Clinical and Wellness Center

DBT Treatment
Manhattan/Westchester NY

Clinical and Wellness Center

DBT Treatment

Manhattan/Westchester NY

At CBC’s Clinical and Wellness Centers

we are committed to providing compassionate evidence – based treatment programs to address a wide range of emotional, behavioral, lifestyle management and personal development issues.

CBC’s Dialectical Behavior Therapy Programs are compassionate, evidence-based treatments for individuals who have significant difficulty regulating emotions and behaviors. DBT targets the issues that cause distress and teach a range of skills to deal with them.

We offer both comprehensive structured DBT programs for Adults, Young Adults, Adolescents and Children and  DBT groups. Please explore our comprehensive structured DBT programs below.

Contact Us To Make An Appointment Or To Make A Referral
Contact Us To Make An Appointment Or To Make A Referral

| The Adult DBT Program |

Phase One - Assessment

At the outset of treatment, clients have a 90-minute consultation with a DBT therapist. An important initial part of treatment is evaluating the “goodness of fit” between DBT and the client’s problems and treatment goals. To this end, we assess for the presence of the following problem areas: (1-2 sessions)

1) Confusion about Self (including one’s goals and values and also how one feels and thinks);

2) Impulsive Behaviors;

3) Emotion Dysregulation; and

4) Interpersonal Difficulties.

Phase Two - Pre-Treatment

We have found that the use of special commitment strategies is very important in the pre-treatment assessment. That is, we ask clients to commit to making certain behavioral changes even though they have not yet learned how to make such changes. We do this because of the ample evidence suggesting that people are more likely to behave in a particular way if they agreed to do so beforehand. Clients are asked to agree to all aspects of treatment as described below, and his/her individual therapist will help to anticipate and problem-solve any potential treatment barriers (e.g., missing sessions due to transportation problems, staying silent in sessions, feelings of hopelessness).

(1-6 sessions)

Phase Three - Treatment

Treatment will include a combination of the following?

Weekly individual psychotherapy (approx. 28 sessions) Individual DBT therapists will help the client to:

1) identify and maintain focus on the primary problems to be addressed;
2) stay motivated to work hard in treatment and apply new behaviors in their daily lives; and
3) coordinate and consolidate the different parts of treatment and make sure it is all tailored for the particular individual’s situation.

Weekly skills training class (28 sessions) The class meets for two hours each week over a seven month period of time, and typically includes 5-9 members. It is led by two skills trainers who combine lecture, discussion, and practice exercises in order to teach the following skill modules:

  • Core mindfulness: teaches participants how to focus the mind, direct attention, and how to nonjudgmentally observe and describe what they are feeling and thinking in the moment. These skills can help adults develop a more stable sense of who they are, and can help reduce reactivity to painful thoughts and emotions.
  • Distress tolerance: targets impulsivity by teaching adults how to effectively distract and soothe themselves while considering pros and cons of their actions. These skills typically replace problem behaviors such as cutting classes, self-inflicted cutting, physical fights, and using alcohol or drugs. Other reality acceptance skills help adults learn how to radically accept and cope with painful life events that cannot be altered (e.g., divorce, death of a loved one, a diagnosis of a chronic medical illness)
  • Emotion regulation: addresses extreme emotional sensitivity, rapid mood changes, and other unregulated moods such as chronic depression, anxiety, anger and shame. Examples of specific skills include learning to identify and label emotions, learning how to increase positive moods, and learning how to make yourself less vulnerable to negative moods.
  • Interpersonal Effectiveness: targets difficulties in maintaining consistent and rewarding relationships by teaching skills such as how to ask for what you want, how to say no in a gentle yet effective manner, and how to maintain your sense of self-respect and independence in the face of external pressure.

Telephone coaching with the therapist. Phone coaching is designed to promote skills use where it matters most–in the real world. When clients feel “stuck” and unsure what to do, they are encouraged to contact their individual therapist for help in applying their newly learned DBT skills in “real time.”

Family therapy. Family therapy occurs on an as-needed basis to increase behavioral skill use within the family system, improve communication between family members, and to reduce family interactions that interfere with either the adult’s or their family’s quality of life.

(Weekly therapist-only consultation team). The two-hour consultation meeting is for DBT practitioners at CBC. The DBT treatment team meets weekly to assist each other in providing effective, efficient, and compassionate treatment. We spend time problem-solving difficulties that interfere with client progress in treatment and help keep each other practicing within a dialectical framework.

Phase Four - Graduate Group

The primary goals of our DBT Graduate Groups are

(1) to learn more advanced DBT skills;
(2) to prevent relapse by reinforcing the progress made in Phase I of DBT; and
(3) to help strengthen and generalize behavioral skills to various settings and relationships.

To achieve these goals, the group leaders encourage participants to employ all of their newly learned DBT skills, with extra attention being paid to the use of validation and problem-solving skills with each other. Each week, participants are required to identify individual homework assignments tailored to assist them in reaching their longer term goals.

The graduate group is a 90-minute group that occurs once weekly for 16 weeks, with the opportunity to re-contract for additional time if there are clear treatment goals identified.

(16 weeks, with opportunity to extend)

| The Young Adult DBT Program |  Ages 18-24 |

| The Young Adult DBT Program |  Ages 18-24 |

Phase One - Assessment

At the outset of treatment, clients have a 90-minute consultation with a DBT therapist. Depending on the age of the individual.  An important initial part of treatment is evaluating the “goodness of fit” between DBT and the client’s problems and treatment goals. To this end, we assess for the presence of the following problem areas:

1) Confusion about Self (including clarity about goals/values, and how one feels and thinks);
2) Impulsive Behavior;
3) Emotion Dysregulation; and
4) Interpersonal Difficulties.

