Probably because I get a lot of teens and young adults, my style tends toward high energy with constant engagement and interaction. I also process pretty quickly, so I am able to help clients connect the skills they learn to the symptoms they reported on diary cards. Every group has its own flavor, but those tend to be themes in the ones I lead

Skills groups emphasize learning and dialogue, where individual sessions allow for more introspection and emotional engagement. Both are important in healing (in DBT we call that a 'dialectic') so I incorporate a little of each into the other.

For good reasons, DBT groups are often prescribed by hospitals and residential care facilities as the first "step-down" into outpatient care. At the end of 8 weeks, members will have learned several dozen skills and the appropriate time to use them, ready to practice emotion regulation on their own

Since healing cannot take place without the proper environment -- in fact the wrong environment can propagate harm -- many steps are taken in my groups to maintain it. I do an intake interview to anticipate potential issues (another DBT saying "there are no wrong clients, just wrong interventions" so some clients need something else other than group, or that particular group). We have group guidelines we review weekly to remind members about things like confidentiality and the importance of focusing on emotions. Probably most helpful are the skills themselves. One of the 4 main skill groups in DBT is…

Mindfulness is what we call in DBT the "base skill", in other words without being mindful, none of the other skills are likely to work. To that end, we begin every weekly session with 15 min mindful practice (guided meditation, yoga nidra, mindful walk, etc.) followed by journaling in diary cards

DBT is especially effective for high acuity clients mostly because of the addition of mindful practices to classic CBT skills training. We recognize that most erratic and undesirable behaviors are actually entrenched coping for fight/flight arousal, and mindfulness helps us ground ourselves back into safety so that we can re-engage our thinking brain in problem solving

At some point, usually around 2-3 weeks into DBT, the clients realize the real healers in the room are actually themselves and each other. This phenomenon happens so regularly that most of what I need to do is simply remind them of it or to encourage them to look forward to it. This also occurs in individual therapy, but in group the atmosphere of empathy becomes much easier to detect. We are often much more able to take care of others than ourselves