Standard treatment modalities

The synergy between individual and group therapy.

The standard DBT model is distinguished by separating treatment functions into different modalities that operate simultaneously, rather than attempting to address everything in a single weekly session.

Individual therapy focuses primarily on motivation and the specific application of skills to the client's life.

Here, the therapist works to keep the individual engaged in treatment and addresses acute crises or life-threatening behaviors.

On the other hand, skills training is conducted in a group format, which functions more like an academic class than a process therapy.

In this setting, the goal is purely the acquisition of new behavioral skills.

No past traumas or deep personal crises are processed; instead, a rigorous curriculum is followed where emotional regulation and interpersonal effectiveness competencies are taught.

This division allows the individual space not to be saturated with didactic teaching, and the group not to be sidetracked by the individual crises of the participants.

The extension of the treatment to the real environment

A distinctive component of this methodology is telephone (or intersession) coaching.

Unlike other models that restrict contact outside the clinical hour, DBT encourages it for a specific purpose: generalization of skills.

It is based on the premise that learning a technique in the quiet of the office does not guarantee that the individual can use it in the middle of a heated argument with a partner or during an anxiety crisis at work.

The telephone contact is designed to have the client call before engaging in destructive behavior, allowing the therapist to guide the client in the application of an in vivo adaptive skill.

This transforms the individual's everyday environment into an active learning laboratory, ensuring that the therapeutic tools are integrated into their real life and do not remain just in theory.

Support for the therapist

The fourth pillar, often invisible to the client but vital to the integrity of treatment, is the consulting team for therapists.

Because working with populations exhibiting severe emotional dysregulation, suicidal risk or self-injurious behaviors can be extremely draining, DBT stipulates that the therapist should never work alone.

This team functions as "therapy for the therapist," providing a weekly space to maintain professional motivation, ensure adherence to the dialectical model, and avoid burnout.

In these meetings, professionals support each other to maintain a balanced stance and not fall into extremes of rigidity or excessive permissiveness with the most complex cases.

Summary

Standard DBT separates functions: individual therapy focuses on motivation and crisis, while group coaching functions as an academic class to acquire new behavioral skills.

Telephone coaching seeks to generalize skills to the patient's actual environment. It allows the therapist to guide the application of techniques in vivo before destructive crisis behaviors occur.

The consulting team supports therapists in the face of extreme emotional exhaustion. It functions as a therapy for the professional, ensuring motivation, adherence to the model and avoiding burnout.