(1-2 sessions)

Phase Two - Pre-treatment

 We have found that the use of special commitment strategies is very important in the pre-treatment assessment. That is, we ask clients to commit to making certain behavioral changes even though they have not yet learned how to make such changes. We do this because of the ample evidence suggesting that people are more likely to behave in a particular way if they agreed to do so beforehand. Clients are asked to agree to all aspects of treatment as described below, and his/her individual therapist will help to anticipate and problem-solve any potential treatment barriers (e.g., missing sessions due to transportation problems, staying silent in sessions, feelings of hopelessness).

It is often helpful for young adults to involve their parents for a portion of this pre-treatment phase to provide any additional family history, as well as to inform parents of the treatment structure and CBC’s policies involving attendance and missed appointments.

(1-6 sessions)

Phase Three - Treatment

Treatment will include a combination of the following?

Weekly individual psychotherapy (approx. 28 sessions) Individual DBT therapists will help the client to:

1) identify and maintain focus on the primary problems to be addressed;
2) stay motivated to work hard in treatment and apply new behaviors in their daily lives; and
3) coordinate and consolidate the different parts of treatment and make sure it is all tailored for the particular individual’s situation.

Weekly skills training class (28 sessions) The class meets for two hours each week over a seven month period of time, and typically includes 5-9 members. It is led by two skills trainers who combine lecture, discussion, and practice exercises in order to teach the following skill modules:

  • Core mindfulness: teaches participants how to focus the mind, direct attention, and how to nonjudgmentally observe and describe what they are feeling and thinking in the moment. These skills can help adults develop a more stable sense of who they are, and can help reduce reactivity to painful thoughts and emotions.
  • Distress tolerance: targets impulsivity by teaching adults how to effectively distract and soothe themselves while considering pros and cons of their actions. These skills typically replace problem behaviors such as cutting classes, self-inflicted cutting, physical fights, and using alcohol or drugs. Other reality acceptance skills help adults learn how to radically accept and cope with painful life events that cannot be altered (e.g., divorce, death of a loved one, a diagnosis of a chronic medical illness)
  • Emotion regulation: addresses extreme emotional sensitivity, rapid mood changes, and other unregulated moods such as chronic depression, anxiety, anger and shame. Examples of specific skills include learning to identify and label emotions, learning how to increase positive moods, and learning how to make yourself less vulnerable to negative moods.
  • Interpersonal Effectiveness: addresses difficulties in maintaining consistent and rewarding relationships by teaching skills such as how to ask for what you want, how to say no in a gentle yet effective manner, and how to maintain your sense of self-respect and independence in the face of external pressure.
  • Walking the Middle Path: targets extreme, rigid, or non-balanced thinking and behaviors among young adults and their roommates and/or family members. These skills involve learning about common areas of conflict and polarization in relationships, and reducing the conflict by learning methods of behavior change as well as methods of validation and acceptance.

Telephone coaching with the therapist. Phone coaching is designed to promote skills use where it matters most–in the real world. When clients feel “stuck” and unsure what to do, they are encouraged to contact their individual therapist for help in applying their newly learned DBT skills in “real time.”

Parents of Young Adult Skills Group (14 weeks)  Parents of young adults often feel confused and at a loss as to how to best help their young adult “children” meet their goals. This may include living more independently, finding gainful employment, improving communication, reducing conflicts, and validating their life challenges, as well as clarifying wants, needs, and expectations.  This group is co-led by two DBT therapists who teach parents some of the same skills their young adult children are learning (e.g., mindfulness, validation, distress tolerance, and interpersonal effectiveness) in the context of a supportive atmosphere.

Family therapy. Family therapy occurs on an as-needed basis to increase behavioral skill use within the family system, improve communication between family members, and to reduce family interactions that interfere with either the adult’s or their family’s quality of life.

(Weekly therapist-only consultation team). The two-hour consultation meeting is for DBT practitioners at CBC. The DBT treatment team meets weekly to assist each other in providing effective, efficient, and compassionate treatment. We spend time problem-solving difficulties that interfere with client progress in treatment and help keep each other practicing within a dialectical framework.

Phase Four - Graduate Group

The primary goals of our DBT Graduate Groups are:

(1) to learn more advanced DBT skills;
(2) to prevent relapse by reinforcing the progress made in Phase I of DBT; and
(3) to help strengthen and generalize behavioral skills to various settings and relationships.

To achieve these goals, the group leaders encourage participants to employ all of their newly learned DBT skills, with extra attention being paid to the use of validation and problem-solving skills with each other. Each week, participants are required to identify individual homework assignments tailored to assist them in reaching their longer term goals. The graduate group is a 90-minute group that occurs once weekly for 16 weeks, with the opportunity to re-contract for additional time if there are clear treatment goals identified.

(16 weeks, with opportunity to extend)

| The Adolescent DBT Program | Ages 12-18  |

Phase One - Assessment

At the outset of treatment, teens and their caregivers have a 90-minute consultation with a DBT therapist.   An important initial part of treatment is evaluating the “goodness of fit” between DBT and the client’s problems and treatment goals. To this end, we assess for the presence of the following 5 problem areas:

1) Confusion about Self (including goals, values, and how one feels and thinks; as well as difficulty consistently maintaining attentional control);
2) Impulsive Behavior;
3) Emotion Dysregulation;
4) Interpersonal Difficulties and
5) Adolescent-Family Challenges.

(1-2 sessions)

Phase Two - Pre-treatment

We have also found that the use of special commitment strategies is very important in the pre-treatment assessment. That is, we ask clients to commit to making certain behavioral changes even though they have not learned to master them. This is based on ample evidence suggesting that people are more likely to behave in a particular way if they agreed to do so beforehand. We also explain all aspects of treatment, and anticipate and problem-solve any potential treatment barriers (e.g., not attending sessions, staying silent in sessions, feelings of hopelessness). We seek commitment not only from adolescents, but also from the accompanying caregivers.

