Displaying items by tag: therapies

Quick Facts

Dialectical behaviour therapy (DBT) is a modified version of cognitive-behavioural therapy (CBT) designed to treat borderline personality disorder (BPD). It can also be used to treat other conditions, like suicidal behaviour, self-harm, substance use, post-traumatic stress disorder (PTSD), depression and eating disorders.

• How DBT works

  The term ‘dialectical’ means ‘working with opposites’. DBT uses seemingly opposing strategies of ‘acceptance’ and ‘change’. The therapist accepts you just as you are, but acknowledges the need for change in order for you to recover, move forward and reach your personal goals.

  During a course of DBT, the therapist works with you to help you move away from harmful coping behaviours and towards a life that you find personally meaningful and fulfilling.

  DBT involves developing two sets of acceptance-oriented skills and two sets of change-oriented skills.

• Acceptance-oriented skills

  Mindfulness

  Learning how to focus your awareness on the present moment, and to acknowledge and accept your thoughts, feelings, behaviours and bodily sensations as they occur, without the need to control or manipulate them.

  Related: Mindfulness

  Distress tolerance

  Learning how to manage and cope during a crisis, and to tolerate distress when it is difficult or impossible to change a situation. Learning to accept any given situation just as it is, rather than how you think it should be, or want it to be. Learning new skills like distraction and self-soothing, for both coping with and improving distressing moments.

• Change-oriented skills

  Emotional regulation

  Learning how to effectively manage your emotional experience, and not allow your emotions to manage you.

  Interpersonal effectiveness

  Learning assertiveness strategies to appropriately ask for what you want or need. Learning how to say no, and how to manage interpersonal conflict in a way that maintains respect for yourself and others.

  A typical course of DBT

  DBT is typically run as a 24-week program, often taken twice to create a one-year program. In its standard form, there are three ways you receive DBT during the program. There are also shorter versions of DBT such as 12 week courses depending on the setting, and some versions do not include telephone coaching. DBT has been adapted for different needs.

  DBT skills training group

  A group facilitator teaches specific skills in a classroom setting, and sets tasks for the group members to practise between sessions. The skills training group typically meets once weekly, usually for around 2½ hours, across the 24-week program.

  Individual therapy

  Running at the same time as the group, individual therapy typically occurs weekly to enhance your motivation and commitment to the program. It’s also an opportunity to discuss and apply specific DBT skills to your current everyday life.

  Between-sessions telephone coaching

  On-the-spot telephone coaching from your therapist can be available at times during the week when you’re struggling. Your therapist guides you and encourages you to apply your new DBT skills to address and manage your issues.

• How to get DBT treatment

  In most Australian states, DBT programs can be accessed through both the public and private mental health system.

  Public services

  Some hospitals may run public DBT programs. Talk to your case manager, mental health professional or GP about referral options.

  Private services

  Private DBT programs require payment. Prices will vary depending on the specific service you choose. If you have private health insurance, check that it covers psychiatric admissions.

  If you don’t have private health insurance but you’re eligible for the National Disability Insurance Scheme (NDIS), you may be able to allocate funds to access a DBT program within the private system.

  To join a private DBT program, a psychiatrist from the specific hospital or clinic can provide a referral for you.

  Finding a service near you

  To find services providing BPD treatment in Australia or New Zealand, visit Project Air Strategy’s Service Directory.

  For state-based mental health assistance:

  • Victorian Mental Health Service Directory and Spectrum
  • NSW Mental Health Line on 1800 011 511 (available 24 hours)
  • ACT Mental Health Triage Service 1800 629 354
  • QLD Health 13 43 25 84
  • SA Health Mental Health Triage Service on 13 14 65 (available 24 hours)
  • WA Mental Health Emergency Response Line 1300 555 788 (metro) or 08 9224 8888 (State Wide)
  • Tasmanian Mental Health Service Helpline 1800 332 388
  • NT Crisis Assessment Telephone Triage and Liaison Service 1800 682 288.

