DBT Skills Application Group for Adults
PURPOSE:
• A process support group for clients who have completed Stage I DBT skills group and who want to continue to strengthen and generalize skills in managing distress and problems of daily living, with a special focus on behavior activation and increasing compassion towards themselves and others.
• The group is to help clients to facilitate working towards their life worth living goals in areas such as work, education, relationships, spirituality, health, sobriety, and however you define it.
• The group is led by a therapist and can be used as a step-down from the more intensive DBT program or as a way to get a refresher if desired.
*The Application group is not appropriate for crisis patterns/behaviors
Criteria and Expectation of Group Members:
• Each member will generate their goals and it is recommended that members complete for themselves, a diary card or a goal tracking sheet and are skilled at doing their own Behavior Chain Analysis.
• Members will have successfully graduated Skills Training Group and will have a fundamental knowledge of skills.
• Members will have achieved an absence or significant reduction of Stage 1 behaviors and has a Therapist referral and recommendation for readiness:
– Absence of hospitalization or ER services for 3 months
– No active self-harm, aggressive, or suicidal behaviors for 3 months
– Come to group clean and sober
• Members have a history of positive group behaviors:
– Able to stay in group despite being dysregulated
– Able to balance sharing with listening and validating and able to give and receive effective feedback
– Does not contribute to, or participate in any maladaptive behaviors of other group members
• Members will either be in DBT therapy or were successfully discharged from DBT Therapy and agree to return to therapy if stage 1 behaviors resume.
Format/ Session structure:
• The group is held every other week virtually for 1.5 hours (day/time to be determined)
• Standard DBT group guidelines apply, especially the guideline about not sharing specific details of events that might trigger someone else. The focus is on the problem solving, less so the specifics of the problem. Exceptions to the Standard DBT group guidelines are that there is no requirement to have weekly individual sessions. Developing supportive friendships outside of group is encouraged as long as they don’t interfere with group.
• Group starts with mindfulness, rotated and led by group leader or members if they choose. (This is encouraged).
• Agenda setting: Leader asks if anyone has any agenda items they want to use the group for: Examples of topics for the agenda include; “I need Validation for….”, “I need problem solving for…”, “I would like to review X skill…..”, “I would like help with skills coaching or doing a cope ahead for…..”, “I want to share a success about…..”. The group member provides a brief description of what the agenda item is about and identifies the level of urgency from 0-10. (This follows the DBT Consultation Team format)• Before we get to the agenda items, group members who haven’t identified agenda items do a Brief Check-in which is a Non-judgmental observation of example of skills used, successes and/or of struggles to use skills related to the group member’s goals.
• The group may decide to review or teach new skills as an agenda item.
• Closing: Did everyone get what they needed? What was your takeaway? (What will you be targeting, focusing on until the next group)
REFERRAL PROCESS AND FEES:
• A minimum of 3 people are needed to make the group viable otherwise it may be cancelled. The maximum is 10.
• Members will be pre-screened by telephone (if client has received or is receiving treatment from a TBC for CBT Therapist) or by a consultation session (if client is a new client to TBC for CBT) to identify individual goals for the group and insure they meet the criteria.
• Confidentiality, releases, crisis plan, telehealth consent, credit card authorization form and registration paperwork will be filled out by the start of the first group.
• Client attendance is documented on “Group progress notes”
• Members can start anytime, there are no “Modules”.
• Fee is $50.00 per session. Unlike the skills group there will not be a fee charged for missed sessions due to the philosophy that if there are things more important than group, that means you are living your life worth living and that is the goal. The 4-Miss rule still stands though.
Please contact Nancy 813-480-8482 or at nancy@tbcforcbt.com for more information