Group Therapy

DBT Group Structure

Dialectical Behaviour Therapy (DBT) workshops run weekly for eight-week blocks during school term. The sessions are 1.5 hour in length and cover the DBT skills across three separate modules:

  • Emotion Regulation
  • Distress Tolerance
  • Interpersonal Effectiveness

Each of these modules incorporates Mindfulness skills for the first two workshops and at the start of the workshop each week.

Skills modules

Mindfulness

Mindfulness skills are considered a foundation of DBT learning and we cover them in every group workshop module.  These skills are aimed at increasing our awareness, focus and acceptance of the present moment.  We practice learning how to attend to the range of details (e.g. our sensations, thoughts, emotions, urges) in a situation and therefore to make wise choices, rather than ones that are driven by or deny emotions.

Emotion Regulation

Emotion Regulation is about learning how to identify emotions, in particular being able to observe emotions before they escalate so that we can respond effectively.  These skills help us to increase our understanding of the function of emotions and the factors that increase vulnerability to emotions, build our capacity to tolerate unpleasant emotions, and guide us to identify ways to generate pleasant emotions. Overall this module increases awareness of our emotions and how to respond to them effectively to reduce our suffering and increase our wellbeing.

Distress Tolerance

This module focuses on the ability to cope in a crisis (situational or emotional) and how to get through the crisis without escalating it or resorting to “problem behaviours”. This module teaches the skills for increasing our options to effectively manage and/or accept the difficult situations which life presents to us.

Interpersonal Effectiveness

Being effective in relationships means being able to maximise your chances of getting your needs met in a way that maintains relationships and maintains self-respect. An important step in this is learning to identify priorities in interpersonal interactions and to identify and manage the barriers to interpersonal effectiveness.  This module teaches skills to identify priorities and to act effectively in relationships depending on our goals.

Format of sessions

Each group workshop session teaches a new skill or set of skills which we are then asked to practice during the week.  We begin each week then by inviting feedback on this skills practice.  As the workshops are 1 hour in length, we do not revise diary cards during the workshop and we do not gain detailed feedback on skills practice.  To ensure that the skills are being applied and generalised, each member of the group is required to attend individual sessions on a fortnightly or weekly basis for the duration of the group. It is anticipated that the individual sessions will be within a DBT frame and cover the following: diary cards, chain analyses, revision of any skills that have been learnt, and behavioural and cognitive strategies to reinforce learning.

Information for persons wishing to attend a DBT group workshop

If you are not currently under the treatment of a DBT trained psychologist / psychiatrist we ask that you call the practice so that we can ask for some history and conduct a brief triage to allocate you to an appropriate clinician. A DBT trained psychologist will conduct the assessment with you and discuss the options for treatments, including attending the workshops if appropriate.

Information for external clinicians wishing to refer into the DBT group workshop

We welcome referrals from external clinicians in a couple of ways. If you are a DBT clinician and will be working with your client in a DBT frame, meeting weekly or fortnightly, checking their diary cards each session and reinforcing the skills discussed in the workshop, then we are happy to complete a 1 hour assessment prior to the group and have them attend the workshop, alongside your individual work with them.

If you are wishing to refer them into the program and will not be working within a DBT frame with them, we will assess them for the workshop and the assessing psychologist will arrange weekly or fortnightly individual sessions for the duration of the workshop. Research suggests that it is not beneficial for clients to receive DBT and another therapy at the same time. With this in mind, we recommend that the client only attends the DBT psychologist here during the workshops, rather than continuing with external individual therapy from a different therapeutic framework.  At the conclusion of the group, in consultation with you and your client, you can decide whether to have the client recommence therapy with you or to continue with the psychologist within this service.

Given the importance of the therapeutic relationship in our work with clients who benefit from DBT, we are very supportive of clients maintaining their ongoing relationship with the referring clinician, particularly when there has been a long-term history with that clinician. We aim to support the work that you are doing with them and to practice in a way that has been shown to assist clients to be most effective in their uptake and application of the DBT skills.

CFT group structure

We offer a nine week Compassion Focused Therapy group program for adults.  This typically runs in the evenings during the school term and lasts one and a half hours.  The first half of each session is dedicated to reflecting on the practice set during the week and ways we can increase our ability to gain benefit from the practices.  The second half of the session is then focused on introducing new learning and skills.  There is no pressure to disclose personal details in this group and we have guidelines to protect the anonymity of members.  At the same time, we often obtain the most benefit when we are able over time to share our experiences and struggles with the CFT practices with other group members.  We often come to realise that we are not alone in some of the challenges that we face, and we can learn ways that others have found to help overcome these challenges.

Group content

Week 1:

  • Developing our group agreements
  • Introducing the old brain and new brain
  • Reflecting on our social shaping
  • Building mindfulness

Week 2:

  • Exploring the meaning of compassion
  • Introducing the three circles model of emotions
  • Soothing rhythm breathing practice

Week 3:

  • Expanding our understanding of components of the emotion systems
    • Focusing on developing awareness of our threat system
  • Introducing imagery
  • Compassionate colour imagery practice

Week 4:

  • Understanding blocks to compassion and their potential origins
  • Introducing the model of training our compassionate mind
  • Compassionate behaviour – using our senses
  • Safe place imagery practice

Week 5:

  • Responding to myths about compassion
  • Introducing compassionate thought balancing
  • Building our compassionate image practice

Week 6:

  • Developing our compassionate self
    • Getting into role through imagery and method acting
    • Recalling compassion flowing out
  • Compassionate self imagery practice

Week 7:

  • Understanding our inner critic and the function of self-criticism
  • Preparing for compassionate letter writing
  • Compassionate self imagery towards our daily struggle

Week 8:

  • Sharing our experiences of letter writing
  • Developing our personal practice plan
  • Gathering a compassionate ‘first-aid kit’
  • Imagery of meeting our vulnerable self with our compassionate self

Week 9:

  • Reflecting on our personal practice plan
  • Processing our ending and saying goodbye
  • Compassion flowing in and out practice