• References

  1. Gottman, J. M., & Levenson, R. W. (1992). Marital processes predictive of later dissolution: Behavior, physiology, and health. Journal of Personality and Social Psychology, 63, 221–233.
  2. Wegner, D. M., & Erber, R. (1992). The hyperaccessibility of suppressed thoughts. Journal of Personality and Social Psychology, 63, 903–912.
  3. Goldfried, M. R., & Davison, G. C. (1976). Clinical behavior therapy. New York: Holt, Rinehart & Winston.
  4. Roemer, L., & Borkovec, T. D. (1994). Effects of suppressing thoughts about emotional material. Journal of Abnormal Psychology, 103, 467–474.
  5. Wegner, D. M., Schneider, D. J., Carter, S. R., & White, T. L. (1987). Paradoxical effects of thought suppression. Journal of Personality and Social Psychology, 53, 5–13.
  6. De Mello, A. (1984). The song of the bird. New York: Image Books.
  7. Nagasako, E. M., Oaklander, A. L., & Dworkin, R.H. (2003). Congenital insensitivity to pain: An update. Pain, 101(3), 213–219.
  8. Kabat-Zinn, J. (1990). Full catastrophe living: Using the wisdom of your body and mind to face stress, pain, and illness. New York: Delacorte Press.
  9. Gross, J. J., & Levenson, R. W. (1997). Hiding feelings: The acute effects of inhibiting negative and positive emotion. Journal of Abnormal Psychology, 106, 95–103.
  10. Gross, J. J., & John, O. P. (2003). Individual differences in two emotion regulation processes: Implications for affect, relationships, and well-being. Journal of Personality and Social Psychology, 85, 348–362.

This SANE factsheet was reviewed by industry professionals.

This SANE resource was created with support from The Vizard Foundation.

Quick Facts

Treatment for mental health issues, trauma, and distressing experiences can include psychological treatments, medication, support in the community, or a combination of these.

• How does psychotherapy help?

  Psychotherapy helps by giving an opportunity to talk to a specially-trained health professional in order to understand your symptoms, and to help you adapt how you feel, think and act in response to them.

• What do we know about psychotherapy?

  You play a role in the therapy yourself

  Psychotherapy helps you to understand why you feel, think and act in ways which are distressing and affect your life, and to work towards changing these. This can be challenging but it means you play an important part in your own therapy, and this in itself is empowering.

  Real change takes time to happen

  Psychotherapy does not work quickly, but over a period of months will help you to learn new ways of thinking, behaving and even feeling. You may notice, for example, that you are better prepared to handle things that used to worry you or get you down. Eventually you may find the whole way you think of yourself and the way you perceive and respond to the world changes for the better.

  Psychotherapy often combines with other treatments

  Psychotherapy is often effective on its own for people with depression and anxiety disorders. Sometimes it is also useful to combine therapy with other treatments. For people with illnesses such as schizophrenia and bipolar disorder, for example, medication, ongoing rehabilitation, accommodation and employment support are often needed.

• What kinds of psychotherapy are there?

  There are many types of psychotherapy which are proven to be effective. These may be provided individually, as part of a group, as a couple or even as a whole family – depending on the nature of the problem.

  Some common therapies are:

  Cognitive behaviour therapy (CBT)

  CBT helps people discover how their feelings, thoughts and behaviour can get stuck in unhelpful patterns. They are encouraged to try new, more positive ways of thinking and acting. Therapy usually includes tasks to try between sessions. CBT is a well-established treatment for depression and most anxiety disorders. It can also be an effective part of treatment for other conditions, including post-traumatic stress disorder (PTSD), eating disorders, bipolar disorder and schizophrenia.

  Interpersonal psychotherapy (IPT)

  IPT looks at the way someone has related to significant people in their life, and how this may have affected other relationships and how they feel, think and act generally. It then looks at finding more positive ways of interacting with others. IPT can been especially effective in treating depression and anxiety disorders.

  Dialectical behaviour therapy (DBT)

  DBT is a form of treatment specifically for people with borderline personality disorder (BPD). DBT is based on an understanding that a key problem for people with BPD is extreme difficulty in handling emotions, and the distress associated with this. DBT helps people learn to handle their emotions better and re-learn the way they typically respond to situations and other people. DBT generally combines individual and group therapy. Read more on our factsheet about DBT here. 

