DBT Skills Coaching

What are coping skills?

Coping skills are strategies that we use to help us manage stressors, our emotional responses to those stressors, and that help us enjoy life and connect with others despite the inherent challenges of being a person in the world. Ideally, we would learn all the coping skills we need while growing up. But the world is not an ideal place! I have yet to meet an individual who has learned every coping skill that would be helpful from their family, friends, and broader culture. And I have yet to meet a client who had a course on coping skills in school!

A major reason people come to therapy, in my experience, is that their stress has outmatched their coping and they are overwhelmed. This means that having difficulty is not a moral failing! Instead, it means that individual can benefit from learning additional strategies to supplement existing coping or overreliance on older/less effective coping strategies (such as avoidance, procrastination, substance use, self-harm, etc.) 

What is DBT and DBT Skills Coaching?

DBT (Dialectical Behavioral Therapy) includes a set of coping skills that help individuals to develop:

• Mindfulness to be more aware of and connected to themselves, others, and the wider world, to facilitate effective change and decrease suffering

• Distress tolerance to endure highly stressful situations and intense emotions without making the situation worse (because you can always make it worse!)

• Emotion regulation to decrease the amount of unwanted emotions experienced in life, increase the amount of positive emotions, and build a life worth living

• Interpersonal effectiveness to improve communication, facilitate getting more of what they want and less of what they don’t, find relationships that nurture growth, and end relationships that do not

While DBT skills were originally developed as part of a broader therapy (often referred to as "full model DBT," or sometimes just "DBT") to help individuals struggling with chronic suicidality, DBT has since been used to address many other challenges and diagnoses. DBT skills are traditionally taught in a group setting, which lets people see that they aren't alone or uniquely bad; it's also helpful to receive support from peers and learn vicariously through the shared experience with other members. 

DBT Skills Coaching is a one-on-one, intensive, individualized review of DBT skills involving skill acquisition and practice in appointments and homework between appointments. Following an initial intake to understand your present and past and an evaluate your fit for skills coaching (more below), we will develop an order of learning skills that matches your situation.  I do encourage at least a 2 month commitment to this process, given that you may not see results immediately. Working through the entire set of DBT skills once takes approximately 6 to 8 months of weekly appointments, though that time can vary further depending on the amount of detail you desire to engage in and the pace that works best for you.

Who is appropriate for DBT skills coaching?

I offer individual DBT skills coaching to those who would benefit from learning additional effective coping skills, but where full model DBT treatment (individual DBT therapy + group skills training + phone coaching) is not necessary. This could include people who:

• have an individual therapist who recommends learning DBT skills, but is not familiar with DBT

• want and could benefit from a structured, skills-based focus as opposed to traditional talk therapy

• find themselves using a limited number of coping strategies, no matter the situation

• are not developing as many new coping strategies as would be helpful while participating in individual talk therapy 

• could benefit from a stronger and broader foundation of coping skills in preparation for exposure-based trauma therapies and reduce the likelihood of re-engaging in ineffective coping during trauma treatment

DBT skills coaching is not a replacement for traditional therapy. In some cases, I will only move forward with coaching if you already have a concurrent individual therapist who is responsible for monitoring and treating behaviors with higher chances of negative consequences, such as suicidal ideation, self-harm, disordered eating, etc. Your health and safety are extremely important to me! Coaching is focused on learning and practicing skills that will help you over time, as opposed to directly treating problem behaviors in the present. It would be disrespectful to you to leave those problem behaviors unaddressed by an appropriate professional.

These skills are not magic. They do not eliminate pain from life. They take hard work to learn and implement. With hard work, I have seen them them help people: understand that their behaviors and emotions have causes and are not moral failings/unique to them; weather difficult moments in their lives; reduce emotional turbulence; provide replacements for unwanted behaviors that are getting in the way of growth, happiness, and connectedness; and provide a foundation for building a happier, more satisfying life. 

My training

I first began to learn DBT skills in 2011 in order to lead a DBT skills group and provide individual DBT therapy in a psychiatric clinic. I have used them ever since, both personally and professionally. Since then, I proposed and created a DBT skills-based group at the University of Wisconsin-Madison's counseling center as a graduate student, co-taught an accelerated skills-only group at SIU-Carbondale's Counseling and Psychological Services as an intern, and co-led a skills group at a community health center while completing my post-doc. Then, during the pandemic, I began providing DBT skills coaching to some of my individual therapy clients as there was no alternative at the time in the St. Louis area outside of referral to a full model program. I have come to see DBT skills coaching as a valuable tool along with traditional talk therapy.