DBT Group Therapy: Mastering Skills for Emotional Balance and Healthy Relationships

Dialectical behavior therapy, commonly abbreviated as DBT, is a type of psychotherapy or talk therapy. It is rooted in the principles of cognitive behavioral therapy (CBT) and was originally designed to treat borderline personality disorder. Today, it is used in the treatment and management of a wide range of conditions, and even used in group settings.

At the NuView Treatment Center, DBT group therapy offers a supportive setting wherein our clients learn essential skills, like emotion regulation, distress tolerance, interpersonal effectiveness, and mindfulness. Moreover, they also benefit from a sense of belonging and community.

What is DBT group therapy?

Dialectical behavior therapy emerged as an individual therapy, mainly designed to treat borderline personality disorder. It is an evidence-based practice that enables clients to come to terms with the reality of their thinking, emotional, and behavioral patterns while also instilling positive changes to achieve balance and healing in their lives. It integrates the opposing (“dialectical”) ideas of acceptance and change.

DBT involves group sessions, and DBT group therapy is more of a skills training setting. Clients learn the DBT-centered skills of mindfulness, interpersonal effectiveness, distress tolerance, and emotional regulation in groups. DBT therapy groups differ from general group therapy sessions, where clients come together to share their experiences and learn from one another.

Within a group setting, DBT seeks to enhance clients’ capabilities so that they can function better in their day-to-day lives.

What are the 4 pillars of DBT therapy?

Dialectical behavior therapy and even DBT group therapy have 4 main pillars they are based on. These are its core techniques, and are delivered as skills training sessions in DBT therapy groups:

1. Mindfulness – It involves learning to live in the present moment by paying attention to one’s thoughts and emotions. It directs the senses to the surrounding environment and events in life and interprets these in a more empathetic manner.
2. Interpersonal Effectiveness – Following mindfulness, interpersonal effectiveness focuses on creating positive interactions with others in life. It comprises clear and direct communication, communicating feelings without losing any dignity or respect, learning to say no, and letting go of any negative feelings toward the other person.
3. Distress Tolerance – As crisis circumstances are common, learning distress tolerance is also important to reduce distress and build resilience. Distress tolerance involves evaluating the distressing circumstances, improving these circumstances, distracting oneself from these circumstances, and being able to engage in self-soothing techniques.
4.  Emotion Regulation – This involves controlling and managing emotions, especially the more intense ones. It can be very useful when one feels frustrated, agitated, anxious, or depressed.

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How DBT Group Therapy Works?

DBT therapy groups are different from process groups and supportive groups, they are more like a learning setting. It is a weekly therapy, where a licensed and skilled therapist will teach a new skill every week. Post this, homework is also assigned so that the clients are able to try out the skills they learned in their real lives. In this manner, the learnings from the therapeutic setting translate to the outer world.

The four skills learned in DBT therapy groups are:

Mindfulness – It involves being in the present moment. It seeks to break unconscious, destructive habits by making the clients more aware of their thinking, emotional, and behavioral patterns. Every DBT group therapy session begins with mindfulness, in fact.

Interpersonal Effectiveness – Seeks to enhance interpersonal relationships by fostering positive communication patterns and setting healthy boundaries without damaging relationships. Clients develop the ability to balance their own and others’ needs while also maintaining dignity and self-respect.

Distress Tolerance – It enables managing difficult emotions and reduces impulsive decisions that may worsen the circumstances. These techniques are geared toward making the clients respond to life crises thoughtfully rather than reactively.

Emotion Regulation – This skill is meant to recognize, understand, and manage emotions effectively. They will help in reducing negative feelings, increasing positive feelings, and establishing a sense of control over intense emotions.

At the end of each session, clients will be given a worksheet. This will be a step-by-step guide to practice the skills learned during the weekly session. Post this, homework assignments will be given wherein clients have to practice what they learned in their daily lives. This will help in bringing about tangible changes. If clients are unable to complete their homework for any reason, then the therapist will seek to understand the hurdles in the way so that they can do it more efficiently in the coming week.

Benefits of DBT Group Therapy

DBT group therapy has many benefits. It is an evidence-based practice that leads to:

• Better Mental Health –

  The skills learned in DBT group therapy help in reducing distress, anxiety, depression, and other negative aspects of life and improve mental health.

• Positive Relationships –

  As interpersonal effectiveness is one of the core techniques of DBT group therapy, clients will experience improvement in their relationships, especially in the way they navigate them.

• Healthy Practices –

  DBT group therapy helps in incorporating healthy practices like mindfulness in life.

• Wide Applicability –

  DBT group therapy can benefit a number of people, across different ages, genders, races, cultures, and so on.

• Long-Lasting –

  DBT group therapy equips clients with skills that bring about long-lasting positive changes in life.

Common Issues Addressed in DBT Group Therapy

DBT group therapy addresses a wide range of conditions, which are as follows:

• Anxiety
• Depression
• Interpersonal relationships
• Borderline personality disorder
• Attention-deficit/hyperactivity disorder
• Eating disorders
• Substance use disorders
• Obsessive-compulsive disorder
• Post-traumatic stress disorder

DBT group therapy focuses on teaching crucial skills to deal with different conditions and it is also beneficial in easing certain unwanted, distressing symptoms.

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Overcoming Challenges in DBT Group Therapy

Overcoming challenges in DBT group therapy is a process. It requires facing vulnerabilities in a group setting, which can especially be difficult for clients who are not comfortable in groups. However, the therapist and group members work toward building a safe place where clients can open up and learn to trust/rely on one another.

Skills training, which is the core of DBT group therapy, in itself is a challenging process. It involves breaking old habits and paving the way for new ones. However, with work and assistance, over time, practicing new ways of thinking and behaving brings about tangible results.

DBT group therapy is a therapy while not being therapeutic as it is a learning setting. At the same time, group members learn and grow together, navigating setbacks and celebrating achievements.

Who Can Benefit from DBT Group Therapy?

DBT group therapy can benefit a large number of people, across different ages, genders, races, and cultures. It does not require one to be a “group person,” as the therapist and group members work together to build openness and trust.

Moreover, DBT therapy groups are different from other groups, like process groups or supportive groups. Even if a person has not benefited from the latter groups, they can seek to benefit from DBT therapy groups as they are skills training groups where clear instruction will be provided.

DBT group therapy can be long, it will take 7 months to review all modules. Each module needs to be repeated twice, so it can take 14 months altogether. However, this time is required to break old habits and build new skills toward positive and healthy living.

Is Dialectical Behavior Group Therapy Effective?

DBT group therapy is an evidence-based practice, which has good success rates. It is especially effective when used in combination with individual DBT therapy. Studies have shown that DBT group therapy is effective in reducing symptoms of a wide range of mental health conditions, like borderline personality disorder, anxiety, and depression.

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Long-Term Outcomes of DBT Group Therapy

DBT group therapy is a highly effective therapy. It leads to long-term outcomes, which are as follows:

• Greater self-control
• Better sense of self-worth
• Increased self-compassion
• Better interpersonal relationships
• Healthy coping mechanisms
• Reduction in self-destructive behaviors (especially in borderline personality disorder)
• Improved mental health
• Overall better quality of life