Structure and Design
- The DBT IOP is located at our Macklind office where each two hour group DBT IOP session occurs four times a week; from 4PM – 6PM on Mondays – Thursdays
- Each client meets with their primary therapist weekly
- Sessions with a psychiatrist are available through the Institute; these are not included in the DBT IOP and must be scheduled and billed through insurance separately
- Family sessions may also be recommended
- All professional appointments need to be scheduled outside of the DBT IOP program hours; in order to avoid missing group.
DBT Intensive Outpatient Program Group Schedule
|Monday 4-6 PM||Tuesday 4-6 PM||Wednesday 4-6PM||Thursday 4-6PM|
Interpersonal Effectiveness skills teaching
Distress Tolerance skills teaching
Emotion Regulation skills teaching
* Relapse Prevention
* Cognitive Restructuring
DBT IOP Skills Training Schedule
|Week||Interpersonal Effectiveness||Distress Tolerance||Emotion Regulation|
Factors that Interfere
What Emotions Do
What Makes It Hard To Regulate
|Model for Describing Emotions|
Myths About Emotions
Ways To Describe Emotions
How to Ask or Say No
Factors to Consider
|Improve the Moment||Check the Facts|
People to Like You
Mindfulness of Others
Turn the Mind
Walking the Middle Path
Recovering From Invalidation
|Mindfulness of Current Thoughts||Build Mastery|
Managing Really Difficult Emotions
|Optional Topics||Paired Muscle Relaxation, Body Scan Mediation, Sensory Awareness, Dialectic Abstinence, Clear Mind, Burn Bridges, Alternate Rebellion, Adaptive Denial||Mindfulness of Emotions|
Troubleshooting & Review
DBT IOP clients use individual therapy sessions to apply the skills learned in group to the individual’s life challenges.
While participating in the DBT IOP program, clients are expected to work with a DBT IOP therapist at least once a week. Clients are responsible for scheduling these appointments. With the client’s permission, we will provide treatment updates to outpatient clinicians and collaborate on discharge planning. We can also assist clients in selecting a DBT therapist to work with after discharge.
Individual DBT therapy follows a hierarchical approach to problems; this may feel different than types of therapy that encourage clients to speak about ‘whatever is on your mind’. Session time, in DBT, is used to address problems in the following order:
Tier 1: Life-threatening problems such as suicide ideation, life-threatening behaviors, etc. Also, self-injurious behavior.
Tier 2: Therapy-interfering behaviors on the client’s part or the client’s therapist’s part, including urges to quit therapy, willfulness about completing homework assignments, missing session, not feeling understood by the therapist, etc.
Tier 3: Quality of life-interfering behaviors or conditions, like mood disorders, substance abuse, eating disorders, anxiety disorders, serious interpersonal conflict, etc.
Tier 4: Increasing behavioral skills.
Tier 5: Creating a life worth living.
The hierarchy serves to guide treatment, prioritize the most pressing problems, and ensure that one problem is focused on long enough to make progress (versus discussing a different crisis each session). Thus, the therapist may conclude that discussing a recent episode of self-injury, for example, is a more pressing use of therapy time than discussing a fight with a significant other, even though the latter may be more distressing to the client.
A required component of treatment is filling out a diary card daily. This is a form of self-monitoring; helps clients become more mindful of thoughts, emotions, and behaviors which is necessary to change them. Clients are asked to fill out a double-sided diary card on which they track both the emotions and problem behaviors they are trying to change, as well as the skills they are using daily. Diary cards are a way of tracking progress and identifying issues to be addressed in therapy.
Upon completing the DBT IOP, an aftercare plan will be developed with your DBT IOP primary therapist. Nearly always, additional outpatient treatment is recommended in order to further develop coping skills and progress further to live the life you really want to be living.
Outpatient DBT skills groups are available at the Institute. It is impossible to fully understand and apply the skills taught after being introduced to them once. Repeated exposure and practice using them is necessary to maximize their effectiveness in their lives.
Individual psychotherapy of some kind is usually recommended. If you have been working with a therapist prior to entering the DBT IOP, we would encourage you to return to them. The Institute has many highly qualified clinicians from a variety of disciplines available work with after discharge.