Notice: This Program is No Longer Accepting New Referrals
As of September 2024, we have paused referrals to the DBT program due to the overwhelming referrals we have received. We apologize for any inconvenience this may have caused.
With Dr. Saby Ramirez and Dr. Kayhan Ghatavi
Dialectical Behavior Therapy or DBT is a mindfulness-based, cognitive behavioural treatment that in its comprehensive form includes individual therapy sessions, skills training in groups, 24-hour strategic coaching calls to apply skills, and family or agency support when needed. It is recognized as the gold standard treatment for borderline personality disorder (BPD), but research has shown that DBT is also effective in treating many other disorders such as substance use disorders, depression, post-traumatic stress disorder (PTSD), ADHD and eating disorders.
Researchers and therapists have found that skills training is a critical component of DBT, and is a primary aspect of how DBT works. DBT skills training by itself is often effective, even without the other elements of DBT.
What is the format and expectations of DBT Skills Training?
There are 4 modules: Mindfulness, Distress Tolerance, Emotional Regulation and Interpersonal Effectiveness. New participants can start during the 2-week Mindfulness module which repeats every 6-weeks between the other modules.
In group, we explore and reinforce each new skill with role play and discussion. Our focus is on learning, practicing and eventually bringing each skill into daily life. DBT skills training groups are not therapy sessions, in which participants share and seek help in resolving personal issues. These are learning sessions, in which participants may share what they need to share in order to improve their understanding of DBT skills.
Each class begins with a mindful awareness practice that is relevant to the learning in that module. Each class is held once a week for 2 hours and includes a 10-minute break. The entire DBT group skills course takes 6 months (24 weeks). Participants are encouraged to complete the course twice.
Participants are expected to make a conscious effort to practice every day the skills learned during the weekly sessions.
Participants are expected to notify MDABC before a class session if they are unable to attend. Please be aware that if a participant misses 4 classes in a row, the participant will be removed from the DBT skills training course. This is necessary to increase commitment and to promote ongoing learning. Of course, there are special circumstances in people’s lives that we can consider if necessary, and a person who has had to leave a course can join another course in the future.
All sessions are currently held via ZOOM.
Suitable referrals
We have limited capacity and are only able to accept a small number of the referrals we receive. As we offer stand alone DBT Skills Training and not a comprehensive DBT program, we will accept patients matched for this less intensive (stepped care) level of intervention. We are accepting referrals only from full-service physicians who have cared for the individual for some time and will continue to support them. We give higher priority to people who are not connected to public mental health services or their mental health services do not have the capacity to offer DBT skills training.
Unsuitable referrals to our program
- Referrals from walk-in clinics, emergency departments or inpatient units
- Patients with severe BPD personality disorder requiring comprehensive DBT skills training including telephone coaching, weekly 1:1 DBT sessions and team consultations.
- Suicide attempt in the last 6-months
- Recent recurrent self-harm requiring medical intervention; unwillingness to commit to lowering suicidal/self-harm behaviours
- Patients with a recent history of and/or at risk of aggression or violence.
- Court-mandated referrals
- Patients with active substance use disorders interfering with ability to engage in therapy
- Patients with active eating disorders interfering with ability to engage in therapy
- Patients with active psychosis
- Patients with moderate to severe autism spectrum disorders, intellectual disability, or cognitive impairment interfering with ability to engage in therapy
- Patients with an inability to attend and participate consistently, including access to a computer.
- Patients with other untreated major psychiatric disorders (e.g. severe panic disorder, OCD) requiring more specific evidence-based treatments for these conditions.
References
The Psychiatric Times: Dialectical Behavior Therapy Skills Training is Effective Intervention