DBT Group Therapy

This week I wanted to share my favorite Dialectical Behavior Group Therapy activity that I use when I run DBT groups with patients at the hospital. As we know, DBT places a strong focus on emotional regulation as well as managing distressing emotions. This activity focuses on both of those aspects and is flexible enough to leave a lot of room for patient's to take the discussion in a direction that is specific to that group of people (99% of groups that I do are with different people every time). I've had the topic end up in a lot of different places but all of them I felt were constructive and I have gotten really positive feedback from group participants. I can't take credit for creating these group therapy activities, I downloaded them from DBT Handouts, Protocols and Client Learning Activities Website, which has lots of really awesome tools to use in DBT individual or group therapy.

The activity includes handouts of a pictorial depiction of the Emotion Regulation model used in DBT, with an additional narrative for the group leader that helps describe what each picture is representing.

These two sheets describe the pictorial handout that is given to the patients that breaks down the Emotion Regulation model into six digest-able steps. I don't usually use this sheet but it was helpful to have the first time I used this activity and sometimes I will glance at it to get some inspiration for things to say if there is a lull in the discussion.

This sheet is the meet and potatoes of the activity that helps people new to DBT get a grasp on the process of emotions so they can gain insight into how activating events and our judgements made about them quickly lead to somatic responses that trigger behavioral reactions which are often negative such as cutting or drinking. I usually starting by facilitating a discussion about different events that occur that start these emotional chain reactions and end in a discussion about how we slow this process down so there is time to avoid a negative behavior reactions.

This brings me to the second part of my activity: "Ways to Manage Distress Now"

This handout has some great tried and true ways that are effective in managing extreme emotions. I like that there are a variety of different strategies, such as distraction techniques, mindfulness techniques and so on. To end the group I usually spend 10 to 15 minutes discussing which of these techniques group members have already tried that work and which techniques are new to them that they think may be helpful in the future for managing distress. I encourage the group members to keep these sheets and practice distress tolerance techniques when they are not feeling extreme emotions so they will be more mindful of ways to reduce their distress the next time they experience an extreme emotion.

As I said, the link to the website that I shared above has tons of great DBT resources to use in counseling. I have also found plenty of other websites that have great free worksheets to down load and use for a variety of different mental illness.