DBT Individual Therapy

Unlike other psychotherapies that utilize a more singular approach to treatment, a standard DBT program combines multiple, highly effective components that consist of  group therapy, individual therapy sessions, and phone coaching that seek to teach individuals valuable self-management skills.

Here, we’ll be taking a closer look at the individual therapy component used in DBT and and its significance and value in the overall therapeutic process.

Individual therapy is at the core of DBT and explores how and why the DBT skills learned can help clients improve their lives and uses techniques such as cognitive modification and exposure to address problematic behaviors. Like any type of psychotherapy, its success depends on the ability to build a healthy, supportive, and safe client-therapist relationship.

Individual Treatment 

A crucial step in the growth and healing process, DBT individual therapy focuses on enhancing client motivation and improving social and coping skills. When combined with DBT skills group and DBT real-time coaching, this therapeutic approach can help lessen the frequency and severity of harmful or troubling behaviors. In most cases, these individual sessions occur once each week throughout the entirety of the therapeutic process. It should also be noted that the individual therapist is sometimes  not the same person as the facilitator leading the skills group. 

With DBT individual therapy, clients meet one-on-one with a therapist to address the unique challenges faced in their everyday lives. During these individual sessions, the client and therapist work together to address the challenges that present themselves over the course of treatment, with special attention paid to self-destructive or potentially self-harmful behaviors. Individual therapy offers the client a secure, consistent environment in which to do this work.

The Diary Card

A popular tool used in DBT individual therapy is the diary card. This card allows clients to better identify when their symptoms occur and which learned DBT skill they used to address it, or which skills they could have used to address it.  Diary cards are completed daily by the client and then brought to the weekly individual meeting where the recorded information can be discussed with the therapist at the beginning of each session.

The primary information therapists encourage their clients to record on their diary cards include thoughts and urges dealing with various challenges: suicidal thoughts, self-harm, substance abuse,  feelings of sadness, pain, or joy. Other behaviors that can be included on the diary card are eating disorder behaviors, OCD behaviors, and panic attacks. The DBT therapist then teaches clients key behavioral skills to cope with those thoughts and behaviors.

Along with teaching new behavioral skills, the diary card enables the therapist to create a ladder of priorities or hierarchy from which to build each individual session. The DBT therapist maps out the thoughts and feelings that led to the recorded behavior, and helps clients identify the missing skills (e.g. mindfulness, distress tolerance, and emotion regulation) needed to cope with their issues, and then teaches and rehearses those needed skills with clients so that they can develop mastery of these new, healthy coping mechanisms. Cognitive restructuring and exposure are also incorporated.

The benefits of working with diary cards are abundant. By recording daily information to share with the therapist each week during the individual therapy session, the client is required to self-monitor their target/unwanted thoughts and behaviors. This developing awareness is recognized as the first step to self-improvement.

Diary cards also present a structured view of the client’s week that give the therapist a foundation for discussion regarding future work. The cards help clients identify both areas of progress as well as areas that need additional attention.

The Case for Individual Therapy

In most cases, a DBT approach will apply various resources to best assist the client in achieving their goals in therapy. When DBT individual therapy is combined with DBT skills group and real-time coaching, it can significantly help to reduce the severity and frequency of unhealthy thoughts and harmful behaviors. Individuals participating in a comprehensive DBT program remain in individual therapy throughout the entire treatment process during which they continue working one-on-one with their therapists to better understand how their thoughts, beliefs, and expectations affect their everyday functioning.