The use of commitment strategies is crucial for teenagers, given that many would not “choose” to be in therapy if given the option. Since adolescents have often not yet experienced the consequences of their behavior, they may feel unconcerned about them. As such, adolescents are often encouraged or mandated by parents, teachers, or friends to seek treatment, and may not be “motivated” initially. It is for this reason that the individual DBT therapist spends a significant amount of time during the early phases of treatment using commitment strategies that aim to help teens understand the triggers of their behaviors, the consequences, both positive and negative, of their behaviors, and the implications for behavior change.

(1-6 sessions)

Phase Three - Treatment

Treatment will include a combination of the following?

Weekly individual psychotherapy (Minimum of 24 sessions)

Individual DBT therapists will help the client to 1) identify and maintain focus on the primary problems to be addressed; 2) stay motivated to work hard in treatment and apply new behaviors in their daily lives; and 3) coordinate and consolidate the different parts of treatment and make sure it is all tailored for the particular teenager and family.

Weekly multi-family skills training class (24 sessions)

The class meets for two hours each week in the evening and includes 3-5 teens along with their caregiver(s). Each family learns skills, and parents learn to understand and respond to certain adolescent behaviors, to encourage use of the skills at home, and to receive support from each other within a DBT framework. The class lasts for 24 sessions and is led by two skills trainers who combine lecture, discussion, and practice exercises in order to teach the following skill modules:

  • Core mindfulness: teaches participants how to focus the mind, direct attention, and how to non judgmentally observe and describe what they are feeling and thinking in the moment. These skills can help teens develop a more stable sense of who they are, and can help reduce reactivity to painful thoughts and emotions. 
  • Distress tolerance: targets impulsivity by teaching teens how to effectively distract and soothe themselves while considering pros and cons of their actions. These skills typically replace problem behaviors such as cutting classes, self-inflicted cutting, physical fights, and using alcohol or drugs. 
  • Emotion regulation: addresses extreme emotional sensitivity, rapid mood changes, and other unregulated moods such as chronic depression, anxiety, or hostility. Examples of specific skills include learning to identify and label emotions, learning how to increase positive moods, and learning how to make yourself less vulnerable to negative moods. 
  • Interpersonal Effectiveness: addresses difficulties in maintaining consistent and rewarding relationships by teaching skills such as how to ask for what you want, how to say no in a gentle yet effective manner, and how to maintain your sense of self-respect and independence in the face of peer pressure. 
  • Walking the Middle Path: targets extreme, rigid, or non-balanced thinking and behaviors among young adults and their roommates and/or family members. These skills involve learning about common areas of conflict and polarization in relationships, and reducing the conflict by learning methods of behavior change as well as methods of validation and acceptance.

Inter-session telephone coaching for the teen and the parents.  Phone coaching is designed to promote skills use where it matters most–in the real world. When adolescents feel “stuck” and unsure what to do, they are encouraged to contact their individual therapist for help in using DBT skills. In addition, parents are able to contact one of the skills trainers for coaching in how to apply skills with their teens while they are participating in the skills group.

Specialized Parenting Sessions. Parents often benefit from an (unspecified) number of additional sessions with a parenting coach (who is typically one of the multi-family skills group leaders so the parents are already familiar with this person).  The coach offers specialized parenting strategies to assist parents reaching their goals in a planful and proactive manner rather than relying on a reactive crisis-oriented approach.  

Family therapy.  Family therapy occurs on an as-needed basis to increase behavioral skill use within the family system, improve communication between family members, and to reduce family interactions that interfere with either the adolescent’s or the family’s quality of life.

(Weekly therapist-only consultation team).  The two-hour therapist-only consultation meeting is for DBT practitioners at CBC. The DBT treatment team meets weekly to assist each other in providing effective, efficient, and compassionate treatment. We spend time problem-solving difficulties that interfere with client progress in treatment and help keep each other practicing within a dialectical framework.

Phase Four - Graduate Group

Graduate group is strongly recommended for adolescents who have completed the 24-week multi-family skills training group (Phase I). Research with adolescents suggests that a continuation phase of treatment is necessary following an acute phase of treatment to help reduce the chances of relapse (back to their old behavioral patterns and symptoms).

Thus, the primary goals of our DBT Graduate Group are

(1) to prevent relapse by reinforcing the progress made in Phase I of DBT;
(2) to help the adolescents strengthen and generalize their behavioral skills to various settings and relationships; and
(3) to help the adolescents increase behaviors that improve their overall quality of life while decreasing behaviors that impede their quality of life.

To achieve these goals, the group leaders encourage the adolescents to employ all of their newly learned DBT skills, with extra attention being paid to the use of validation and problem-solving skills with each other. Each week, the adolescents are required to identify individual homework assignments tailored to assist them in reaching their longer term goals.

The graduate group is a 90-minute group that occurs once weekly for 16 weeks, with the opportunity to re-contract for additional time if there are clear treatment goals identified.

(approx 16 weeks)

 

Clients contract for an initial 16 sessions with an option to renew at the end of the graduate group cycle

|The Child DBT Program | Ages 8-11 |

Phase One - Assessment

At the outset of treatment, children and their caregivers have a 90-minute consultation with a DBT therapist. An important initial part of treatment is evaluating the “goodness of fit” between DBT and the child’s problems and treatment goals.

To this end, we assess for the presence of the following 5 problem areas:

1) Confusion about Self (including how one feels and thinks; as well as difficulty consistently maintaining attentional control);
2) Impulsive Behavior;
3) Emotion Dysregulation;
4) Interpersonal Difficulties and 5) Child-Family Challenges.

