Elements of DBT

DBT Skills Training:  With rare exceptions skills training is generally done in a group format and is led by a pair of therapists.   Sessions are 2 ½ hours long and occur once per week.  These sessions are a lot like taking a class and do not involve a great deal of personal sharing or disclosure, although there is some when reporting on homework. In the first half of group individuals report on their homework and receive coaching on how things went.  After a 10 minute break new skills are taught in the second half and homework is assigned.  We work from the current edition of the book DBT Skills Training Handouts and Worksheets by Marsha Linehan, who developed the DBT treatment model.  Skills training takes a bit more than a year. Any program that does less than this during skills training does not offer the standard model of DBT. Currently skills training is conducted in two separate sessions on Wednesdays. The morning session is 10:30 a.m. to 1:00 p.m. The evening session is 5:30 p.m. to 8:00 p.m.

Individual therapy sessions: Individual sessions are typically an hour long with meetings once per week.  Techniques designed or adapted for DBT are used to help individual clients understand their behaviors, thoughts & emotions and apply DBT Skills to deal with life’s problems.  In individual sessions the therapist validates rather than blames the client, while also helping the client to eliminate ineffective, self-defeating behavior patterns and replace it with more skillful and effective patterns.

Between Session Coaching: Because DBT is for people with severe problems, often including suicidal thoughts and feelings, between session coaching is available by phone ot or text. It’s often hard to pull out new skills in a crisis so coaching helps in these situations. It’s not extra therapy, but brief coaching. Any program that doesn’t offer this is not doing the standard model.

Therapist Consultation meetings: Because DBT is a treatment for people that are at high risk, therapists need to be at their best. Standard DBT requires weekly therapist consultation meetings to help therapists meet this goal and provide DBT as it is designed. Linehan believes this is in fact the most innovative part of the model, without it the services are not consistent with standard DBT.