DBT skills groups for adults

What is the purpose of this service?

To enable people to manage intense and extreme emotions that interfere with quality of life and frequently lead to out-of-control (and often shameful) behaviors.

What do I get out of it?

Because severe emotions get in the way of other aspects of life, clients who start to learn and utilize the skills are generally more in control of self across different contexts and situations. Clients who leave my groups generally have a better capacity to deal with very intense emotion and to make sense of and use emotional experiences adaptively.

When people start to look at certain realities and the painful aspects of what they tend to ignore or avoid, the threat of what they have to deal with on a day-to-day basis decreases over time. The benefit of an increased ability to tolerate and experience strong emotions generally leaves people with an increased sense of self-efficacy, self-confidence, and sometimes a radical shift on how they experience themselves. It also frees people from relying on extreme behavior that has generally been relied on to get through stressful situations.

Clients who share relevant and meaningful information about painful feelings may increase their comfort level around other people. Audiences who can share and reflect similar circumstances decrease the stigma around shame and set the tone for normalizing and validating experience that just isn’t happening in current environments outside of group.

When a person no longer has to rely on self-defeating behaviors, the painful aftermath of picking up the pieces is also no longer necessary. It makes sense that people naturally feel more in control of self and emotions if act and behave in ways that they feel good about!

The nutshell version? Reduce emotional chaos and turmoil, increase confidence and self-control, decrease self-defeating behaviors.

How long are the DBT skills groups?

It takes six months to complete the entire skills training modules. Each module (interpersonal effectiveness, distress tolerance, and emotion regulation) last for two months. The fourth skills module (mindfulness) is considered so important that it is incorporated into every single group. At the end of six months clients can repeat skills modules, exit treatment, or get into an advanced group.

What materials are needed?

I ask clients to purchase the original “nuts and bolts” materials that come straight from the person who developed the treatment: Dialectical Behavior Therapy Skills Training Manual for Borderline Personality Disorder by Marsha M. Linehan. This book has a red and black cover and was published by Guilford Press in 1993. Other materials may be available to clients online between sessions, and may include handouts, experiential exercises, and audio recordings.

What are the DBT groups like?

DBT skills groups are fairly structured. We begin with a mindfulness exercise that generally lasts about 10 minutes. Clients are then asked to fill out a data tracking form based on individualized treatment needs. After this we review the worksheets or “homework” that clients were asked to complete during the week. Emphasis is placed on improvements in behavior, or adaptive/skillful means of handling situations or interacting that have been challenging. I then introduce the new material for the upcoming week. The focus of treatment is on what is relevant, current, and practical on a week-to-week basis. Because the groups are small, there is opportunity for in depth skill review and feedback, discussion, and connections among group members.

Are the DBT skills groups for you?

Most of my clients are working professionals (and sometimes students) in the greater Boston area, ready to make changes in their life, and are miserable and dissatisfied with current behaviors (including how emotions are handled). They are also looking for venues for change, connection, and personal growth in addition to (or outside of) individual therapy.

Clients who tend to do well in my groups generally (but not always) have individual therapists who value this venue of treatment. They are willing to commit to four to six months of group, can endure group changes, and participate in giving (me) feedback when things don’t go smoothly. They also understand that extreme behaviors and extreme emotions show up in a wide variety of ways, and can connect with each other despite (sometimes) conflicting values.

That being said, not all groups are a good fit for all people. Consistent attendance over time has been the best factor for making my groups work, and can open the door for deepening trust and obtaining valuable feedback. Conflicts are seen as opportunities, and structure provides a sense of safety.

Because I do not provide “comprehensive” DBT treatment services, it is possible that my groups will not meet the needs of every person who contacts me. Clients who are frequently hospitalized will not be able to attend group regularly, and may need to find treatments in which inconsistent attendance does not interfere with obtaining treatment. Individual therapy often addresses this problem in a way that I am not always able to.

Comprehensive DBT programs sometimes only accept clients who meet certain criteria for borderline personality disorder, severe psychopathology, or severe psychiatric conditions. My groups are for people who are miserable and want to do something about it- because they can’t keep going on the way they’ve been living.

How are my groups different from standardized DBT groups? What makes them so unique?

Many clients are unaware of the impact and influence of “third wave behavior therapies” in the DBT community (DBT being one of several third wave behavior therapies). Another such therapy is Functional Analytic Psychotherapy, or FAP.

My training in FAP helps make my treatment relevant to your presenting problems.

This is how it works: (Watch video below).

Clients who are looking for “just skills” and are not interested in the intensity of this type of treatment will probably not do as well in my groups. People who are looking for “just FAP” may want to consider my FAP group! People who are interested in a FAP-influenced DBT skills group are looking in just the right place.

When clients plan on leaving my group, I write a letter which includes a reflection of goals and progress, highlights of unique qualities, what I appreciate about him/her, interactions that stood out or impacted me personally, what I will take from my work with him/her, how I may have changed as a result, my hopes and wishes for him/her, what I will miss, and parting advice. I generally read this out loud in front of the entire group. This is a specific FAP intervention and is not part of the DBT agenda.

What really makes my groups unique is me. You will (of course not!) find any other groups like mine. You will (of course not!) find anyone who will teach you the skills quite like I do.

What’s the next step?

Priority is given to clients who contact me in advance and are willing to wait until there is an opening in the group. Your chances of getting into a group may be increased (but is not required) if you have an individual therapist who contacts me in advance. Three intake sessions cover a clinical interview, a formulation of treatment goals, mutually agreed upon suggestions for tracking change and progress over time, a detailed informed consent for the groups, structured assignments to help assess your needs, and further interview assessments. If I do not think you are ready to join the group I may offer to meet with you individually until you are ready for a group, or refer you to individual therapy. For current group times and locations, click here.