Standard DBT

If we recommend Standard or Comprehensive DBT based on our assessment, treatment includes:

• Individual DBT Therapy: The client meets with an individual DBT therapist for 2-4 sessions to 1) identify treatment goals, 2) determine if they are a good fit, 3) discuss what “doing DBT” involves for the therapist and the client, and 4) obtain commitment from the therapist and client to work together for an initial 6-month contract that can be extended contingent on progress.

• DBT Skills Group: After the client and therapist commit to treatment, the client starts DBT Skills group, in addition to attending weekly individual sessions.

  • The individual sessions are 60 mins each and are held weekly

  • The group therapy sessions are 90 mins and are held weekly. These sessions are conducted like a class – they are structured and focus on reviewing homework, practicing skills, and group leaders teaching new skills

• We are running several skills groups:

  • Skills Groups are separated into groups of individuals who are under 25 years old & individuals who are over 25 years old (depending upon availability)

• Openings occur approximately every 6-8 weeks.

• Clients commit to 8-session modules, totaling 24 sessions. We often take a few weeks off between modules. The modules cover the following topics – Mindfulness, Distress Tolerance, Emotion Regulation, and Interpersonal Effectiveness. New group members can join at the beginning of a module with Mindfulness or at the start of the module (the 2nd or 3rd group within the module).

• Before starting group, clients attend an orientation session with one of the group leaders to discuss how the group can help them meet their goals and to identify any potential issues with group attendance and participation.

• Coaching: The client can also contact his/her individual therapist for coaching when challenging situations arise during the week. The primary purpose of these calls is to help the client apply skills to his or her “real life” issues, with the goal of using and applying skills becoming more automatic as treatment progresses.

• Consultation Team: Our individual and group therapists attend a weekly DBT consultation team. The purpose of this meeting is for the therapists to 1) deliver high-quality DBT, and 2) to stick with treatment even through rough patches.

Skills Group for Individuals with Emotion Dysregulation

For individuals who already have individual DBT therapists and don’t have access to a DBT or for individuals who can benefit from skills group alone, we offer skills group that follows the same skills taught in the Standard DBT Skills group.

Our team will recommend whether skills group alone would be beneficial. For some individuals, based on their particular concerns and difficulties, we may recommend Standard DBT as the most effective treatment option – skills group alone may not provide the support the individual needs to make change. If we determine that Standard DBT is the most effective treatment option, the client cannot participate in skills group alone. We do this to ensure that we are meeting our ethical obligation to provide effective treatment.

Please see the Standard DBT description for more information about the group.

Treatment for PTSD

We offer several treatment options for individuals diagnosed with PTSD alone or co-occurring BPD and PTSD. Many individuals with emotion regulation issues and BPD have experienced traumatic events that continue to haunt them. A goal of DBT treatment for many individuals is to be able to stabilize their behaviours and be able to cope with intense emotions enough to treat PTSD. In our experience, PTSD treatment is life-changing and can help individuals truly move forward with their lives.

The assessment process will help determine whether an individual can start with PTSD treatment immediately or would benefit from doing some Standard DBT prior to starting PTSD treatment. In light of how impairing PTSD is, we work to target it in treatment as soon as possible.

There are several treatment options we offer for PTSD, including CPT and DBT-PTSD

Cognitive Processing Therapy (CPT) for PTSD

CPT is an evidence-based treatment for PTSD that has been evaluated by research. It focuses on identifying “stuck points”, places where the person’s thinking has become stuck since the traumatic event. Common stuck points include “It’s my fault”, “People can’t be trusted”, and “I’m broken”. The stuck points often fuel painful emotions (e.g., shame, guilt, fear, grief, and anger) and lead individuals to retreat from their lives and the world. These thoughts and the trauma-related emotions are explored in treatment with the goal of individuals developing beliefs that acknowledge the impact of the traumatic experience and take into account the context in which the event occurred. Individuals are encouraged to live their lives based on these new beliefs to establish “anti-PTSD lives.”

The CPT protocol is 12 sessions. Sessions typically run 15-18 sessions to allow for “booster sessions.”

To learn more about CPT

To hear about a woman’s firsthand experience participating in CPT to address sexual assault

DBT-PTSD for Individuals who Experienced Traumatic Events in Childhood and Adolescence

Dr. Martin Bohas developed DBT-PTSD to treat some unique issues that individuals who experienced trauma during childhood and adolescence. Many people who have experienced this type of abuse experience intense emotion dysregulation, however, they may not have a diagnosis of BPD. Alternatively, some people diagnosed with BPD may want to treat their PTSD from the start. Rather than doing Standard DBT and then starting with PTSD treatment, they could benefit from focusing on trauma treatment from the start.

DBT-PTSD is based on a phased model where individuals are oriented to the treatment, learn how PTSD plays out in their lives, learn skills specific to PTSD, participate in exposure to traumatic memories, grieve the losses, and then build new lives. These topics are covered in approximately 45 individual sessions. DBT-PTSD is an exposure-based treatment which requires individuals to revisit memories of the traumatic event. Exposure to the traumatic event activates the trauma network and in particular trauma-related emotions (e.g., shame, loneliness, powerlessness, fear, sadness). Once the network is activated, individuals can experience and process their trauma-related emotions successfully.

DBT-PTSD is also an evidenced-based treatment. Up to 80% of individuals who complete DBT-PTSD no longer meet criteria for PTSD after conclusion of the treatment.

You can find out more about DBT-PTSD.

DBT-PTSD is an exposure-based treatment that incorporates Prolonged Exposure (PE), an evidenced-based approach to treating PTSD. Sometimes our team uses PE alone as to treat PTSD. To learn more about exposure and PE.