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How does DBT work? For DBT to be successful, the treatment has to do two things
effectively: (1) Teach skills that people need in order to move closer
toward their life goals and; (2) Help people cultivate an ability to work
these skills into their daily lives. The teaching skills part happens
through our 16-week DBT Skills Group. When people sign-up for the DBT
Skills Group we ask that they make a commitment to the entire 16-week
course. The Skills Group is run very much like a class or a seminar. It
meets one time per week for 90-minutes. Participants are provided with
notebooks that go along with the skills being taught in group. Homework
that corresponds with the skills topics is routinely assigned and reviewed.
Individual DBT psychotherapy and DBT group therapy are two ways of developing
and sharpening the ability to apply skills taught in skills group to real
life. DBT clients usually meet individually with their therapist one to
two times per week for 45-minute sessions. DBT group therapy consists
of 5-8 group members once a week for 90 minutes. While individual DBT
therapy is more personalized, DBT group therapy offers the participant
more social support as well the opportunity to see how others incorporate
DBT skills into their lives. Some people choose to do both, while others
enroll in one or the other. A beginning discussion of how to decide how
much and what to sign-up for occurs just below. As is the case with the
Skills Group, when people enroll in either individual DBT psychotherapy
or DBT group therapy we ask that they make a 16-week commitment.
At our Center, we offer DBT Skills Groups, DBT group therapy, and DBT
individual psychotherapy. The skills and therapy groups are held at a
wide range of times during the week, including early evenings and mornings.
Each group occurs for 90-minutes and participants typically attend 1-2
groups per week. DBT individual psychotherapy can be scheduled at a wide
range of times, including evenings and Saturday’s.
Decisions regarding which parts of DBT to enroll in usually depend upon
individual goals and whether an individual already has an individual therapist
they wish to continue with and who understands and supports the goals
of Skills Group training. Our Center’s therapists are available
to assist in making these choices. With this said, enrolling in a Skills
Group is an essential part of DBT for anyone who has not already successfully
completed Skills Group training in another setting. To get to this level,
we have found that the majority of people need to complete the equivalent
of two cycles of our Center’s 16-week skills group.
Either DBT group therapy or DBT individual psychotherapy is also typically
included in most people’s initial plans. These two parts of DBT
are the main ways we have of helping people develop and sharpen their
ability to apply what is learned in the Skills Group to their lives. To
get an even more intensive experience, some people choose to sign-up for
both.
Several people come to our Center already involved in psychotherapy with
a therapist in the community. In these instances, we usually recommend
that people enroll in both a skills and therapy group. At other times,
people may come to our Center already involved in individual DBT psychotherapy
with a therapist in the community. In these cases, many people choose
to limit their enrollment to a skills group. Also, whether part of our
Center or not, a pre-requisite of our DBT program is that clients have
an individual therapist, who may or may not be the prescribing physician.
Medication is a useful adjunct to many clients in DBT. In these cases
clients need to have a prescribing physician familiar with DBT. We do
not provide medication at the Center. If medication alone has successfully
treated the problematic symptoms, though, there is no need for DBT. If
not, it is important to understand that in undertaking DBT, DBT becomes
the primary treatment. If medication side-effects interfere with effective
participation in DBT, it is usually a good idea to postpone enrolling
in DBT or to discuss with the prescribing physicians the pros and cons
of continuing the medications at their current dose.
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