(1-2 sessions)

Phase Two - Pre-treatment

We have  found that the use of special commitment strategies is very important in the pre-treatment assessment. That is, we ask children to commit to making certain behavioral changes even though they have not learned to master them. This is based on ample evidence suggesting that people are more likely to behave in a particular way if they agreed to do so beforehand. We also explain all aspects of treatment the child and his or her parents, and anticipate and problem-solve any potential treatment barriers (e.g., not attending sessions, staying silent in sessions, feelings of hopelessness). We seek commitment not only from the child but also from the accompanying caregivers.

The use of commitment strategies is crucial for children, given that many would not “choose” to be in therapy if given the option. Since children have often not yet experienced long-term consequences of their behavior, they may feel unconcerned about them. As such, children are often encouraged or mandated by parents or school personnel to seek treatment, and may not be “motivated” initially. It is for this reason that the individual DBT therapist spends time during the early phases of treatment using commitment strategies that aim to help the child understand the triggers of his/her behaviors, the consequences, both positive and negative, of their behaviors, and the implications for behavior change.

(1-6 sessions)

Phase Three - Treatment

Treatment will include a combination of the following?

Weekly individual psychotherapy (24 sessions)
Individual DBT therapists will help the child to 1) identify and maintain focus on the primary problems to be addressed; 2) stay motivated to work hard in treatment and apply new behaviors in their daily lives; and 3) coordinate and consolidate the different parts of treatment and make sure it is all tailored for the particular child and family.

Weekly multi-family skills training class (24 sessions)
The multi-family skills class meets for 90-minutes each week in the evening and includes 3-5 children along with their caregiver(s). For the first half of the group session the children and caregivers will learn the DBT skills (described below) together. For the second half of the group session, the group will be divided into two smaller groups.  The children will continue to practice the newly learned skills with one of the DBT skills trainers while the parents go into a room next door and learn specialized behavioral management strategies to effectively handle the children’s behavioral difficulties.  Each family learns skills, and parents learn to understand and respond to certain maladaptive behaviors, to encourage use of the skills at home, and to receive support from each other within a DBT framework. The class lasts for 24 sessions and is led by two skills trainers who combine lecture, discussion, and practice exercises in order to teach the following skill modules:

  • Core mindfulness: teaches participants how to focus the mind, direct attention, and how to non judgmentally observe and describe what they are feeling and thinking in the moment. These skills can help teens develop a more stable sense of who they are, and can help reduce reactivity to painful thoughts and emotions. 
  • Distress tolerance: targets impulsivity by teaching teens how to effectively distract and soothe themselves while considering pros and cons of their actions. These skills typically replace problem behaviors such as leaving their classrooms, oppositional and defiant behavior at home and/or at school, emotional outbursts at home and/or school, that may involve temper tantrums. 
  • Emotion regulation: addresses extreme emotional sensitivity, rapid mood changes, and other unregulated moods such as chronic depression, anxiety, or hostility. Examples of specific skills include learning to identify and label emotions, learning how to increase positive moods, and learning how to make yourself less vulnerable to negative moods.
  • Interpersonal Effectiveness: addresses difficulties in maintaining consistent and rewarding relationships by teaching skills such as how to ask for what you want, how to say no in a gentle yet effective manner, and how to maintain your sense of self-respect and independence in the face of peer pressure. 
  • Walking the Middle Path: targets extreme, rigid, or non-balanced thinking and behaviors among young adults and their roommates and/or family members. These skills involve learning about common areas of conflict and polarization in relationships, and reducing the conflict by learning methods of behavior change as well as methods of validation and acceptance. 

Inter-session telephone coaching for the child and the parent
Phone coaching is designed to promote skills use where it matters most–in the real world. When adolescents feel “stuck” and unsure what to do, they are encouraged to contact their individual therapist for help in using DBT skills.

In addition, parents are able to contact one of the skills trainers for coaching in how to apply skills with their teens.

Specialized Parenting Sessions.
Parents often benefit from an (unspecified) number of additional sessions with a parenting coach (who is typically one of the multi-family skills group leaders so the parents are already familiar with this person).  The coach offers specialized parenting strategies to assist parents reaching their goals in a planful and proactive manner rather than relying on a reactive crisis-oriented approach.  

Family therapy.
Family therapy occurs on an as-needed basis to increase behavioral skill use within the family system, improve communication between family members, and to reduce family interactions that interfere with either the adolescent’s or the family’s quality of life.

(Weekly therapist-only consultation team).
The two-hour therapist-only consultation meeting is for DBT practitioners at CBC. The DBT treatment team meets weekly to assist each other in providing effective, efficient, and compassionate treatment. We spend time problem-solving difficulties that interfere with client progress in treatment and help keep each other practicing within a dialectical framework.

Phase Four - Graduate Group

MISSing – is this ok?

Graduate group is strongly recommended for adolescents who have completed the 24-week multi-family skills training group (Phase I). Research with adolescents suggests that a continuation phase of treatment is necessary following an acute phase of treatment to help reduce the chances of relapse (back to their old behavioral patterns and symptoms).

Thus, the primary goals of our DBT Graduate Group are

(1) to prevent relapse by reinforcing the progress made in Phase I of DBT;
(2) to help the adolescents strengthen and generalize their behavioral skills to various settings and relationships; and
(3) to help the adolescents increase behaviors that improve their overall quality of life while decreasing behaviors that impede their quality of life.

To achieve these goals, the group leaders encourage the adolescents to employ all of their newly learned DBT skills, with extra attention being paid to the use of validation and problem-solving skills with each other. Each week, the adolescents are required to identify individual homework assignments tailored to assist them in reaching their longer term goals.

The graduate group is a 90-minute group that occurs once weekly for 16 weeks, with the opportunity to re-contract for additional time if there are clear treatment goals identified.

