Dialectical behaviour therapy operates on a multi-stage approach, in two separate ways.

Firstly the approach of treatment has multiple stages:

• individual therapy
• group skill training sessions
• phone coaching in between treatments

These may run separately or concurrently – you may receive individual therapy, then move on to group skills, or you may do both therapies alongside each other with phone coaching in between.

Secondly, the treatment path itself has multiple stages:

1. Stage 1 treats the most harmful behaviours, such as self-harm, suicidal thoughts or attempts, and reckless behaviour that puts you at risk of harm.
2. Stage 2 begins to address skills that can help improve your quality of life, and begin your recovery journey. This includes the four core skills of emotional regulation, mindfulness, distress tolerance and interpersonal effectiveness.
3. Stage 3 moves the focus onto improving your interpersonal relationships and building your self-esteem.
4. Stage 4 looks at developing positive outlooks, gaining a sense of connection in life, and building capacity to experience joy in life.