Anatomy of a Dialectical Behaviour Therapy group session

Currently I’m attending a 20-week Dialectical Behaviour Therapy group class. I’ll be blogging about my experiences and what I learn.

DBT was developed by Marsha Linehan, based on strategies she used to recover from BPD herself, as she had found she was not responding to current treatments available. Linehan thought others could benefit from her findings and designed this new practical psychotherapy with concrete strategies that aimed to address key issues arising from BPD, including unstable self-identity and emotions, challenges in successful interpersonal interactions, and unhelpful impulsive behaviours. DBT expands on cognitive behavioural therapy to include more focus on validating and accepting emotions, rather than purely a change-based focus.

DBT teaches life skills in four key psychoeducational areas: Mindfulness, Distress Tolerance, Interpersonal Effectiveness, and Emotional Regulation.

DBT is an intensive treatment model. It involves weekly group skills classes facilitated by two therapists, in addition to weekly 1:1 sessions between an individual client and therapist. Phone coaching is also offered if clients need emergency help with the skills they learn, if they are at high risk of relapsing or engaging in unhelpful behaviours. Consultation sessions where therapists debrief are also embedded in treatment to protect the mental health of therapists.

According to Associate Professor Sathya Rao from Monash University, recovery/remission from symptoms associated with BPD through participation in DBT is highly possible. Rao stated that within one year 23% of clients go into remission, within two-three years 50% of clients go into remission, and an amazing 83% of clients have gone into remission within 10 years.

I’ll be writing a series of blog posts to give an inside look at what it is like to attend a DBT group, including insight into practical skills I learn and how my perspective on BPD evolves.

Below are key points from my DBT group experience so far.

DBT is effective across various life stages: There are 10 people in my DBT group, all from wildly different walks of life and life stages, including university students, professionals working as teachers and social workers, and high schoolers. DBT is highly adaptive to different circumstances. It also proves it’s never too late to get better.

DBT is highly practical and collaborative: Therapists work from the assumption that you are an active, competent agent of your own life, and clients are given the opportunity to share stories and ideas. Therapists guide and facilitate rather than unilaterally directing sessions. Concepts are gradually layered one over the other, and concrete solutions to issues are discussed.

-DBT gives you a vocabulary as a client: You are given a name for the different things you are experiencing, and why you are experiencing them. This helps you to access effective treatment as you can identify to a therapist what issues you want to address, and possible underlying causes for your feelings.

DBT group members learn from each other: You often recognise your own thought processes in other group members when they share life stories. It can give you the emotional distance to consider whether these thought processes are helpful or counterproductive. You also derive inspiration from other group members for strategies in dealing with different situations.

What are YOUR thoughts on Dialectical Behaviour Therapy?

Further reading: Linehan, MM 2014, “DBT Skills Training Manual”, 2nd edn., Guildford Publications, New York, NY.

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