Podcast
Questions and Answers
What is the primary difference between formal DBT skills training and individual DBT psychotherapy?
What is the primary difference between formal DBT skills training and individual DBT psychotherapy?
Which component is NOT included in the structure of skills training sessions?
Which component is NOT included in the structure of skills training sessions?
What assumption is made in DBT regarding group members?
What assumption is made in DBT regarding group members?
What is the initial activity that begins each skills training session?
What is the initial activity that begins each skills training session?
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What is the recommended duration for skills training sessions for individuals with severe disorders?
What is the recommended duration for skills training sessions for individuals with severe disorders?
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Which of the following best describes the agenda setup in individual DBT psychotherapy?
Which of the following best describes the agenda setup in individual DBT psychotherapy?
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What potential problem is mentioned for outpatient settings regarding homework review sessions?
What potential problem is mentioned for outpatient settings regarding homework review sessions?
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What is the typical break duration incorporated during skills training sessions?
What is the typical break duration incorporated during skills training sessions?
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What is the primary purpose of the session beginning ritual in group sessions?
What is the primary purpose of the session beginning ritual in group sessions?
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Why do some clients prefer the term 'homework practice'?
Why do some clients prefer the term 'homework practice'?
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What is a common practice implemented at the start of each mindfulness session?
What is a common practice implemented at the start of each mindfulness session?
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How does the session leader facilitate sharing among group members?
How does the session leader facilitate sharing among group members?
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What is the purpose of ending the session with each person saying a personal goodbye?
What is the purpose of ending the session with each person saying a personal goodbye?
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What might be a concern regarding the terminology used in the group sessions?
What might be a concern regarding the terminology used in the group sessions?
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How long do most group sessions in the friends-and-family and skills training programs last?
How long do most group sessions in the friends-and-family and skills training programs last?
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What is the maximum duration recommended for individual skills training sessions?
What is the maximum duration recommended for individual skills training sessions?
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What is typically expected from participants regarding snacks during group sessions?
What is typically expected from participants regarding snacks during group sessions?
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Why are handouts printed on a different color of paper compared to worksheets?
Why are handouts printed on a different color of paper compared to worksheets?
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What does the session primarily focus on during group discussions?
What does the session primarily focus on during group discussions?
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Which of the following skills is NOT mentioned as part of the mindfulness practices in the sessions?
Which of the following skills is NOT mentioned as part of the mindfulness practices in the sessions?
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What is the purpose of providing corrective feedback during the sharing of experiences?
What is the purpose of providing corrective feedback during the sharing of experiences?
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What should be addressed if there are issues related to attendance and participation in the group?
What should be addressed if there are issues related to attendance and participation in the group?
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Which of the following is NOT a component of the standard skills training session format?
Which of the following is NOT a component of the standard skills training session format?
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What is the primary objective of using labeled dividers in the training binders?
What is the primary objective of using labeled dividers in the training binders?
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What is the primary purpose of weekly homework sharing in skills training?
What is the primary purpose of weekly homework sharing in skills training?
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What is emphasized to clients during the first session of each skills training module?
What is emphasized to clients during the first session of each skills training module?
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Which aspect of group dynamics is mentioned as potentially problematic during the sharing of homework?
Which aspect of group dynamics is mentioned as potentially problematic during the sharing of homework?
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Why is winding down time allocated at the end of a skills training session?
Why is winding down time allocated at the end of a skills training session?
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What is noted as a challenge in maintaining the homework sharing process?
What is noted as a challenge in maintaining the homework sharing process?
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Leaders are tasked with convincing clients that skills training will result in what?
Leaders are tasked with convincing clients that skills training will result in what?
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During the practice of skills, what is critical for the leaders to manage effectively?
During the practice of skills, what is critical for the leaders to manage effectively?
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Which of the following is NOT an expected challenge during homework sharing sessions?
Which of the following is NOT an expected challenge during homework sharing sessions?
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What is the purpose of the last 15 minutes of each session?
What is the purpose of the last 15 minutes of each session?
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How much time is generally allocated for reviewing new material in a session?
How much time is generally allocated for reviewing new material in a session?
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What aspect of the final session differs from the regular sessions?
What aspect of the final session differs from the regular sessions?
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Why is 1½ hours considered insufficient for a group session?
Why is 1½ hours considered insufficient for a group session?
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What is one of the activities included in the individual skills training sessions?
What is one of the activities included in the individual skills training sessions?
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What is typically done for participants leaving the skills training group?
What is typically done for participants leaving the skills training group?
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What is a key focus during the review of skills in the final session?
What is a key focus during the review of skills in the final session?
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What approach is recommended for setting up the room for skills training sessions?
What approach is recommended for setting up the room for skills training sessions?
