DBT

What is the DBT Group?

Marsha Linehan, Ph.D., developed dialectical behavior therapy (DBT) with the therapeutic goal of learning how to focus and control attention. DBT involves using Buddhist mindfulness techniques and meditative exercises that allow clear awareness, acceptance and tolerance of the present moment. Much like the meditative practice of yoga, DBT skills provide improved self-control that, in turn, allows one to fully experience emotions and senses with perspective and understanding. The four basic learned skills of DBT include; Core Mindfulness (developing an awareness of different aspects of an experience and keeping them within the present moment), Interpersonal Effectiveness (ways of becoming more assertive with people), Emotion Modulation (learning how to cope with intense emotions and express them adaptively), and Distress Tolerance (finding acceptance in situations where there is no immediate solution).

The purpose of the DBT Group is to aid clients in the development of tools and skills to address life problems in a meaningful manner. It emphasizes skill building though the combination of cognitive-behavior strategies and mindfulness. The group focus is upon both skills building and processing the feelings that arise for each member in a supportive, emotionally accepting group led by a highly experienced clinician. The clinician will often discuss a goal or series of goals at the onset of the group to help focus the members and encourage exploration in a somewhat focused manner. Given that the group is more didactic in nature, the group leader may assign homework for the members to complete along with handouts to help refresh their memories when out of group. The DBT therapist may also encourage the client to bring the issues raised in the group into their individual therapy appointment to help them continue to work on the insights gained and to practice the skills discussed in the group. As the DBT therapist is also an integral member of our holistic treatment team, the themes and issues raised by the group are also presented in the weekly treatment team meeting so that the entire treatment team is aware of the successes and challenges of the client in regard to relationships.


How does the DBT Group work?

Our residential program found that the modules developed in the DBT framework clearly reflected the needs and struggles of our population. Given the fact that most clients remain in our program for an average of only 6 weeks, the full DBT program cannot be fully executed (as the DBT full module can require 6 or more months to complete). Thus, we attempt to focus on those skills and tools that are most needed by the client population. The identification of needed skills is often co-determined by a general consensus of the group and the group leader regarding the skills needed by the different group members and how best to integrate the needs of each individual into the collective whole. The challenge for each member will be different, of course, depending on their early life experiences with problem solving as well as their feelings of self-efficacy when interacting with a problem. The group leader takes the differences of each member into consideration, of course, when developing the skills to be focused upon during each session and will check in frequently with the group to ensure that the necessary skills and feelings are being processed and understood effectively.


What happens if someone is reluctant to engage in the group?

Many individuals that come to our residential program will relate that they have never participated in group therapy before and are uncomfortable sharing their private thoughts and feelings with others. Most clients who enter into our program often do not choose group therapy, as a component of their outpatient treatment choice and our group therapists make every effort to acclimate entering clients to the group psychotherapy experience. The rules of the group and the manner in which sharing and reflecting is done by the different group members is reviewed by the group leader with each new member to help increase comfort level and decrease anxiety. Further, the DBT Group is a more structured, didactic group as compared to other, more open format groups. The group leader provides members with handouts each week that follow the modules outlined by Dr. Lineahan with an emphasis on the issues presenting in the community that week. Group leaders, especially in the DBT Group, will use the experience of being in a small group format as an opportunity to provide skills that are requested for each individual member as indicated to help them focus and integrate the tools and skills in a meaningful manner. It is through this process that many group members report feeling more comfortable and safe to integrate the problem-solving tools to address their struggles and experiment with their new skills in an empathic and encouraging setting.


What should the DBT Group accomplish?

The DBT Group should provide an individual with tools and skills to manage their relationships, mental health issues, professional conflicts, and overall life adjustment struggles. We find this group to be an integral to the individual therapy as the expression of underlying issues is often seen in the themes discussed in the group setting. The skills provided in the group aids individuals struggling with many emotional issues including; suicidal thinking, body image issues, intense bouts of depression and anxiety, and impulsivity.

Our small milieu of six individuals maximum in each residential program allows for each person to have the time and opportunity to process their current relationship struggles with enough time to feel heard and understood. Many individuals report feelings of increased self-worth and the ability to identify new ways to address the problems in their lives that they wish to change and feel empowered to continue to work upon when they leave our residential program.

Bridges to Recovery utilizes DBT therapists who are highly experienced and who demonstrate a strong motivation to help clients reach their full potential and reach their goals and dreams.


Who leads the DBT group at Bridges to Recovery?


Gabriella Calo Siegel, Psy.D.