Dialectical Behavior Therapy, a Quick Guide for Therapists

What is DBT?

DBT is an empirically-supported treatment that has been shown to be effective for those struggling with substance abuse, eating disorders, suicide thoughts, self-harm behaviors, PTSD, anxiety, and depression. DBT Skills Training groups are for clients who would like to cope more effectively with intense emotions, addictive behaviors, and/or relationship struggles. Mindfulness, Interpersonal Effectiveness, Emotion Regulation, and Distress Tolerance skills are taught to reduce self-destructive behaviors and learn more adaptive ways to manage painful emotions. The term “dialectical” means a synthesis or integration of opposites. The primary dialectic within DBT is between the seemingly opposite strategies of acceptance and change. For example, DBT therapists accept clients as they are while also acknowledging that they need to change in order to reach their goals.

Group Process:

DBT is a skills/teaching group, not a process group. The first hour of the group is where the group leader will review DBT Diary Cards individually with each group member to give coaching, feedback, and observations about skills used in an effective way. Group members not only benefit from the individual coaching, but by being exposed to hearing how other group members are practicing skills.

The second hour of the group is spent going over new DBT skills. Multiple handouts, homework sheets, experiential exercises, board work, and discussion are used as learning tools. Group members are asked to practice new skills over the week and to give feedback the following week on how this skill worked for them and what challenges occurred. The size of each DBT group is limited to ensure enough time for all members to participate.

All of the DBT skills build on each other. The group lasts a total of 6 months to finish all of the modules (Mindfulness, Interpersonal Effectiveness, Emotion Regulation, and Distress Tolerance). Group members are asked to be able to commit to 6 months of the group therapy, which meets once a week, before joining the group. However, research recommends at least a year of skills training for clients to be able to learn, practice, and apply new coping skills to replace their maladaptive coping mechanisms. At the end of the 6 months, clients may wish to “graduate” the group if they feel satisfied with what they have gotten out of the group, or they can remain in the group until they feel confident in their use of coping skills.

Learn more about our Adult DBT Skills Group and Adolescent DBT Skills Group.