Problem Behaviours DBT Aims to Reduce

​

DBT focuses on behaviours that interfere with safety, quality of life, and treatment progress, including:

​

1. Life-Threatening Behaviours

• Self-harm (cutting, burning, hitting oneself)

• Suicide attempts

• Suicidal thoughts when they lead to unsafe actions

2. Therapy-Interfering Behaviours

• Missing appointments

• Withdrawing from therapy

• Difficulty engaging in treatment

• Behaviours that prevent learning or applying skills

3. Quality-of-Life Interfering Behaviours

• Relationship conflict

• Angry outbursts

• Impulsive decision-making

• Substance misuse

• Disordered eating behaviours

• Risk-taking behaviours

• Chronic avoidance

• Difficulty maintaining employment, education, or daily responsibilities

4. Emotion Dysregulation

• Rapid mood shifts

• Intense emotional reactions

• Difficulty calming down after becoming upset

• Feeling overwhelmed by emotions

​

To change these behaviours, DBT aims to help people:

​

Build Emotional Regulation

• Understand emotions

• Reduce emotional vulnerability

• Respond rather than react

• Recover more quickly from distress

Improve Distress Tolerance

• Survive crises without making things worse

• Accept difficult realities when they cannot be immediately changed

• Reduce impulsive coping strategies

Strengthen Relationships

• Ask for needs effectively

• Set healthy boundaries

• Manage conflict constructively

• Balance self-respect with maintaining relationships

Increase Mindfulness

• Stay present in the moment

• Notice thoughts and feelings without being controlled by them

• Reduce rumination and worry

​

Create a Life Worth Living

​

This is one of DBT's central goals. The therapy helps people:

• Clarify values

• Build meaningful relationships

• Increase engagement in enjoyable activities

• Develop self-respect and self-compassion

• Move toward long-term goals rather than short-term emotional relief

 

DBT's Hierarchy of Treatment Targets

A distinctive feature of DBT is that it prioritises problems in a specific order:

1. Life-threatening behaviours (suicidality, self-harm)

2. Therapy-interfering behaviours

3. Quality-of-life interfering behaviours

4. Skills acquisition and strengthening

This hierarchy helps ensure that safety is addressed first before moving on to broader life goals.