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How a DBT group works

What Happens in a DBT Group

Thinking about joining a DBT group?
Maybe a therapist suggested you check it out.
Or maybe you’ve just heard about DBT and are curious about how it can help you.

Let’s explain what happens in a Dialectical Behavior Therapy group and how it’s different from other therapy groups.

How a DBT group is different from other groups

DBT group is not a process group

Group time is not spent processing feelings between group members. The purpose of the group is to learn new skills so you have the tools to build the life you want.

Learning practical ways to approach your life is the goal of each session.

DBT is not a support group

You’ll get plenty of support and encouragement in learning the skills and using them in your life, but the focus of the group isn’t support .

For example, in a support group, group members may go around the room sharing details of what brought them to the group. In a DBT group, you will only share details of your personal life if you choose to and only as they relate to your use of the skills.

DBT group is more like a class

Joining a DBT group is similar to taking a class, except without the pressure of tests and grades. You will be learning a new skill each week and have homework to help you try out the tools in your life.

DBT group is therapeutic but it’s not therapy

DBT group helps you make changes, but it’s not actually therapy. The therapy part of DBT happens with your individual therapist. You need to be attending weekly individual therapy sessions at the same time that you are participating in the group.

So what actually happens in DBT group?

Mindfulness Practice

Each group begins with a mindfulness practice. Mindfulness is the foundational skill in DBT and you get a chance to practice it every week.

The type of mindfulness practice you do varies from week to week. Some mindfulness exercises are done with your eyes closed (or you looking downward) and others are more interactive, such as mindful eating or a mindful coloring exercise.

You don’t need to have any prior experience with mindfulness. The group will teach you both how and what to do to practice mindfulness.

If you’ve done mindfulness practice before, you’ll learn DBT’s approach to it.

Homework Review

After mindfulness practice comes homework review.

Some people get stressed out at the thought of homework because it brings up negative associations with school. Don’t worry, DBT homework is not academic; it’s therapeutic and simple. Simple doesn’t mean easy, though, as trying out new behaviors will require some willingness to stretch yourself beyond what you’ve done in the past.

At the end of each class, you will be assigned a worksheet to complete that week. The worksheet will guide you step-by-step in practicing the skill you learned that week.

If for some reason you don’t complete the homework one week, you won’t get a bad grade. We’ll troubleshoot what got in the way so you’ll be more likely to do the homework the following week.

Why there’s Homework

Have you had the experience of having great insights in individual or group therapy, but later realized those insights didn’t actually change anything in your life? This can be frustrating.

The homework helps you do things differently, so you can see tangible (even if it’s sometimes small) changes from week to week.

Learning a New Skill

The last portion of the group is dedicated to learning a new skill.

The skills in DBT are broken down into the following 4 modules:

  • Mindfulness
  • Distress Tolerance
  • Emotional Regulation
  • Interpersonal Effectiveness

Let’s look at each module a little more in depth

Mindfulness:

Mindfulness is a particular way of paying attention. When you’re mindful, you’re paying attention (on purpose) to the present moment. However, mindfulness is not meditation.

Mindfulness in DBT is not sitting on a cushion silently, far removed from your life (although this can be very helpful and is one way to practice). Mindfulness in DBT is about paying attention to the moment you’re actually in as you go about your life.

Mindfulness is the antidote to mindless, habitual ways of thinking and acting that can get you into trouble.

Have you ever just found yourself doing something you swore you wouldn’t do, like eating something you said you wouldn’t?
Or arguing with your partner when you swore to try to get along?

Mindfulness helps address and change these often unconscious habits that get us into trouble.

Mindfulness also helps with emotional suffering, worry, and depression. It keeps you in the moment you’re in right now versus in the past (where regret, shame and grief can live) or the future (where worry and fear live).

Distress Tolerance:

The skills in the distress tolerance module teach you how to survive difficult feelings without making things worse.

Sometimes you can’t immediately change a hard situation and you need a new way to effectively ride out feelings until they pass.

For example, if you have the urge to yell at your partner when they come home late – which might lead to a big fight – you’ll learn how to tolerate the angry feelings without lashing out at your partner.

This doesn’t mean that you won’t address what’s upsetting you with your partner. Just that you’ll do it when you’re in ‘wise mind’ (another foundational DBT concept), using some of the skills you’ll learn in the interpersonal effectiveness module.

Emotion Regulation:

Have you ever been confused by your emotions?
Or wondered if your emotions were ‘normal’?

DBT’s emotion regulation skills will help you understand what causes emotions and what makes some painful emotions seem to come out of nowhere.

You’ll learn how to decrease painful emotions. And increase the presence of more pleasant emotions.

Most importantly, what you learn will help you feel some degree of control when strong emotions come on – rather than feeling that your emotions control you.

Interpersonal Effectiveness:

Similar to assertiveness training courses, interpersonal effectiveness skills teach you how to approach relationships differently.

Interpersonal effectiveness skills help you learn the nuances of effective communication in a range of relationships, from work relationships to family relationships to romantic relationships.

You’ll learn how to ask for what you want, and how to say no while maintaining relationships and your self-respect.

Common objections to joining a DBT group

I’m not a group person

You don’t need to be a group person to benefit from a DBT group. You just need to be open to learning new ways of managing your emotions and relationships.

I’ve tried other groups and they haven’t worked

A DBT group is different from other therapy groups you may have experienced. The group is not free-form; it’s structured.

You will get clear instruction on how to use new skills in your life. The more willing you are to experiment with new behaviors, the more you’ll benefit.

Over a year?!  That’s too long!

It takes approximately 7 months to review all the modules. We strongly encourage group members to repeat each module twice which takes approximately 14 months. We have found that people who commit to this extended learning make the most progress.  It is a commitment because change takes time.

I don’t have Borderline Personality Disorder (BPD)

DBT is great for people with BPD. But you don’t need to have a particular diagnosis in order to benefit from a DBT group.

If you struggle with managing your emotions and your behaviors, or find conflict and asserting your needs in relationships hard, you’ll get a lot out of a DBT group.

* A note about BPD
BPD is one of the most stigmatized mental health diagnoses. This is not okay, and DBT therapists are working hard to change this.

If you relate to the symptoms of BPD, DBT can help. Some people relate to some symptoms of BPD and not others, or they only have BPD-like symptoms in their closest relationships. DBT can help with all of these.

Sometimes people don’t want to join a DBT group because they believe it means they have BPD. This is a result of shame and stigma. Don’t let that get in the way of you getting the help you need.

Still have questions?

Call  (415) 310-5142 for a phone consultation.