What Happens In a DBT Therapy Group? How It Can Help You?

Do you tend to blow up easily toward the people closest to you? Do your emotions feel out of control and get in the way of you achieving your goals? Do you feel misunderstood and have trouble connecting with people? If so, this article may be for you.

What Is DBT?

DBT (dialectical behavior therapy) is a comprehensive, evidence-based treatment plan based on cognitive behavioral therapy (CBT), that has been especially adapted for people who feel emotions intensely, see things as black or white, and struggle with mood swings, emotional instability, relationship issues, and impulsive behaviors.

It is conducted through a combination of one-on-one therapy sessions and participation in group therapy sessions. Both are vital to the program’s success, but the therapy group is where you learn the skills and practice them with your peers.

The dialectical part of DBT focuses on balancing opposing forces and helping you detach from either-or thinking. It teaches you to acknowledge that two things that seem opposite or contradictory can both be true at the same time. You can, for instance, both accept your challenges and work toward changing them simultaneously.

The ultimate goal of DBT is to help you understand and accept your difficult feelings while equipping you with effective coping skills to manage them and make the positive changes you desire in your life.

The DBT Therapy Group

A DBT therapy group generally consists of six to ten people who meet for one to two hours a week for six months to a year. The group is conducted like a class with a structured curriculum that you attend to learn specific skills such as mindfulness, emotion regulation, distress tolerance, and interpersonal effectiveness that serve as tools to help you manage difficult emotions, cope with stress, reduce self-destructive behaviors, and improve your relationships.

You are also required to complete homework assignments to practice the skill you were taught during the weekly session.

The Four Pillars Of DBT

DBT is founded on the following four modules that work together to help you manage your emotions, reduce self-destructive behaviors, and improve your relationship with others. These are known as the four pillars of DBT, each one of which is comprised of several interconnected skills.

Mindfulness

The first pillar, mindfulness, is the foundation upon which the others are built because it is what equips you to accept and tolerate the intense emotions you may feel when exposed to distressing situations.

Mindfulness is the practice of staying focused on the present moment instead of worrying about the past or future. It is about acknowledging and accepting thoughts and feelings that come up without judging them or reacting to them, and being able to separate the two. Mindfulness helps you stay anchored and maintain equilibrium in times of turmoil.

Distress tolerance

Distress tolerance is about learning how to accept and tolerate negative emotions and ride them out rather than trying to escape or resist them. It teaches you skills that help you cope with crisis situations in healthy ways rather than defaulting to emotional outbursts, impulsive overreactions, or destructive behaviors that make the situation worse.

Emotion regulation

The more you try to suppress emotions, the bigger they get. Emotional regulation helps you identify and label your feelings, understand what causes them, and why they can appear out of nowhere.

It teaches you how to change the feelings you want to change rather than try to resist them, as well as how to decrease painful emotions by purposefully increasing pleasant ones to help you gain some feeling of control over your feelings rather than letting them control you.

Interpersonal effectiveness

This module combines listening skills, social skills, and assertiveness training to help you understand your needs, set healthy boundaries, and be able to effectively communicate what you want with others in a manner that is confident, assertive, and maintains self-respect, as well as be able to graciously say “no” when appropriate, without causing hurt, resentment, or damaging the relationship.

Examples of Specific DBT Skills Taught in DBT Therapy Groups

DBT skills are divided into two categories – acceptance skills and change skills. Acceptance skills fall under the mindfulness and distress tolerance modules, whereas change skills fall under the emotional regulation and interpersonal effectiveness modules. Several of the skills use acronyms to make it easier to remember and use them.

The following are some samples.

Mindfulness Skills

Deep abdominal breathing

Focus on your breathing as you inhale slowly through your nose for a count of 3 to 5, hold for a count of 5 to 7, and exhale slowly through your mouth for a count of 7 to 9. Repeat several times until you start to feel calm and relaxed.

Progressive muscle relaxation

Slowly move up or down your body, tensing and relaxing different muscle groups as you go.

Separating from your thoughts

Thoughts are not facts. You can accept them without believing them. Visualize them as attached to balloons that float away.

Emotional Regulation Skills

Opposite action

Your body and emotions are linked. Doing the opposite of what your body’s impulse is telling you to do can help change what you are feeling.

Checking the facts

Checking the facts can help dial back the intensity of a distressing emotion. Ask yourself what triggered it and if the assumptions you made that caused you to overreact are realistic.

Increase positive emotions

Learn to pay attention to what is good, edifying, and positive instead of ruminating on things that make your negative emotions worse. Increasing positive emotions can help build resilience and decrease negative ones.

Distress Tolerance Skills

Cold water

Taking a cold shower or immersing your face under extra cold water for 15-30 seconds can impact your vagus nerve and act like a reset button that decreases your heart rate and brings your intense emotions down a notch.

STOP

This acronym reminds you to remain still and resist the urge to react.

• S – Stop. Stay still.
• T – Take a step back. Avoid acting impulsively by removing yourself from the situation.
• O – Observe. Detach yourself from the situation by assessing your surroundings and focusing on what you are feeling.
• P – Proceed mindfully. Remind yourself of what your goals are and how you can achieve them under the circumstances.

Pros and cons

Before impulsively reacting to an urge, make one list of the pros and cons of doing so and another list of the pros and cons of not doing it.

Interpersonal Effectiveness Skills

DEAR MAN

An acronym to help you dialogue more effectively.

• D – Describe the situation. Providing a clear, factual description of the issue you are dealing with can help prevent misunderstandings and ensure that you are both on the same page.
• E – Express your feelings. Express how the situation is making you feel, using “I” statements.
• A – Assert yourself. Make your needs known in a clear, direct way without being aggressive or confrontational.
• R – Reinforce your position. Help the other person understand where you are coming from by providing reasons for or evidence to support your position.
• M – Mindful of the other person. Be empathetic and mindful of the other person’s feelings and perspective to help keep them from getting defensive or shutting down.
• A – Appear confident. Confidence helps convey your message more effectively and makes it more likely the other person will take you seriously.
• N – Negotiate. Look for a mutually acceptable solution.

GIVE

An acronym to learn to communicate positively.

• G – Gentle. Don’t attack or threaten.
• I – Interested. Listen actively to show you are interested in what the other person is saying.
• V – Validate. Be empathetic and acknowledge the other person’s feelings.
• E – Be easy-going and have a cheerful attitude.

If you have questions or would like to set up an appointment with one of the faith-based counselors in our directory to see how we can help you manage the challenges you are facing, please give us a call.