How does dBt work?

DBT separates skills training from individual psychotherapy, requiring participants to attend a weekly skills training group in addition to being in ongoing weekly individual therapy. As a unique and powerful way to further reinforce the skills taught in the skills training groups, telephone coaching is available between sessions to help generalize the use of skills. One of the key assumptions of DBT is that while we may not have caused all of our problems, we are the only ones capable and responsible for fixing them. This requires a continual willingness on the part of any DBT client to put in the hard work necessary for making the desired changes in order to create a life worth living. 

At SFDBT we offer a comprehensive DBT program that is fully adherent to the DBT treatment model outlined by Marsha Linehan, Ph.D., ABPP. In our comprehensive DBT program clients are in weekly individual therapy (with one of our SFDBT-affiliated therapists or a SFDBT-approved therapist in the community) and in one of our weekly skills training groups. In addition, our SFDBT-affiliated therapists and SFDBT-approved therapists are expected to participate in a weekly consultation team meeting and provide 24-hour skills phone coaching. 

A SFDBT-approved therapist is a therapist in the community that is able to provide adherent DBT treatment. For example, but not limited to, the individual therapist is on a DBT consultation team, provides 24-hour skills phone coaching, and interventions include dialectical, behavioral, and validation strategies. We realize that there are DBT therapists in the community who will meet these criteria with the exception of the 24-hour skills phone coaching requirement. Those individual therapists interested in having a client participate in our program would need to be willing to provide that coverage while the client is a participant in our program. Another option for these individual therapists is that the client begins individual DBT therapy for a limited time (12 months) with a SFDBT-affiliated therapist, affording the client the opportunity to be in comprehensive DBT therapy. The individual DBT therapy could be in lieu of or adjunct to the current therapy being provided.  

dbt skills training

Our DBT skills training group is a twelve-month long group where participants are expected to attend once weekly. The group is comprised of four modules (Core Mindfulness Distress Tolerance, Emotion Regulation, and Interpersonal Effectiveness). 

  • Core Mindfulness Skills: Skills to increase being present and non-judgmentally aware in the moment 

  • Distress Tolerance Skills: Skills to manage difficult feelings without acting impulsively

  • Emotion Regulation Skills: Skills to prevent or decrease emotions or the intensity of emotions

  • Interpersonal Effectiveness Skills: Skills to manage effective communication with others

The Core Mindfulness skills are woven throughout each of the other three modules and is always the first module taught.  For example, in a two-month long period, we present two weeks of Core Mindfulness skills followed by 6-7 weeks (depending on the day of the group and the month) of another skill set. All group members are expected to attend two rounds of the six-month curriculum outlined below in order to fulfill the twelve-month commitment to skills training. 

  • Two Month Section: 

    2 weeks of Core Mindfulness skills

    6-7 weeks of Distress Tolerance skills  

  • Two Month Section: 

    2 weeks of Core Mindfulness skills

    6-7 weeks of Interpersonal Effectiveness skills  

  • Two Month Section:

    2 weeks of Core Mindfulness skills

    6-7 weeks of Emotion Regulation skills  

Mindfulness, Emotions, and Effectiveness Training (MEET)

For those clients that do not necessitate Comprehensive DBT as outlined above, we offer Mindfulness, Emotions, and Effectiveness Training (MEET). MEET is a skills-training group that is based on the skills taught in Dialectical Behavior Therapy but does not adhere to the DBT treatment model outlined by Marsha Linehan, Ph.D., ABPP.

The MEET skills program departs from a traditional DBT treatment model in the following ways: 

  • Skills trainers do not provide 24-hour skills coaching to group members. Skills trainers will be accessible via phone for coaching calls between certain limited hours (e.g. 8am and 8pm) and group members will be alerted to each skills trainers’ specific hours at the beginning of each module. Skills trainers attempt to return phone calls the same day whenever possible. If calls are made outside of those hours, skills trainers make every effort to return the call the following day and usually do so within 24 hours.

  • The MEET program invites group members to participate in any type of weekly psychotherapy, and does not require that group members be in individual DBT therapy.

  • MEET is a six-month program. MEET group members may choose to do two rounds of the skills training modules but are not required.

Participation is not a substitution for Comprehensive DBT and is only appropriate for people who do not necessitate Comprehensive DBT.