[Hope-Full]

I am hoping that you guys can help - I have never experienced DBT before, and it's looking like that is going to change soon. Could someone explain to me what a DBT therapy session is like? What to expect?

[Fixated]

I don't know, personally. There definitely are a few people on here that do that sort of therapy. I bet there's some articles out on the internet too.

[minefield]

Hello, I have just been approved to start DBT too, I'm waiting on my start date which should be in about 6 months. I have been told that it is one on one therapy, group therapy which I'm personally freaking out about and then telephone support to help us apply the therapy in real life. By what I have read on web sites mainly ones assessing DBT it seems to be about recognising bad behaviours then teaching yourself to do the opposite our brains tell us to do. My first impression was that it was just a cost effective way to treat as many as possible in one go but there is a lot of support out there on the web that this is the treatment of future and most effective for complicated people with complicated problems that have been resistant to typical treatments. I was also told it was not going to be about trauma therapy but teaching me how to manage my emotions first so that I can handle the trauma work which if I show signs of improvement they will add extra time on at the end. As to how they go about doing this I'm clueless as not started yet. I hope that helps you a little but I will be watching for how people respond to your question myself.

Dialectical behavior therapy - used to treat emotional disregulation.

If they are doing OFFICIAL DBT:

Depending on the program, there are 4 or 5 modules of skills. Skills are taught in a group setting if you are getting true DBT. The group is 6 months, sometimes it is required to do 2 rounds. They are: Core Mindfulness (how to stay in the moment), Distress Tolerance (how to manage crisis), Emotional Regulation (how to keep emotions in check), Interpersonal Effectiveness (how to communicate with others to meet your needs), and Middle Path (move from a world of black/white to grey).

DBT individual therapy requires you complete a diary card, to monitor your emotions, urges, any suicidal attempts, and use of skills and their effectiveness. A true DBT therapist will begin with obtaining your diary card at the start of session and review it. The diary card sets your session. They will focus on lowering life threatening behaviors, therapy interfering behaviors, quality of life interfering behaviors, etc. Focus of session agenda is set on where you are in terms of your behaviors and how intense they are.

DBT also offers coaching weekly. That means your therapist will commit to a weekly check in or check ins to monitor you throughout the week. They will also be available for skills coaching only (NOT processing things, only helping with skills on the phone call).

DBT therapists are also commiting to: being in DBT consultation, being available for phone consultation, doing the best they can to meet your needs in the moment while also keeping appropriate boundaries for health and safety in place.

The client is commiting to do the best you can, that you will attend, that you will use the skills and commit to really wanting to change behaviors. If you miss 4 weeks of therapy in a row for any reason (sickness, vacation, hospitalization, etc) you are out of the DBT program.

This is phase 1 of treatment. Per psychcentral article:
In stage 1 of the treatment, therapy is focused on getting behavioral control. People who enter treatment at this stage are actively struggling with life threatening behaviors (e.g. cutting, suicide attempts, excessive drinking), treatment interfering behaviors (e.g dropping out of treatment, hostility towards therapist, skipping therapy) and major quality of life interfering behaviors (e.g. risk of losing housing, being expelled from school, losing marriage, custody of children).
The rationale for focusing on gaining behavioral control at this point is that it is assumed that a life lived out-of-control is excruciating. Progress cannot be made on underlying emotional issues until you have the skill to manage emotion without engaging in dangerous behaviors and are committed to the process of therapy.

Stage 2 begins to focus on emotional experiencing. For those with Post Traumatic Stress, this is the stage where past trauma is explored and maladaptive thoughts, beliefs and behaviors are identified. The primary goal of stage 2 is to reduce traumatic stress. This is achieved by remembering and accepting facts of earlier traumatic events, reducing stigmatization and self-blame, reducing the denial and intrusive response syndromes and resolving dialectical tensions regarding who to blame. Stage 2 targets are worked on only when behavior is under control.

The goal of stage 3 is to solve the problems of everyday living and improve happiness and joy in life. This stage of treatment focuses on owning your own behavior, building trust in yourself and learning to value yourself.

And finally, stage 4. In this stage the focus is on achieving transcendence and building a capacity for joy. I believe that most people, from Oprah Winfrey to Madonna would feel they could benefit from work on this stage.

[Hope-Full]

Still unsure of *how* it works, but reading over stage one and stage two help clear things up a little bit - thanks for posting that Stormy.

I went for my "assessment" and am awaiting my first "session" where we will go over my "treatment plan." I put all of this in quotes because it feels SO different from therapy that I don't have enough understanding to know what is coming up, nor what just happened.

[rainbow8]

I almost finished with my first round of group DBT, 6 months. It's nothing to be afraid of! It may be different if you see a DBT individual T too, but my group is more like a class than therapy. I feel close to the other members but we don't interact much; we're supposed to interact mainly with the T who is the group leader. People have started and stopped for various reasons, but a few of us have been in it together.

We have homework from the manual, and we have to check-in with a triggering situation each week, that we write on our diary card. Sometimes we have a group discussion about the homework, and DBT T writes on the board, just like school.

We start and end with some kind of mindfulness meditation. I don't know if all groups do that. We meet for 2 hours a week with a 10 minute break at some point. I don't feel stressed in the group; it's structured but informal, and the DBT leader is professional but easy-going.

She is available for coaching but it's not manditory. I think I called her once or twice but she wasn't able to call me back. She apologized. For me, she's not like my "real" T but if I have a problem with DBT skills, I know she'd help me.

Good luck!