  Family interventions

  These treatments aim to support families and other carers by fostering calm and constructive family relationships where a member of the family has a psychotic illness such as bipolar disorder or schizophrenia. Family intervention sessions typically focus on education about mental illness, solving of problems encountered as a result of the illness, and improving communication and relationships where these are strained or stressful. Family interventions can reduce relapse rates for people with psychotic illness while also supporting everyone involved.

• How long does therapy take to work?

  Psychotherapy varies in the length of time it takes to work, depending on the particular treatment and the person’s needs. The benefits of therapy often happen at a different rate for different people. Sessions usually last between 45 and 90 minutes. Most people receive up to ten sessions, with some attending further sessions if required.

• Who provides psychotherapy?

  General practitioners (GPs)

  A GP is always the best place to start if concerned about your physical or mental health. As well as making an assessment and diagnosis, a GP can prescribe a Mental Health Care Plan, which may include referral for psychological treatment to a psychiatrist, psychologist or other mental health professional. With a referral from a GP, the cost of this treatment is largely covered by Medicare. Health professionals at Community Mental Health Services and public hospitals do not charge fees

  Psychiatrists

  Psychiatrists are medically qualified doctors who specialise in the study and treatment of mental illness. They can therefore prescribe medication as well as provide psychological treatments.

  Psychologists

  A psychologist is a health professional trained to provide treatments to people with emotional and mental health problems.

  Other mental health professionals

  Other mental health professionals may also be able to provide psychological treatments: for example, social workers and occupational therapists who have received specialised training.

• How do I find the best help?

  Use these tips to get what you need.

  Word of mouth

  As well as your GP, ask other health professionals, local pharmacists or trusted family and friends about providers of psychotherapy they would recommend.

  Australian Psychological Society (APS)

  The APS has a referral service that gives contact details of privately-practising psychologists in your area who work with particular mental health problems.

  Ask questions

  It’s important to be engaged as much as possible yourself in the psychotherapy. When making an appointment, or during an early session, ask the provider what the goals of therapy are and what it will involve.

  Speak out

  The more you speak out and are frank with yourself as well as with the person providing the treatment, the more successful it is likely to be. If you feel concerned, confused or uncomfortable with the treatment, let the provider know, so they can work with you to address the reasons for these feelings. If you feel that they are not the right person to help you, then explain this and ask for another referral. A good therapist will want what is best for you and will not hesitate to refer you to someone more appropriate.

• How do I find out more?

  Ask your doctor about any concerns you have, or contact the SANE Helpline 1800 18 SANE (7263).

  SANE also produces a range of easy-to-read publications and multimedia resources on mental illness. For more information related to this topic see:

The facts

• Many people use complementary therapies to support medical treatment.
• Complementary therapies are not a replacement for adequate medical treatment.
• Many substances or therapies labelled ‘complementary’, ‘alternative’ or ‘natural’ are not required to undergo the same safety testing as prescribed medications.
• Complementary therapies have varying degrees of effectiveness. Consult with your doctor before using them, especially about how they with prescribed medications.

• Physical therapies

  Being physically active has many physical, mental and emotional benefits.

  • Exercise is shown by research to have a definite effect in reducing the symptoms of depression and anxiety disorders. You don’t have to join a gym – it’s enough to get brisk exercise at least three times a week, for a minimum of 30 minutes. This could include running, walking fast, or cycling, for example. Consult your doctor before starting, if you have not exercised for a while.
  • Yoga can reduce stress and worry, and this in turn can have a beneficial effect on symptoms of depression. Yoga does not suit everyone, but can be helpful for some people, such as those with anxiety disorders.
  • Massage can relax people in a similar way to yoga, and lead to reduced symptoms of depression. It should be performed by a trained professional, and only if you are comfortable with a stranger touching your body.