(approx 16 weeks)

 

Clients contract for an initial 16 sessions with an option to renew at the end of the graduate group cycle

Please contact our Director of Intake Services at 212-595-9559 (ext.5) or 914-385-1150 (ext.1), or fill out the form above, with any questions regarding eligibility, for further information, or to make a referral.  If you are a current patient at CBC, please speak to your individual therapist to see how this group may be of added benefit to you.

At CBC’s Clinical and Wellness Centers

we are committed to providing compassionate evidence – based treatment programs to address a wide range of emotional, behavioral, lifestyle management and personal development issues.

CBC’s Dialectical Behavior Therapy Programs are compassionate, evidence-based treatments for individuals who have significant difficulty regulating emotions and behaviors. DBT targets the issues that cause distress and teach a range of skills to deal with them.

We offer both comprehensive structured DBT programs for Adults, Young Adults, Adolescents and Children and  DBT groups. Please explore our comprehensive structured DBT programs below.

Contact Us To Make An Appointment Or To Make A Referral

| The Adult DBT Program |

Phase One - Assessment

At the outset of treatment, clients have a 90-minute consultation with a DBT therapist. An important initial part of treatment is evaluating the “goodness of fit” between DBT and the client’s problems and treatment goals. To this end, we assess for the presence of the following problem areas: (1-2 sessions)

1) Confusion about Self (including one’s goals and values and also how one feels and thinks);

2) Impulsive Behaviors;

3) Emotion Dysregulation; and

4) Interpersonal Difficulties.

Phase Two - Pre-Treatment

We have found that the use of special commitment strategies is very important in the pre-treatment assessment. That is, we ask clients to commit to making certain behavioral changes even though they have not yet learned how to make such changes. We do this because of the ample evidence suggesting that people are more likely to behave in a particular way if they agreed to do so beforehand. Clients are asked to agree to all aspects of treatment as described below, and his/her individual therapist will help to anticipate and problem-solve any potential treatment barriers (e.g., missing sessions due to transportation problems, staying silent in sessions, feelings of hopelessness).

(1-6 sessions)

Phase Three - Treatment

Treatment will include a combination of the following?

Weekly individual psychotherapy (approx. 28 sessions) Individual DBT therapists will help the client to:

1) identify and maintain focus on the primary problems to be addressed;
2) stay motivated to work hard in treatment and apply new behaviors in their daily lives; and
3) coordinate and consolidate the different parts of treatment and make sure it is all tailored for the particular individual’s situation.

Weekly skills training class (28 sessions) The class meets for two hours each week over a seven month period of time, and typically includes 5-9 members. It is led by two skills trainers who combine lecture, discussion, and practice exercises in order to teach the following skill modules:

  • Core mindfulness: teaches participants how to focus the mind, direct attention, and how to nonjudgmentally observe and describe what they are feeling and thinking in the moment. These skills can help adults develop a more stable sense of who they are, and can help reduce reactivity to painful thoughts and emotions.
  • Distress tolerance: targets impulsivity by teaching adults how to effectively distract and soothe themselves while considering pros and cons of their actions. These skills typically replace problem behaviors such as cutting classes, self-inflicted cutting, physical fights, and using alcohol or drugs. Other reality acceptance skills help adults learn how to radically accept and cope with painful life events that cannot be altered (e.g., divorce, death of a loved one, a diagnosis of a chronic medical illness)
  • Emotion regulation: addresses extreme emotional sensitivity, rapid mood changes, and other unregulated moods such as chronic depression, anxiety, anger and shame. Examples of specific skills include learning to identify and label emotions, learning how to increase positive moods, and learning how to make yourself less vulnerable to negative moods.
  • Interpersonal Effectiveness: targets difficulties in maintaining consistent and rewarding relationships by teaching skills such as how to ask for what you want, how to say no in a gentle yet effective manner, and how to maintain your sense of self-respect and independence in the face of external pressure.

Telephone coaching with the therapist. Phone coaching is designed to promote skills use where it matters most–in the real world. When clients feel “stuck” and unsure what to do, they are encouraged to contact their individual therapist for help in applying their newly learned DBT skills in “real time.”

Family therapy. Family therapy occurs on an as-needed basis to increase behavioral skill use within the family system, improve communication between family members, and to reduce family interactions that interfere with either the adult’s or their family’s quality of life.

(Weekly therapist-only consultation team). The two-hour consultation meeting is for DBT practitioners at CBC. The DBT treatment team meets weekly to assist each other in providing effective, efficient, and compassionate treatment. We spend time problem-solving difficulties that interfere with client progress in treatment and help keep each other practicing within a dialectical framework.

Phase Four - Graduate Group

The primary goals of our DBT Graduate Groups are

(1) to learn more advanced DBT skills;
(2) to prevent relapse by reinforcing the progress made in Phase I of DBT; and
(3) to help strengthen and generalize behavioral skills to various settings and relationships.

To achieve these goals, the group leaders encourage participants to employ all of their newly learned DBT skills, with extra attention being paid to the use of validation and problem-solving skills with each other. Each week, participants are required to identify individual homework assignments tailored to assist them in reaching their longer term goals.

The graduate group is a 90-minute group that occurs once weekly for 16 weeks, with the opportunity to re-contract for additional time if there are clear treatment goals identified.

(16 weeks, with opportunity to extend)

| Young Adult DBT Program |

Phase One - Assessment

At the outset of treatment, clients have a 90-minute consultation with a DBT therapist. Depending on the age of the individual.  An important initial part of treatment is evaluating the “goodness of fit” between DBT and the client’s problems and treatment goals. To this end, we assess for the presence of the following problem areas:

1) Confusion about Self (including clarity about goals/values, and how one feels and thinks);
2) Impulsive Behavior;
3) Emotion Dysregulation; and
4) Interpersonal Difficulties.

