During individual DBT therapy sessions, the therapist pays close attention to client behaviors looking for motivational concerns, including personal and environmental factors that inhibit effective behaviors (the things clients want to do more) and that elicit and reinforce maladaptive behaviors (the things clients want to do less). Then, the individual therapist is responsible for helping the client inhibit maladaptive behaviors and replace them with adaptive, skillful responses. Specifically, the therapist will utilize diary cards to help individuals track and report their behaviors between sessions. The goal is to begin recognizing the maladaptive behaviors and replacing them with one of the four modules developed through DBT. DBT modules are simply strategies you can use to navigate difficult situations. The four DBT modules are mindfulness, distress tolerance, emotion regulation, and interpersonal effectiveness.

DBT multifamily skills groups are part of the DBT process for adolescents. In most cases, teens and their families will only join these groups if the adolescent is currently engaging in comprehensive DBT with one of our therapists. Multifamily skills groups do not support groups or even traditional group therapy where people share experiences and process difficult situations with a group of their peers. Instead, DBT multifamily skills groups are geared toward learning and practicing a specific set of skills. Specifically, you’ll be learning and practicing the skills your teen should be developing during their individual and group DBT sessions. By practicing these skills as a family, you can be prepared to support your child consistently as they apply DBT strategies to their daily lives and increase the benefit of these therapy services for you teen now and in the future.

When it comes to making real change, many receive effective support through individual and/or group therapy sessions, and they’re easily able to apply these knew skills and strategies to daily life. For others, it takes time, and maybe some help understanding how to apply learned strategies and skills to your life outside the therapy practice. Comprehensive dialectical behavior therapy (DBT) incorporates a full range of therapy solutions, including phone coaching to help clients generalize new skills and strategies to be applicable to daily life.

The skills you discuss and ideas you explore in individual and group therapy sessions seem simple during your session. Then, you have to go back to your life, and it’s not always clear how to apply what you’ve learned during DBT sessions. Phone coaching is ideal when a crisis situation arises, you feel urges to self-harm, you engage in impulsive behaviors, or you’re in conflict with other people. Your therapist can help you work through the situation safely and effectively, applying your new knowledge as you move through your daily routines. On the phone, your therapist will discuss the situation, provide support, and help you find the right solution. You should expect these calls to last for about ten minutes.

At The Harmony Center for Change, we understand the value of parental involvement in your teen's treatment is a crucial factor in achieving overall success. Parents also need help not only with dialectics and validation but also with the behavior change skills of reinforcement, shaping, extinction/ignoring, and consequences. Many parents feel that their parenting is erratic, reactive, and extreme toward their emotionally dysregulated teens, and the parents often struggle with emotional dysregulation themselves while trying to implement parenting skills.

Our program includes separate sessions for parents with a therapist on the treatment team who is not the adolescent’s primary therapist. The therapist works with the teen’s parent(s) to implement more consistent and effective parenting strategies, while bringing in other DBT skills as needed (e.g., mindfulness, distress tolerance). We offer this modality to individual families for the parenting challenges that arise regarding their particular teen. We offer parenting sessions while your teen is enrolled in Comprehensive DBT; many parents feel they receive substantial help in 6–12 parent-focused sessions, whereas some opt to continue longer. The parent-training therapist then becomes the parent’s telephone skills coach. While we offer the mode to one or both parents from a family, a team could consider walking the middle path–based parenting skills as a separate group modality for parents as well.