DBT Program

The Dialectical Behavior Therapy Program

The first step to becoming involved in Bloomfield DBT is to participate in an assessment to determine eligibility. The therapist will complete a thorough history and a treatment plan to target specific goals. Then pre-treatment begins, where the therapist will explore the client's commitment and provide education and engagement. Orientation will proceed after the assessment. The therapist will then discuss expectations of treatment with the client. Both the client and therapist will make a mutual commitment before treatment beginning. The discussion will take place at this time about the client's start date in skills group and individual therapy sessions.

Individual therapy includes meeting with a DBT therapist for individual therapy once a week for 45-60 minutes. These sessions will focus on skills that can be used while working through barriers. Diary cards will be used during the session. These are used to track behaviors that could hinder progress. The clients will notice daily urges, emotions, substance use, lying, and any other targets, which they will keep track of daily. They will bring their diary card into their therapy session.

Skills group meets once a week for 90 minutes. Groups meet for 8–10 week modules which are focused on Mindfulness, Emotion Regulation, Distress Tolerance, and Interpersonal Effectiveness. The skills training groups are psycho-educational in nature. The clients will be expected to participate in learning the material through lectures, exercises, role play, handouts, and discussion of the material. The DBT program takes around one year to complete.

Parent skills group teach DBT skills while providing psycho-education to family members who have a family member that struggles with emotion regulation problems. Parents learn how to communicate effectively with their children and how to regulate their emotions in difficult situations. This group allows parents to notice and acknowledge when their child is using their skills. Parents report that the skills are useful not only with their children but in their own lives relative to work, with spouses, and friends. We hear from clients that when their parents participate, it motivates them to continue to use their skills. Parent groups are offered twice a month in the evenings. During the assessment/orientation stage of treatment, start dates will be discussed for parent participation. Our parent coach is also available to meet with parents on an individual basis to work on specific individual needs within the family.

Increase Behavioral Skills

Core Mindfulness Skills - Improves the ability to stay focused in the present moment. Mindfulness is the core DBT skill. The goal is to get to a place of wisdom or "Wise Mind." We teach clients how to notice what they are experiencing in a non-judgmental way, focus their attention, and be more in control of impulses.

Distress Tolerance Skills - These reduce impulsive and self-harming and self-destructive behaviors and quality of life interfering behaviors. It focuses on how to not make situations worse, survive or tolerate a situation or accept the situation while using skills.

Emotion Regulation Skills - Reduces suffering to emotional triggers and improves one's ability to cope with emotional pain. Emotion regulation focuses on how to understand how emotions function, ways to increase positive emotions, and decrease vulnerabilities to emotions.

Interpersonal Effectiveness Skills -Improves relationships and one's ability to become assertive enough to set appropriate boundaries with others. We focus on how to improve relationships and build skills to communicate effectively.

Coaching calls are used in between sessions with your therapist to practice the skills learned when experiencing stressful events. The skills coach will assess the situation, have the client discuss what skills they have been using, think about what skills the client can use, how they can use them, and discuss skills the coach thinks may be effective. Coaching calls are available seven days a week with your therapist, and clients can call their therapist's cell phone for coaching.

Stages of Treatment

During the first phase of treatment, therapy is focusing on decreasing any life-threatening behaviors (i.e., suicidal behaviors, thoughts, self-injury), therapy interfering behaviors (anything that gets in the way of treatment progress), and quality of life interfering behaviors (eating disorders, substance use, quitting jobs, school or relationship problems, avoiding, lying.)

The second phase of treatment is targeting decreasing emotions and behaviors that get in the way of having a life worth living. These targets help clients learn how to live their life to the fullest.

The third phase is focusing on increasing self-worth and learn how to be assertive, and work toward goals such as get a better job, do better in school or solve problems effectively.

The fourth phase is moving from a sense of incompleteness towards experiencing joy and freedom.