
• Increasing positive emotions

  • Decreasing emotional suffering

• Letting go of painful emotions through mindfulness
• Changing painful emotions through opposite action

Interpersonal Effectiveness will help achieve three goals:

  1. Keeping and maintaining healthy relationships
  2. Getting what you want from people in your life
  3. Maintaining self-respect