(1-2 sessions)

Phase Two - Pre-treatment

 We have found that the use of special commitment strategies is very important in the pre-treatment assessment. That is, we ask clients to commit to making certain behavioral changes even though they have not yet learned how to make such changes. We do this because of the ample evidence suggesting that people are more likely to behave in a particular way if they agreed to do so beforehand. Clients are asked to agree to all aspects of treatment as described below, and his/her individual therapist will help to anticipate and problem-solve any potential treatment barriers (e.g., missing sessions due to transportation problems, staying silent in sessions, feelings of hopelessness).

It is often helpful for young adults to involve their parents for a portion of this pre-treatment phase to provide any additional family history, as well as to inform parents of the treatment structure and CBC’s policies involving attendance and missed appointments.

(1-6 sessions)

Phase Three - Treatment

Treatment will include a combination of the following?

Weekly individual psychotherapy (approx. 28 sessions) Individual DBT therapists will help the client to:

1) identify and maintain focus on the primary problems to be addressed;
2) stay motivated to work hard in treatment and apply new behaviors in their daily lives; and
3) coordinate and consolidate the different parts of treatment and make sure it is all tailored for the particular individual’s situation.

Weekly skills training class (28 sessions) The class meets for two hours each week over a seven month period of time, and typically includes 5-9 members. It is led by two skills trainers who combine lecture, discussion, and practice exercises in order to teach the following skill modules:

  • Core mindfulness: teaches participants how to focus the mind, direct attention, and how to nonjudgmentally observe and describe what they are feeling and thinking in the moment. These skills can help adults develop a more stable sense of who they are, and can help reduce reactivity to painful thoughts and emotions.
  • Distress tolerance: targets impulsivity by teaching adults how to effectively distract and soothe themselves while considering pros and cons of their actions. These skills typically replace problem behaviors such as cutting classes, self-inflicted cutting, physical fights, and using alcohol or drugs. Other reality acceptance skills help adults learn how to radically accept and cope with painful life events that cannot be altered (e.g., divorce, death of a loved one, a diagnosis of a chronic medical illness)
  • Emotion regulation: addresses extreme emotional sensitivity, rapid mood changes, and other unregulated moods such as chronic depression, anxiety, anger and shame. Examples of specific skills include learning to identify and label emotions, learning how to increase positive moods, and learning how to make yourself less vulnerable to negative moods.
  • Interpersonal Effectiveness: addresses difficulties in maintaining consistent and rewarding relationships by teaching skills such as how to ask for what you want, how to say no in a gentle yet effective manner, and how to maintain your sense of self-respect and independence in the face of external pressure.
  • Walking the Middle Path: targets extreme, rigid, or non-balanced thinking and behaviors among young adults and their roommates and/or family members. These skills involve learning about common areas of conflict and polarization in relationships, and reducing the conflict by learning methods of behavior change as well as methods of validation and acceptance.

Telephone coaching with the therapist. Phone coaching is designed to promote skills use where it matters most–in the real world. When clients feel “stuck” and unsure what to do, they are encouraged to contact their individual therapist for help in applying their newly learned DBT skills in “real time.”

Parents of Young Adult Skills Group (14 weeks)  Parents of young adults often feel confused and at a loss as to how to best help their young adult “children” meet their goals. This may include living more independently, finding gainful employment, improving communication, reducing conflicts, and validating their life challenges, as well as clarifying wants, needs, and expectations.  This group is co-led by two DBT therapists who teach parents some of the same skills their young adult children are learning (e.g., mindfulness, validation, distress tolerance, and interpersonal effectiveness) in the context of a supportive atmosphere.

Family therapy. Family therapy occurs on an as-needed basis to increase behavioral skill use within the family system, improve communication between family members, and to reduce family interactions that interfere with either the adult’s or their family’s quality of life.

(Weekly therapist-only consultation team). The two-hour consultation meeting is for DBT practitioners at CBC. The DBT treatment team meets weekly to assist each other in providing effective, efficient, and compassionate treatment. We spend time problem-solving difficulties that interfere with client progress in treatment and help keep each other practicing within a dialectical framework.

Phase Four - Graduate Group

The primary goals of our DBT Graduate Groups are:

(1) to learn more advanced DBT skills;
(2) to prevent relapse by reinforcing the progress made in Phase I of DBT; and
(3) to help strengthen and generalize behavioral skills to various settings and relationships.

To achieve these goals, the group leaders encourage participants to employ all of their newly learned DBT skills, with extra attention being paid to the use of validation and problem-solving skills with each other. Each week, participants are required to identify individual homework assignments tailored to assist them in reaching their longer term goals. The graduate group is a 90-minute group that occurs once weekly for 16 weeks, with the opportunity to re-contract for additional time if there are clear treatment goals identified.

(16 weeks, with opportunity to extend)

| The Adolescent DBT Program ~ Ages 12-18  |

Phase One - Assessment

At the outset of treatment, teens and their caregivers have a 90-minute consultation with a DBT therapist.   An important initial part of treatment is evaluating the “goodness of fit” between DBT and the client’s problems and treatment goals. To this end, we assess for the presence of the following 5 problem areas:

1) Confusion about Self (including goals, values, and how one feels and thinks; as well as difficulty consistently maintaining attentional control);
2) Impulsive Behavior;
3) Emotion Dysregulation;
4) Interpersonal Difficulties and
5) Adolescent-Family Challenges.

(1-2 sessions)

Phase Two - Pre-treatment

We have also found that the use of special commitment strategies is very important in the pre-treatment assessment. That is, we ask clients to commit to making certain behavioral changes even though they have not learned to master them. This is based on ample evidence suggesting that people are more likely to behave in a particular way if they agreed to do so beforehand. We also explain all aspects of treatment, and anticipate and problem-solve any potential treatment barriers (e.g., not attending sessions, staying silent in sessions, feelings of hopelessness). We seek commitment not only from adolescents, but also from the accompanying caregivers.

