Access to Dialectical Behavioral Therapy (DBT) for BPD: Challenges and Alternatives

Many individuals with Borderline Personality Disorder (BPD) face significant challenges in accessing Dialectical Behavioral Therapy (DBT), a specialized form of therapy designed to address the unique needs of individuals with BPD. This article explores these challenges and discusses some alternative options that may prove helpful.

Challenges in Accessing DBT

People living with BPD often find it incredibly difficult to get access to trained therapists who specialize in DBT. In regions like British Columbia, Canada, where I currently reside, the wait times can be exceptionally long—sometimes stretching from almost one year up to 18 months. While this is a common issue, it is particularly disheartening for individuals seeking immediate relief from the intense emotional distress that BPD can bring.

However, the situation may be slightly different in the United Kingdom. Due to the economic and healthcare system, post-COVID, there has been an 18-month waiting list even for basic talking therapies. In pre-COVID times, requests for DBT were often denied, with individuals being informed that they were not considered a high priority due to not being actively suicidal. This decision seems somewhat contradictory, given the specific need for DBT addressing the conditions presented by BPD.

Remote Therapy and Online Resources

Fortunately, the advent of teletherapy has provided a significant relief to those struggling to find a local therapist. Most therapists now work over platforms like Zoom, meaning that specialized therapists can be located from anywhere across the United States. This is particularly useful for those living in remote areas. In my hometown, I am receiving DBT and emotional regulation therapy despite vast distances from major centers. This highlights the potential of remote therapy to bridge the gap in access to specialized mental health services.

However, even with the availability of online therapy, finding a therapist experienced in DBT can still be challenging, with limited slots available in many regions. As one individual pointed out, in the UK, the National Health Service (NHS), while essentially amazing, is vastly underfunded, leading to such long wait times. This shortage is further exacerbated by the fact that many therapists do not accept certain insurances, making the prospect of professional treatment potentially unaffordable for those who need it the most.

Self-Help Resources and Alternative Approaches

Given these challenges, some individuals have turned to alternative resources like the DBT deck of cards. These decks are designed to help cope with stress and manage emotions, and have been endorsed by counselors. While these tools may not fully replace professional therapy, they can provide valuable support and possibly even alleviate symptoms to a certain extent.

Others have not been entirely satisfied with these self-help approaches. Some share personal experiences of ghosting treatment programs due to the intense scheduling requirements. Despite wanting to commit to therapy, they may not feel able to meet the demands of the schedule. For those who can find a supportive friend or helper who understands the struggle, DBT can still be partially self-learned through online resources and materials. However, the success rates of this approach are lower compared to professional therapy, as individualized care is often crucial in managing BPD.

Conclusion

Access to DBT for BPD remains a significant challenge, but technology and additional resources provide hope for those facing these difficulties. Whether through professional therapy, remote treatment, or self-help tools, it is essential to find the support that works best for each individual. While the road to recovery may be long and challenging, there are steps available to make this journey more manageable.