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What is a significant challenge when clients with dysregulated emotions seek therapy?
What is a significant challenge when clients with dysregulated emotions seek therapy?
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Why might some young children not access treatment on their own?
Why might some young children not access treatment on their own?
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In what context should new behavioral skills be practiced?
In what context should new behavioral skills be practiced?
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What is a fundamental assumption about behaviors and their causes?
What is a fundamental assumption about behaviors and their causes?
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What is a more effective approach to changing unwanted behaviors than judgment and blame?
What is a more effective approach to changing unwanted behaviors than judgment and blame?
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What is a common limitation faced by public health clinics regarding psychotherapy?
What is a common limitation faced by public health clinics regarding psychotherapy?
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Who often helps clients find appropriate individual therapists when needed?
Who often helps clients find appropriate individual therapists when needed?
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What can result from prematurely terminating therapy for clients with dysregulated emotions?
What can result from prematurely terminating therapy for clients with dysregulated emotions?
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Study Notes
Skills Training Sessions
- DBT skills training sessions have specific attendance guidelines, requiring four individual sessions per week unless on a waiting list. Exceptions are for clients in other therapies.
- Skills training effectiveness in reducing suicide attempts in suicidal individuals on waiting lists has been supported by Canadian research.
- High levels of dysregulation or suicidality in clients necessitate extra support to master skills.
- DBT skills training does not require individual therapists to be DBT-trained, but the importance of individual therapy is acknowledged.
- Skills training leaders can sometimes act as short-term crisis therapists and assist clients in finding suitable individual therapists.
DBT Assumptions
- People are doing the best they can, given their contextual factors.
- People inherently want to improve their lives.
- People have a need to change, try harder, and be more motivated to improve themselves. Although this isn't always the case, particularly in instances of consistent progress.
- People are not solely responsible for all their problems, but they are responsible for finding solutions to address them. This does not exclude needing help in situations like childhood or disabilities.
- Maintaining the use of learned skills across different contexts is essential.
- All behavior, thoughts, and emotions are caused, and understanding those causes is necessary for change.
- Judging and blaming are less effective than examining and finding solutions as to the causes of unwanted behavior.
Format of Ongoing Skills Training Sessions
- The structure of skills training sessions differs from individual psychotherapy, as the therapy agenda is set before the session, rather than by the client's behavior.
- Sessions typically include: beginning ritual, homework review, break, new material presentation, and wind down.
- Session lengths vary depending on client needs. Individual sessions can last 45-60 mins, friends and family groups can be 90-120 mins.
- Inpatient settings may split the sessions into two parts (homework review and new skills).
- Shorter session times (1 hr 30 mins or less) are considered too short for certain difficult groups.
Session Room Setup and Materials
- Skills training rooms should be set up to feel like a classroom setting.
- Handouts are printed on different colours of paper to improve readability.
- Three-ring binders with pockets help organized handouts and worksheets.
- Specific forms for tracking practice exercises, DBT skill diaries and distress tolerance materials (e.g., cold packs, balls, balance boards) are used.
- Snacks and drinks are provided at group sessions.
Session Beginning Rituals
- A mindfulness practice leads the session.
- Mindfulness exercises vary weekly to allow for different skill practice.
- Members share their practice attempts from the previous week.
- Clients who missed sessions explain their absence, and there is a short feedback period for the group.
- A general warm-up or introductory discussion is included to address any group concerns/ issues.
Review of Homework
- Members share their efforts to practice the skills between sessions.
- Leaders use this phase to provide feedback or guidance on how skill practice can be implemented better.
- The sharing segment is intended to ensure accountability and motivation for skill practice.
Break
- Breaks are common (10-15 mins) halfway through the sessions to refresh and facilitate interaction among participants.
- Group clients are encouraged to leave the break room.
Presentation of New Material
- New skills are presented and discussed during the session after the break.
- The rationale for the skills and how they are relevant to the participants' lives are discussed.
Closing Wind-Down
- A wind-down period is crucial for clients with emotional dysregulation, assisting with managing emotional responses.
- This segment is intended for de-escalation and to allow for reflection on observations of the day's events.
- Techniques like "observe and describe" and "process observing" might be utilized.
- Giving time for self-reflection and discussion before taking the group's adjournment helps to develop dialectical thinking.
Observing Limits
- DBT emphasizes observing limits rather than explicitly setting them in skill training contexts.
- Certain limits are implied through the boundaries of the sessions in skill training.
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Description
Explore the key concepts of DBT skills training sessions, including attendance guidelines, effectiveness in reducing suicidality, and the role of skills training leaders. Understand the foundational assumptions of DBT and the importance of individual therapy in support of client progress.
