Adolescent Dialectial Behavioral Therapy Skills Group | Adult Dialectial Behavioral Therapy Skills Group

Adult Dialectical Behavioral Therapy (DBT) Skills Group

For adults with an eating disorder, regular daily functioning in work, school and relationships are interrupted by feelings of self-loathing, preoccupation with weight and shape, intrusive obsession with calories, and paralyzing self-doubt. The skills taught in DBT can help adults gain control over their eating disorder behaviors which will impact all areas of their life. Skill modules addressing mindfulness, emotion regulation, interpersonal effectiveness and distress tolerance empower individuals to manage their social, emotional and physical worlds with a new and expanded sense of competence and control.

DBT addresses four areas of skills necessary to increase participants’ adaptive coping and reduce the frequency and severity of eating disordered behaviors: Core Mindfulness, Distress Tolerance, Emotion Regulation, and Interpersonal Effectiveness.

Core Mindfulness Skills

Mindful awareness is requisite in order for the participants to make use of the other skills taught in DBT: Distress Tolerance, Emotion Regulation, and Interpersonal Effectiveness.  As conceptualized by Dr. Linehan, Core Mindfulness Skills, central to all other aspects of DBT, are heavily influenced by Zen practice and, “compatible with most Western contemplative and Eastern meditation practices (Linehan, M, 1993).” The mindfulness skills taught in DBT emphasize the psychological and behavioral aspects of meditative practice and the quality of awareness participants bring to all aspects of their life, including treatment and recovery.

Distress Tolerance Skills

Pain and distress are inevitable aspects of human existence. Individuals with eating disorders often attempt to escape from, and/or eliminate, pain and distress, through their eating disorder behaviors. Although the desire to feel less pain is both natural and often adaptive, for those who suffer from anorexia, bulimia and other eating disorders, the effort to escape from pain comes at the expense of engaging in life. Learning to tolerate pain and distress involves accepting, and coping adaptively, with life as it is in the moment.

Emotion regulation Skills

People with eating disorders have a difficult time managing intense emotions, and eating disorder behaviors serve as maladaptive mechanisms for reducing unpleasant emotional states. In this module, individuals learn to identify and manage their emotional reactions. Skills for emotion regulation include: identifying and labeling emotions; identifying obstacles to changing emotions; and increasing positive emotional events.

Interpersonal Effectiveness

The focus of this module is on learning to successfully assert needs and manage conflict in relationships. The interpersonal effectiveness skills taught include learning new interpersonal response patterns, including effective strategies for asking for what one needs, saying no, and coping with interpersonal conflict.

How the group is structured:

Sessions are held weekly.

Each session is structured as follows:

The group then starts over at Session 1.

Why are Core Mindfulness Skills taught 3 times?

Due to their fundamental importance, Core Mindfulness skills are taught after each of the other 3 skill modules. As a result, every participant will have 9 sessions of mindfulness training.

When do new members enter the group?

New members may enter the group only during a mindfulness module. As there are 3 mindfulness modules, some participants will enter before the DT sessions while others start prior to ER or IE. Because the group starts again at session 1, within 30 sessions all participants will have been exposed to all 4 skill areas.
The Relapse Prevention Strategy sessions serve to consolidate what participants have learned and allow time for transitions and goodbyes as those who have completed 30 sessions graduate.

Participant commitment:

We ask that all group members make a 30 session commitment in order to enter the group. A commitment of this length ensures that each group member is educated in all 4 skill areas (Mindfulness, Emotion Regulation, Interpersonal Effectiveness, and Distress Tolerance).

At the end of 30 sessions, participants are given the option to re-enroll in the group should the participant, and the group leaders, feel the participant could benefit from additional skills training.