Dialectical Behavour therapy (DBT) is an evidence-based therapy designed to help with emotion regulation issues. DBT was created by Marsha Linehan (Phd) in the 1980’s in an effort to help clients struggling with suicidality. Since then it has evolved to be studied to treat a variety of conditions including: eating disorders, depression, anxiety, complex PTSD, substance use and Borderline Personality Disorder.
Many people come to Emotion Wise Counselling requesting DBT therapy in individual therapy, and although we offer individual DBT therapy for the most effective DBT therapy I invite those interested in DBT to join a DBT group to best learn DBT emotion regulation skills.
People are often hesitant to join a group- they worry they may have to be vulnerable and share personal trauma stories, they will feel embarrassed, or they do not know what to expect in a group.
What Happens in. DBT Skills Group?
It is important to note that DBT skill group are therapy but they are different than process groups or support groups. In contrast, DBT skills groups do not devote a lot of time for sharing personal stories.
A DBT group is more similar to a class where you learn new concepts each week, and have homework outside of session, and sharing about one’s life is done in the context of what challenges or successes you had in using DBT skills the previous week.
A typical DBT Group has the following elements:
1. Mindfulness Practice- a short exercise to practice mindfulness skills such as breathing, a visualization, listening to music, or even movement or drawing.
2. Check-In and Homework Review. A brief personal check-in focusing on sharing about DBT skills practice and homework outside of the group
3. Skills Learning: Learning a new skills of emotion regulation, distress tolerance, or interpersonal effectiveness. This may be followed by in-session discussion and/or practice with fellow group members.
4. Brief Check-out: A brief ending exercise or go-around the room to reflect on the learning experience.
Why Join a DBT Skills group, Why not just learn DBT in Individual therapy?
Although you can learn DBT skills in individual therapy the skills are designed to be learned in a group format. There are a number of reasons for this:
A group format creates support for one another- when other members report doing homework or using skills outside of group it buoys and encourages other group members to practice DBT skills outside of session.
The structure of a group allows for consistency in following up with homework including the use of diary cards and chain analysis worksheets, which allows people to take DBT skills to the next level from just hearing about them to practicing them outside of session.
Having a group allows individual therapy to be devoted to problem solving the application of the skills and building a supportive therapeutic relationship without using session time to didactically teach skills to clients. This allows more time in individual therapy for personalized therapy.
Joining a DBT group creates a set routine in a participant's life to prioritize the learning of skills. This greatly reinforces the use of new DBT skills for emotion regulation, allowing for further generalization and use of skills in daily life.
One of the main benefits of DBT skills group is the feeling of not being alone. In DBT skills group group members meet other people who are similarly struggling with emotion regulation issues who have experienced similar life circumstances and challenges. Group members become more hopeful when hearing about how other people have both struggled in life and grown and overcome adversity. It is powerful to see the group begin to positively support each other as they learn DBT skills for emotion regulation.
As a DBT Trained therapist I can attest that participating in a DBT group is a very effective way to learn skills due to the reasons shared above. Ideally according to DBT treatment philosophy a person attends a DBT skills group to learn emotion regulation skills alongside individual 1-1 therapy.
Excitingly, there is increasing promising research that DBT Skills group alone (without the added 1-1 therapy) can be effective (Valentine, Smith and Stewart, 2020)*, as well as evidence for shortened versions of DBT group therapy (Wieczorek, Kacen, King, and Wilheim, 2021)**.
At Emotion Wise Counselling we offer a unique adaptation of DBT Skills group entitled “Trauma-Informed DBT Therapy”. This group is geared to those who have experienced trauma and in addition to teaching the key DBT skills we also spend time on trauma psycho-education and normalize experiences of emotion dysregulation as trauma responses.
If you would like to join our Trauma-Informed DBT Group reach out today to inquire about our next offering by emailing info@emotionwise.ca.
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