Despite evidence suggesting that skills training is an important mechanism of change in dialectical
behaviour therapy, little research exploring facilitators and barriers to this process
has been conducted. The study aimed to explore clients’ experiences of barriers to dialectical
behaviour therapy skills training and how they felt they overcame these barriers, and to
compare experiences between treatment completers and dropouts. In-depth qualitative
interviews were conducted with 40 clients with borderline personality disorder who had
attended a dialectical behaviour therapy programme. A thematic analysis of participants’
reported experiences found that key barriers to learning the skills were anxiety during the
skills groups and difficulty understanding the material. Key barriers to using the skills were
overwhelming emotions which left participants feeling unable or unwilling to use them. Key
ways in which participants reported overcoming barriers to skills training were by sustaining
their commitment to attending therapy and practising the skills, personalising the way they
used them, and practising them so often that they became an integral part of their behavioural
repertoire. Participants also highlighted a number of key ways in which they were
supported with their skills training by other skills group members, the group therapists, their
individual therapist, friends and family. Treatment dropouts were more likely than completers
to describe anxiety during the skills groups as a barrier to learning, and were less likely
to report overcoming barriers to skills training via the key processes outlined above. The
findings of this qualitative study require replication, but could be used to generate hypotheses
for testing in further research on barriers to skills training, how these relate to dropout,
and how they can be overcome. The paper outlines several such suggestions for further
research.