Welcome to those who are coming to TBC for CBT to attend DBT Skills Group-Only ! We are excited that you chose to get started right away on learning skills to build your life worth living. It can seem overwhelming and confusing at first on how to make the most out of attending DBT Skills Group without being in the full program at TBC for CBT — here are some tips to get you started!

  1. This group is a psycho-educational group designed to teach you DBT skills while you are waiting for a TBC for CBT individual therapist to be assigned OR if you have an outside therapist. Although learning the DBT skills is an important part of DBT we want to be clear that attending a stand-alone DBT Skills Group without the rest of the DBT Treatment modalities is NOT Full Comprehensive DBT treatment. Unless you have a DBT individual therapist here, TBC for CBT is not responsible for any clinical care other than simply providing you a place and structure to learn DBT skills. You must have a primary provider who will assume responsibility for any crises or any other clinical care to attend this group. If you are on the wait list for a TBC for CBT therapist, when an opening comes up you will be notified and offered individual therapy to begin full, comprehensive DBT Treatment. Being in Skills-Only Group puts you ahead on the waitlist for an individual therapist. Group leaders will provide brief “check-ins” once a month to see how things are going and to help you problem solve any difficulties with the group. This is not individual therapy.
  2. Currently, both of our adult groups are virtual. One of our adolescent groups are in-person while the other is virtual. Our virtual groups are held on our HIPAA Compliant Zoom and are one hour and forty-five minutes. The Adult group fee is $70.00 per group unless you are receiving individual therapy or other services within TBC for CBT; in this case the fee is $65.00 per group. The Adolescent group is a Multifamily group that includes the teen and one parent who must join them to the group sessions on consistent basis. An adolescent group is also about 2 hours long, and the fee is $80.00 per group or $75.00 a client is receiving any other services at TBC for CBT, including individual therapy. There are 4 Modules of DBT skills and each module is 6-7 weeks.  You can commit to attend a group on a per-module basis, meaning you do not need to commit to the entire 4 modules; however, wishes to discontinue the group must be discussed between a client and their therapist.  Client are financially responsible for each group session in each module they commit to, regardless of attendance (no refunds). For the Adult Groups we will be teaching out of the DBT Skills Training Handouts and Worksheets by Marsha Linehan which clients will need to purchase in time for the first group. For the Adolescent Multi-family Groups, group leaders will email you a DBT training packets adapted for adolescents, created by Nancy Gordon, LCSW, Clinic Owner and adapted from the Teen Manual by Alec Miller and Jill Rathus. The packets are provided for clients and don’t require additional costs.
  3. GETTING STARTED. For clients wishing to join a DBT Skills Group as a group-only client (meaning they already have an outside therapist and are either wanting to receive DBT Skills Group services only at our center or are waiting for a DBT therapist at our center and wish to start a group while they wait), an intake call must first be completed with our intake coordinator in order to gather clinical information and to asses the client’s appropriateness to join the group (call: (813) 434-0094). After this point, the intake coordinator will email the client (or parent of the adolescent client) a patient portal set-up link which will allow then to have access to the intake forms and clinical assessments that will need to be completed prior to starting the group. The link will be emailed from our Electronic Medical Record platform, Valant MYIO. After this, the co-leader of the client’s preferred group will call to schedule a one-on-one 30-45-minute Group Orientation session (via Zoom) to further discuss group expectations and the client’s appropriateness to join the group. The Group Orientation is a standard fee of $65.00. Once this session is completed, you will be given a start date for your first group.  All forms and intake paperwork must be completed and submitted prior to starting the group, including the Credit Card Authorization form to ease in billing. In addition to the Group Orientation, the co-leader will also reach out to the client/parent on a once-per-module basis to schedule a 30-min check-in session via Zoom. Each Group-Only check-in is a standard fee of $40.00.
  4. It is advised to have clear behavioral goals to apply the skills to. It is difficult to accomplish goals that are vague or too broad. Rather than having a goal such as “I want to be happier” (which we all do!) or “I want to be calmer”, identify specific behaviors you would engage in if the goal were accomplished and, at the same time, identify behaviors you need to stop engaging in to reach those goals. For example, a goal could be increasing the ability to tolerate feedback from others without shutting down or verbally lashing out. Or a goal could be engaging in social activities outside of your home at least 1x/ week. We call these “target behaviors” and this is how you will refer to them in group.
  5. Complete either a Behavioral Chain Analysis (BCA on pages 19-23 in your DBT skills book) every time you engage in a behavior you want to decrease or eliminate, or a Missing Links Analysis when you fail to engage in a behavior you are trying to practice or increase when it would have been beneficial. Your DBT Skills group leader will reference these analysis skills, and regular use will help you get clarity around what keeps behaviors you don’t want around or stops more adaptive behaviors from being present when you want them to be!  Generally BCA’s are done with the individual therapist, not in group.  Missing links might be done in group for tardiness, missed homework, etc.
  6. While we require individuals in Skills Group-Only to have an outside provider, it is not a requirement for your outside provider to be a therapist, it could be your psychiatrist, psychologist, primary care doctor, etc.; however, we have found that individuals who have a DBT therapist tend to grasp the skills and make progress more quickly than those who do not. It is most helpful to have a therapist that you meet with on a regular basis (at least 2x/ month) who you can talk to about your behavioral goals and the skills you learn than can help with these goals.
  7. Attend all of the groups and do all of the homework! There are many valid reasons why doing one or both of those things can be incredibly challenging. If you are having difficulty with either, please be sure to try to problem-solve it on your own as well as get help from your TBC for CBT group leader and your outside provider. The skills can be incredibly effective at making changes AND, for many of us, they are a completely new way of thinking and acting. It takes dedication and commitment to keep choosing to practice the skills when having strong urges to fall back on habits you are trying to change. Like anything you have learned in your life, it takes practice to learn these new skills — give yourself as much opportunity as you can by attending group and intentionally doing the homework.
  8. Use the diary card! Make sure you get a clear understanding of how to use the diary card from your Individual therapist or group leader and complete it daily. Tracking your behaviors, moods, and skill use will increase your self-awareness and help you make the changes you want. The diary card helps to increase your use of mindfulness skills and can help behavior change to occur.  We will not be reviewing the Diary Card in Group, other than skills used.  That is saved for your private use or with an individual therapist.
  9. Talk about the skills with your support people. Sharing what you’re learning with your friends and family will increase your own understanding of the skills and will also make it possible for them to use the same language/framework with you. There are a variety of online support groups to discuss skills use as well!

Go to the Resource page at https://tbcforcbt.com/resources/ or at https://fbpda.org/bpd-resources/ for ideas. We hope this information is helpful and let us know if you have any questions.

Mindfully, Nancy and all the staff at TBC for CBT