The use of commitment strategies is crucial for teenagers, given that many would not “choose” to be in therapy if given the option. Since adolescents have often not yet experienced the consequences of their behavior, they may feel unconcerned about them. As such, adolescents are often encouraged or mandated by parents, teachers, or friends to seek treatment, and may not be “motivated” initially. It is for this reason that the individual DBT therapist spends a significant amount of time during the early phases of treatment using commitment strategies that aim to help teens understand the triggers of their behaviors, the consequences, both positive and negative, of their behaviors, and the implications for behavior change.

(1-6 sessions)

Phase Three - Treatment

Treatment will include a combination of the following?

Weekly individual psychotherapy (Minimum of 24 sessions)

Individual DBT therapists will help the client to 1) identify and maintain focus on the primary problems to be addressed; 2) stay motivated to work hard in treatment and apply new behaviors in their daily lives; and 3) coordinate and consolidate the different parts of treatment and make sure it is all tailored for the particular teenager and family.

Weekly multi-family skills training class (24 sessions)

The class meets for two hours each week in the evening and includes 3-5 teens along with their caregiver(s). Each family learns skills, and parents learn to understand and respond to certain adolescent behaviors, to encourage use of the skills at home, and to receive support from each other within a DBT framework. The class lasts for 24 sessions and is led by two skills trainers who combine lecture, discussion, and practice exercises in order to teach the following skill modules:

  • Core mindfulness: teaches participants how to focus the mind, direct attention, and how to non judgmentally observe and describe what they are feeling and thinking in the moment. These skills can help teens develop a more stable sense of who they are, and can help reduce reactivity to painful thoughts and emotions. 
  • Distress tolerance: targets impulsivity by teaching teens how to effectively distract and soothe themselves while considering pros and cons of their actions. These skills typically replace problem behaviors such as cutting classes, self-inflicted cutting, physical fights, and using alcohol or drugs. 
  • Emotion regulation: addresses extreme emotional sensitivity, rapid mood changes, and other unregulated moods such as chronic depression, anxiety, or hostility. Examples of specific skills include learning to identify and label emotions, learning how to increase positive moods, and learning how to make yourself less vulnerable to negative moods. 
  • Interpersonal Effectiveness: addresses difficulties in maintaining consistent and rewarding relationships by teaching skills such as how to ask for what you want, how to say no in a gentle yet effective manner, and how to maintain your sense of self-respect and independence in the face of peer pressure. 
  • Walking the Middle Path: targets extreme, rigid, or non-balanced thinking and behaviors among young adults and their roommates and/or family members. These skills involve learning about common areas of conflict and polarization in relationships, and reducing the conflict by learning methods of behavior change as well as methods of validation and acceptance.

Inter-session telephone coaching for the teen and the parents.  Phone coaching is designed to promote skills use where it matters most–in the real world. When adolescents feel “stuck” and unsure what to do, they are encouraged to contact their individual therapist for help in using DBT skills. In addition, parents are able to contact one of the skills trainers for coaching in how to apply skills with their teens while they are participating in the skills group.

Specialized Parenting Sessions. Parents often benefit from an (unspecified) number of additional sessions with a parenting coach (who is typically one of the multi-family skills group leaders so the parents are already familiar with this person).  The coach offers specialized parenting strategies to assist parents reaching their goals in a planful and proactive manner rather than relying on a reactive crisis-oriented approach.  

Family therapy.  Family therapy occurs on an as-needed basis to increase behavioral skill use within the family system, improve communication between family members, and to reduce family interactions that interfere with either the adolescent’s or the family’s quality of life.

(Weekly therapist-only consultation team).  The two-hour therapist-only consultation meeting is for DBT practitioners at CBC. The DBT treatment team meets weekly to assist each other in providing effective, efficient, and compassionate treatment. We spend time problem-solving difficulties that interfere with client progress in treatment and help keep each other practicing within a dialectical framework.

Phase Four - Graduate Group

Graduate group is strongly recommended for adolescents who have completed the 24-week multi-family skills training group (Phase I). Research with adolescents suggests that a continuation phase of treatment is necessary following an acute phase of treatment to help reduce the chances of relapse (back to their old behavioral patterns and symptoms).

Thus, the primary goals of our DBT Graduate Group are

(1) to prevent relapse by reinforcing the progress made in Phase I of DBT;
(2) to help the adolescents strengthen and generalize their behavioral skills to various settings and relationships; and
(3) to help the adolescents increase behaviors that improve their overall quality of life while decreasing behaviors that impede their quality of life.

To achieve these goals, the group leaders encourage the adolescents to employ all of their newly learned DBT skills, with extra attention being paid to the use of validation and problem-solving skills with each other. Each week, the adolescents are required to identify individual homework assignments tailored to assist them in reaching their longer term goals.

The graduate group is a 90-minute group that occurs once weekly for 16 weeks, with the opportunity to re-contract for additional time if there are clear treatment goals identified.

(approx 16 weeks)

 

Clients contract for an initial 16 sessions with an option to renew at the end of the graduate group cycle

|The Child DBT Program ~ Ages 8-11 |

Phase One - Assessment

At the outset of treatment, children and their caregivers have a 90-minute consultation with a DBT therapist. An important initial part of treatment is evaluating the “goodness of fit” between DBT and the child’s problems and treatment goals.

To this end, we assess for the presence of the following 5 problem areas:

1) Confusion about Self (including how one feels and thinks; as well as difficulty consistently maintaining attentional control);
2) Impulsive Behavior;
3) Emotion Dysregulation;
4) Interpersonal Difficulties and 5) Child-Family Challenges.

