The DBT Skills Group lasts 34 weeks, or about 8 months.  There are four modules taught in this 8 month period: Mindfulness, Relationship Effectiveness, Emotion Regulation, and Distress Tolerance.  The groups are always ongoing.    Often, clients start group at the beginning of one of these modules with other clients who have already been present, some longer than others. The value of being in group with others in different stages of treatment is to gain hope and momentum from others who are already familiar with the process and making improvement.  

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The first 45 minutes of group is spent with the therapist giving about 5 minutes of coaching to each client on their current stressors and use of the skills.  The DBT Diary Card is used as a tool for clients to fill out daily and then show to the therapist each week so that the therapist is more effective at recognizing patterns of behavior and how it it relates to the clients' triggers and emotions.  Therefore, this first part of group is used for the therapist to give the client observations and direct feedback from what they see on the client's diary card and how the client is reportedly using the skills. The second half of group (another 45 minutes) is spent with the DBT therapist teaching a skill.  Handouts, outlines, and worksheets are used to assist the client in not only intellectualizing the coping skill, but exploring how to apply it to their own problem behaviors, symptoms, and relationship issues.   The group is structured more like a coping skill class.   Clients are not expected to interact or give feedback to others.  The value of clients observing others share and how the therapist gives others coaching is to assist them in gaining insight into their own issues and gain more momentum and accountability from the vulnerability and energy of watching others grow and learn in the group.  

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