Dialectical Behavior Therapy Is My Class Good

[Laurie2001]

I began DBT a few weeks ago. I'm finding the class very disorganized. There hasn't been a real introduction with regards to how the classes will be run, what is expected from us, what we can expect from the teachers/leaders, etc. Someone in the class had told me it was not being run the same way DBT skills classes she had taken elsewhere had been. A person walked out of the room in the middle of class very angry because of the disorganization or lack of structure. It was extremely distressing and there was no comment about what had happened even though one of the leaders of course followed her and we could hear them.

Does this sound normal to you? If you have taken DBT before could you provide me with a description of how the classes are generally structured. I'm pretty freaked out and worried about whether this will be useful but I really need it.

 

[recoveringfromptsd]

Thats scary, even for me, as I am expected to begin DBT myself soon. I hope that does not happen with me.

 

[Laurie2001]

It is my understanding that this is not the case for most places. I'm just trying to get a reality check on what I should expect. I've already emailed the leaders with my concerns. But, I need to hear from other people who've had DBT.

 

[Freedomfighter]

I began DBT a few weeks ago. I'm finding the class very disorganized. There hasn't been a real int...

Well, any kind of disorganization is worrisome, but especially if it comes to your personal health. I am often forced to work with people who do not have the necessary skills to ensure even flow, to ensure completing tasks in the most efficient way with the least amount of trouble while insisting at the same time that it is only their way that will work.

I hope in time the disorganization will lift in your class, but I have learned that any kind of disorganization stems from an inefficient leader.

 

[EveHarrington]

I've done DBT before and it was highly organized.

LOTS of rules. If you break the rules, you may have one forgiveness, otherwise you're gone.

I mean by definition doesn't it have to be?

It's the #1 treatment for borderline, a disorder which involves a lot of chaos.

It's the rigor and rigid ness of the program which helps people so much IMHO.

 

[recoveringfromptsd]

I've done DBT before and it was highly organized.

LOTS of rules. If you break the rules, you ma...

I am required to have DBT (I don't have a choice my MH care providers won't work with me anymore unless I do), on this forum I have read it was an essential part of recovery, and it was made clear on my discharge papers from SP TDU that I needed DBT.

You have me a little scared, what kind of rules?

 

[joeylittle]

Does this sound normal to you? If you have taken DBT before could you provide me with a description of how the classes are generally structured. I'm pretty freaked out and worried about whether this will be useful but I really need it.

You can ask the leader if they are going off of the Marsha Linehan protocols. Sounds like not...

Full-on DBT is three components: one group session a week, one private session (therapy) a week, and unlimited counselor support except in cases of suicidality/self harm. It's usually structured as 6 or 9 months. Some groups take rolling admissions, meaning you may enter at many different points in the material, but you'll always end up getting all the way through it.

Typical structures include discussing the log (you keep a log of the times you applied skills since the previous session), going over the next section in the workbook, doing an in-class exercise, and sometimes some brief meditation.

Many people offer DBT classes in an abbreviated form; they might just work with the group, not do the private component, may work off a workbook other than the one that is officially approved...and with those, much depends on the purpose of the group, and what the leader's goals are.

Either way, I'd suggest having a short conversation with the group leader. You might try and arrange for them to stay after and talk with you for 10 minutes.

 

[recoveringfromptsd]

They used the work book when I was in PHP in july, but in no particular order, sounds like an abbreviated form. THis sounds like its going to be hard, I am told its once a week for a year. I have a hard time just keeping a journal now, and just functioning. I have to wonder how I will get thru DBT.

Eve when I was at PRATT's TDU I had a individualized abbreviated schedule because my level of functioning was I could not keep up, so they had me not do any of the processing groups.

 

[Laurie2001]

A belated thank you joeylittle for your response. I really appreciate your advice and information. As I said I emailed the two leaders and they in the end have responded to my concerns. They explained that they are going by the book. I do have an individual DBT therapist there and calls when skills aren't working. I was having continued concerns with the main leader and did have time alone with her to discuss them. They have the modules - but they do not follow the structure in terms of time frame. They allow more time per module in case there needs to be more discussion in the group which contributes I guess to the looseness. They also start each module with a couple of weeks on mindfulness (in addition to having the separate mindfulness module). It is sort of ridiculous that I literally delineated in my email what I needed in terms of structure of the group - in terms of teaching the skills in a structured manner - because it was a little all over the place. But, they did respond. I'm a very direct person and will not hesitate to speak up especially when it comes to my treatment. Sooo I think its better. But I think they have a slightly more loose style. I don't really have the option of going anywhere else at this time - I'll try to get as much out of it as I can. But will ask for advice when I need it. I also know I really need DBT. Thanks again joeylittle

 

[Laurie2001]

You can ask the leader if they are going off of the Marsha Linehan protocols. Sounds like not...

Hi Joeylittle. I have some more concerns about my DBT program. The leaders have responded to my requests although I have had to ask a few times and sometimes and on occasion comments they make to clients are sort of the opposite of one would do when using the skills - like insensitive. But mostly I still wonder about the rigor of the program.

I read how people found the attentiveness to detail demanded was torturous but ultimately helpful. I don't want it to be torturous, but I feel like homework is pretty loose - one sheet and not everyone does it. My daily card, which I do isn't always reviewed and never taken by my therapist which I think they are supposed to do. I can be more active on my own obviously. I just am feeling like something isn't right.

And then my therapist wanted to do some training one day a month for about 7 months when we have a therapy session. We could switch it to a phone session - that's the only option. It just made me anxious about her investment. Although, she is responsive to phone calls and kind and did respond to my letting her know how I felt about how she presented her plan to miss these sessions. She had asked me if it was OK for her to do it.

And I felt asking me put me in a pretty awkward position especially since she already made it notably clear that it was extremely important to her so what was I supposed to say. Regardless I made it clear that this was something for her to decide and I'd deal. I think my reaction was compounded by the fact that I had to sign all these committing myself to rules, i.e. how many sessions I could miss.

And also when I brought up wanting more structure, again, she apologized but then said she and her partner have been doing it for so long she guesses they forget to provide the structure that may be necessary. That was just concerning to me.

Sorry this is so long, but I guess I started to worry about the degree of her investment . I mean its not all bad, but I'm having a seriously hard time now - because aspects of what's going on in the world have been majorly triggering for me so my symptoms are intense. Ugh.

I think I need to research other places. Appreciate your or anyone's responses. Thanks for "listening"!!!