(1-2 sessions)

Phase Two - Pre-treatment

We have  found that the use of special commitment strategies is very important in the pre-treatment assessment. That is, we ask children to commit to making certain behavioral changes even though they have not learned to master them. This is based on ample evidence suggesting that people are more likely to behave in a particular way if they agreed to do so beforehand. We also explain all aspects of treatment the child and his or her parents, and anticipate and problem-solve any potential treatment barriers (e.g., not attending sessions, staying silent in sessions, feelings of hopelessness). We seek commitment not only from the child but also from the accompanying caregivers.

The use of commitment strategies is crucial for children, given that many would not “choose” to be in therapy if given the option. Since children have often not yet experienced long-term consequences of their behavior, they may feel unconcerned about them. As such, children are often encouraged or mandated by parents or school personnel to seek treatment, and may not be “motivated” initially. It is for this reason that the individual DBT therapist spends time during the early phases of treatment using commitment strategies that aim to help the child understand the triggers of his/her behaviors, the consequences, both positive and negative, of their behaviors, and the implications for behavior change.

(1-6 sessions)

Phase Three - Treatment

Treatment will include a combination of the following?

Weekly individual psychotherapy (24 sessions)
Individual DBT therapists will help the child to 1) identify and maintain focus on the primary problems to be addressed; 2) stay motivated to work hard in treatment and apply new behaviors in their daily lives; and 3) coordinate and consolidate the different parts of treatment and make sure it is all tailored for the particular child and family.

Weekly multi-family skills training class (24 sessions)
The multi-family skills class meets for 90-minutes each week in the evening and includes 3-5 children along with their caregiver(s). For the first half of the group session the children and caregivers will learn the DBT skills (described below) together. For the second half of the group session, the group will be divided into two smaller groups.  The children will continue to practice the newly learned skills with one of the DBT skills trainers while the parents go into a room next door and learn specialized behavioral management strategies to effectively handle the children’s behavioral difficulties.  Each family learns skills, and parents learn to understand and respond to certain maladaptive behaviors, to encourage use of the skills at home, and to receive support from each other within a DBT framework. The class lasts for 24 sessions and is led by two skills trainers who combine lecture, discussion, and practice exercises in order to teach the following skill modules:

  • Core mindfulness: teaches participants how to focus the mind, direct attention, and how to non judgmentally observe and describe what they are feeling and thinking in the moment. These skills can help teens develop a more stable sense of who they are, and can help reduce reactivity to painful thoughts and emotions. 
  • Distress tolerance: targets impulsivity by teaching teens how to effectively distract and soothe themselves while considering pros and cons of their actions. These skills typically replace problem behaviors such as leaving their classrooms, oppositional and defiant behavior at home and/or at school, emotional outbursts at home and/or school, that may involve temper tantrums. 
  • Emotion regulation: addresses extreme emotional sensitivity, rapid mood changes, and other unregulated moods such as chronic depression, anxiety, or hostility. Examples of specific skills include learning to identify and label emotions, learning how to increase positive moods, and learning how to make yourself less vulnerable to negative moods.
  • Interpersonal Effectiveness: addresses difficulties in maintaining consistent and rewarding relationships by teaching skills such as how to ask for what you want, how to say no in a gentle yet effective manner, and how to maintain your sense of self-respect and independence in the face of peer pressure. 
  • Walking the Middle Path: targets extreme, rigid, or non-balanced thinking and behaviors among young adults and their roommates and/or family members. These skills involve learning about common areas of conflict and polarization in relationships, and reducing the conflict by learning methods of behavior change as well as methods of validation and acceptance. 

Inter-session telephone coaching for the child and the parent
Phone coaching is designed to promote skills use where it matters most–in the real world. When adolescents feel “stuck” and unsure what to do, they are encouraged to contact their individual therapist for help in using DBT skills.

In addition, parents are able to contact one of the skills trainers for coaching in how to apply skills with their teens.

Specialized Parenting Sessions.
Parents often benefit from an (unspecified) number of additional sessions with a parenting coach (who is typically one of the multi-family skills group leaders so the parents are already familiar with this person).  The coach offers specialized parenting strategies to assist parents reaching their goals in a planful and proactive manner rather than relying on a reactive crisis-oriented approach.  

Family therapy.
Family therapy occurs on an as-needed basis to increase behavioral skill use within the family system, improve communication between family members, and to reduce family interactions that interfere with either the adolescent’s or the family’s quality of life.

(Weekly therapist-only consultation team).
The two-hour therapist-only consultation meeting is for DBT practitioners at CBC. The DBT treatment team meets weekly to assist each other in providing effective, efficient, and compassionate treatment. We spend time problem-solving difficulties that interfere with client progress in treatment and help keep each other practicing within a dialectical framework.

Phase Four - Graduate Group

MISSing – is this ok?

Graduate group is strongly recommended for adolescents who have completed the 24-week multi-family skills training group (Phase I). Research with adolescents suggests that a continuation phase of treatment is necessary following an acute phase of treatment to help reduce the chances of relapse (back to their old behavioral patterns and symptoms).

Thus, the primary goals of our DBT Graduate Group are

(1) to prevent relapse by reinforcing the progress made in Phase I of DBT;
(2) to help the adolescents strengthen and generalize their behavioral skills to various settings and relationships; and
(3) to help the adolescents increase behaviors that improve their overall quality of life while decreasing behaviors that impede their quality of life.

To achieve these goals, the group leaders encourage the adolescents to employ all of their newly learned DBT skills, with extra attention being paid to the use of validation and problem-solving skills with each other. Each week, the adolescents are required to identify individual homework assignments tailored to assist them in reaching their longer term goals.

The graduate group is a 90-minute group that occurs once weekly for 16 weeks, with the opportunity to re-contract for additional time if there are clear treatment goals identified.

(approx 16 weeks)

 

Clients contract for an initial 16 sessions with an option to renew at the end of the graduate group cycle

Cancel