DBT Skills

One of the most important components of any successful Dialectical behavior therapy program is the DBT skills component. When used in conjunction with the other three main elements of the program—individual therapy, phone coaching, and consultation team—DBT skills training serves as a powerful tool to help clients manage painful emotions, problematic behaviors, and decrease conflict in relationships.

So what exactly is DBT skills training?

Unlike a traditional group therapy session, during which participants simply share their thoughts and feelings, DBT skills groups are more like classes on “emotional intelligence.” While members support each other and share their concerns, they build on this environment of mutual support by learning about key behavioral skills that can help them to develop effective ways of navigating challenging situations that arise in everyday life.

By being in a group setting, DBT skills training allows clients to connect with others who are experiencing similar difficulties in life. It is in this setting that the therapist teaches behavioral skills and assigns homework to each member to carry out on their own. The homework calls upon the clients to practice using their newly learned skills outside the group on a regular basis.

As for frequency and duration, the DBT skills training classes typically meet once a week. In most cases, each class runs about 2.5 hours. In a standard DBT program, it takes approximately 24 weeks to complete the entire DBT skills curriculum. The same curriculum is commonly repeated for another 24 weeks to create a full 1-year program. Briefer programs that teach a subset of the skills have also been created to target specific populations.

DBT Skills training is made up of four modules: core mindfulness, distress tolerance, emotion regulation, and interpersonal effectiveness.  Each module is designed to enable clients to better manage their behaviors, emotions, and thoughts.

The four modules used in DBT skills training:

Core Mindfulness

Here, a person learns how to focus their mind and attention to the present moment. This concept is all about living in the moment and experiencing one’s emotions and senses fully while keeping perspective. Core mindfulness is considered a foundation for the other skills taught in DBT, because it helps individuals accept and tolerate the powerful emotions they may feel when challenging their habits or exposing themselves to upsetting situations. In this module, clients are encouraged to keep a diary and reflect on the challenges and triumphs of their daily efforts along the way.

Distress Tolerance

This skillset teaches individuals to reframe their thoughts, implement self-soothing techniques, and have a firmer understanding of the present moment to better cope with uncomfortable events and occurrences that cause anxiety and stress. Rather than becoming overwhelmed by stressful emotions, individuals are taught methods to soothe themselves in healthy ways. This allows them to make better decisions about whether and how to take action.

Emotional Regulation

Skills learned in this module include being able to identify emotions, reduce vulnerability to reactive behaviors, and identify obstacles to changing emotions.  Because many clients experience fluctuations of extreme emotional states, helping to clients to regulate their emotions during stressful times is a primary goal. Emotional regulation helps clients to better understand, adapt, and alter their emotions to improve their mindset.

Interpersonal Effectiveness

Helping clients learn how to speak up for what they want is the goal of this approach. Interpersonal effectiveness provides the tools for helping clients to ask effectively for what they need and also helps them to say no in a way that minimizes conflict and keeps relationships healthy. This involves respecting the self and others, listening and communicating effectively, dealing with difficult people, and repairing relationships.

Who is Best Suited to Lead a Skills Training Group?

Skills trainers should have a solid grasp of DBT skills, practice the skills themselves, and fully understand how to teach them. In addition, they need to know basic behavior therapy techniques and the various DBT treatment strategies.

Clients with identified mental health issues such as borderline personality disorder, post-traumatic stress disorder (PTSD), eating disorders, and depression can benefit from DBT skills training taught by psychotherapists, counselors, case managers, social workers, and psychiatrists.