  Related: Healthy living • Ten tips for sleep hygiene

• Nutritional and herbal therapies

  Eating fresh, healthy food is important for our mental as well as physical health. Evidence is poor, however, that consuming herbs or other substances makes a significant difference to the symptoms of mental illnesses.
  
  

  • Omega 3 oils (found in some nuts and fish) are important for our general health and maintaining good brain function. There is no evidence that they reduce the symptoms of depression, but it is speculated they may possibly be helpful in reducing the risk of developing psychotic illnesses such as schizophrenia.
  • St John’s Wort can be effective in reducing symptoms for people with mild to moderate depression. However, it should not be taken at the same time as antidepressant medication prescribed by a doctor. St John’s Wort can interact with other medications to cause a range of problems – increasing the effects of some, while decreasing the effects of others.
  • SAMe may be helpful for some people with mild to moderate depression. People with bipolar disorder should not take SAMe, however, as it may induce a manic episode. It should not be taken at the same time as a prescribed antidepressant, because of the danger of interactions.
  • Ginkgo biloba and ginseng have no effect on symptoms of depression. There is no evidence to support its use for this purpose.

• Other therapies

  • Light therapy can be helpful for some people affected by Seasonal Affective Disorder. Discuss this with your doctor.
  • Homeopathy has no effect on the symptoms of mental illness. There is no evidence to support its use for this purpose.
  • Meditation can be helpful in reducing stress for some people. It is not recommended for people severely affected by Depression or those at risk of experiencing psychotic symptoms.

  Related: Mental health in music - Mindfulness factsheet

Quick Facts

• Mental illness can be treated.
• When you or someone you know starts to feel mentally unwell, the first step in obtaining treatment is to see a doctor or other health professional for diagnosis. 
• Treatment can involve psychological therapy, medication, community supports, and self-help strategies.

• Is mental illness treatable?

  Yes, mental illness can be treated. This means that many people who have a mental illness, and are treated, recover well or even completely. However, because there are many different factors contributing to the development of each illness, it can sometimes be difficult to predict how, when, or to what degree someone is going to get better.

• What does being diagnosed mean?

  When you or someone you know starts to feel mentally unwell, the first step in obtaining treatment is to see a doctor or other health professional for diagnosis. After a thorough assessment, a doctor can make a diagnosis based on a particular pattern of symptoms. A decision can then be made about the best treatment for these symptoms and their underlying causes.

• What does treatment really mean?

  Treatment means all the different ways in which someone with a mental illness can get help to minimise the effects of the illness and promote recovery.

  It can involve psychological therapy, medication, and various supports in the community, as well as people with the mental illness helping themselves.

  • Psychological therapy
    A doctor, psychologist or other health professional talks with the person about their symptoms and concerns, and discusses new ways of thinking about and managing them.
  • Medication
    Some people are helped by taking medication for a while; others may need it on an ongoing basis. The doctor should explain the benefits and possible side-effects of medication before it is prescribed. Medical research shows that many mental illnesses are associated with changes in our brain chemistry. Medications help the brain to restore its usual chemical balance, so that the symptoms are reduced or even eliminated.
  • Community support programs
    Support programs are especially important for people with recurrent symptoms or who have a psychiatric disability. This support may include information, accommodation, help with finding suitable work, training and education, psychosocial rehabilitation and mutual support groups. Understanding and acceptance by the community is also very important.

  Further information about these different approaches is available in the Guide (see tab above).

• Where are people treated?

  These days, clinical treatment generally takes place in the community rather than in a hospital. Anyone who has been diagnosed with a mental illness which needs treatment, should be able to receive a range of clinical services in their own community. If necessary, ongoing support can be provided by a community mental health service clinic, where there are a range of mental health professionals.
  
  

• How can people help themselves?

  There are lots of things that people with a mental illness can do for themselves, to help recover a balanced life. Healthy eating, getting plenty of sleep, and regular physical activity are all important to good mental health. Learning skills which help deal with stress, feeling down, relationships or the symptoms of the illness, are also ways in which someone with a mental illness can look after themselves.

• How do I find out more?

  If you have any concerns about your treatment speak to your doctor.