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DBT Program Components

Dialectical Behavior Therapy (DBT) Program Overview

Generally, DBT has two main components:

  • Individual weekly therapy sessions
  • Weekly group therapy sessions

Individual weekly therapy sessions emphasize problem-solving behavior for the past week’s issues and troubles that arose in the person’s life. Self-injurious and suicidal behaviors take first priority, followed by behaviors that may interfere with the therapy process. Quality of life issues and working toward improving life in general may also be discussed. Individual sessions in DBT also focus on decreasing and dealing with post-traumatic stress responses (from previous trauma in the person’s life) and helping enhance his or her own self-respect and self-image.

Weekly group therapy sessions generally last 60 minutes and are led by a trained DBT therapist. They focus on learning skills from one of five different modules:

  • Core mindfulness skills
  • Distress tolerance/reality acceptance skills
  • Walking the middle path
  • Emotion regulation
  • Interpersonal effectiveness

Core mindfulness helps to be in control of your mind rather than letting your mind be in control of you. This section focuses on:

  • Emotional Mind v. Reasonable Mind v. Wise Mind
  • “What” Skills – Keep the focus on the here and now
  • “How” Skills – Focus on coping skills that work

Distress tolerance teaches pain is a part of life and can’t always be avoided; if you can’t cope with painful feelings, it may lead to impulsive behaviors and acting impulsively can lead to hurting yourself or someone else. Participants will learn:

  • Crisis Survival Skills – Utilize distractions, self-sooth, improve the moment, and look at the pros and cons when in distress
  • TIPPS – Use the body’s autonomic nervous system to calm intense emotional moments
  • Accept Reality – Accept the things that cannot be changed and see things for what they are rather than what you want them to be.

Walking the middle path assists in thinking and acting dialectically. In other words, walking the middle path teaches that there is more than one way to see a situation, and more than one way to solve a problem. All people have unique qualities and different points of view and two things that are opposites can be true, while honoring the truth of both sides of a conflict. Participants will learn:

  • Thinking Mistakes – Correct errors in thinking that often times lead to miscommunications or misunderstandings
  • Validations – Validate self, validate others, and learn to recognize invalidating relationships
  • Behavior Changes – Positive reinforcement, ways to increase or decrease behavior, and extinguish personal problem behaviors

Emotional regulation assists in taking control of emotions rather than allowing emotions to take control of you. Participants will learn:

  • Emotional Vocabulary – More accurately describe emotions for more effective communication
  • ABC PLEASE – Increase positive emotions and decrease negative emotions by building mastery, planning for potentially emotional situations, and focusing on self-care
  • Accumulate positive experiences – Build a “force field” between the individual and their intense emotions
  • The “Wave” Skill – Utilize mindfulness techniques to assist in “feeling” the emotions rather than pushing them away or succumbing completely
  • Opposite Action – “Do the opposite” in an effort to curb behaviors that are motivated by emotional states

Interpersonal effectiveness assists in keeping and maintaining healthy relationships, asserting oneself, and maintaining self-respect.

  • Barriers to Achievement – Review barriers to achieving such as lack of skill or indecisiveness
  • GIVE Skills – Relational skills of being gentle, acting interested and validating others
  • THINK Skills – Make peace, reduce conflict, and reduce anger by having empathy and using kindness