Comprehensive DBT Process

Starting Dialectical Behavior Therapy (DBT) can feel overwhelming, especially if you've tried other treatments without success. At DBT Institute of Central Illinois (DBTICI), we strive to make the process as clear and supportive as possible. Below are answers to some of the most common questions about entering our Comprehensive DBT Program.

What is Comprehensive DBT?

Comprehensive Dialectical Behavior Therapy (DBT) is an evidence-based treatment developed by Marsha Linehan, Ph.D., for individuals who experience intense emotions, self-destructive behaviors, relationship difficulties, or chronic emotional suffering.

Unlike traditional therapy, Comprehensive DBT includes four treatment components:

  • Weekly individual therapy

  • Weekly DBT skills training group (one parent will participate with teen client in Multi-family Group (MFG))

  • Between-session phone coaching

  • Therapist consultation team

Research has shown that this full treatment model is highly effective for reducing suicidal behaviors, self-harm, emotional dysregulation, eating disorder behaviors, and other life-interfering difficulties.

Who is Comprehensive DBT designed for?

Our program may be a good fit for adolescents and adults struggling with:

  • Chronic suicidal thoughts

  • Self-injury or self-harm

  • Borderline Personality Disorder (BPD)

  • Severe emotion dysregulation

  • Depression and anxiety

  • PTSD and complex trauma

  • Eating disorders

  • Substance use concerns

  • Frequent crises or psychiatric hospitalizations

  • Intense relationship conflict

During the intake process, we will help determine whether Comprehensive DBT is the most appropriate level of care for your needs.

What happens first?

The first step is to contact our office to schedule an intake evaluation.

During the intake process, you will meet with a DBT clinician who will:

  • Learn about your current concerns

  • Review your treatment history

  • Assess safety concerns and risk factors

  • Discuss your goals for treatment

  • Determine whether Comprehensive DBT is appropriate

Many clients begin participating in Pretreatment Group while completing the intake process.

What is Pretreatment?

Pretreatment is the first stage of DBT and is designed to prepare clients for success in treatment.

During individual pretreatment sessions, clients meet with a DBT therapist to review treatment goals, assess problem behaviors, discuss expectations, and develop commitment to the changes necessary to build a life worth living. Therapists also provide an overview of the four modes of comprehensive DBT (individual therapy, skills training group, phone coaching, and consultation team) and answer questions about the treatment process. 

Pretreatment group serves as a supportive bridge while clients move through the intake process, introducing core DBT concepts, treatment expectations, and foundational skills. This group helps clients and families begin learning the language of DBT and increase readiness to engage fully in comprehensive DBT services.

How often will I attend treatment?

Clients in Comprehensive DBT participate in:

Individual Therapy

  • One session per week

  • Approximately 50-60 minutes

  • Focused on reducing problem behaviors and applying DBT skills

Skills Training Group (replaces Pre-treatment Group)

  • One group per week

  • Structured curriculum

  • Learn practical skills for managing emotions, relationships, and crises

Phone Coaching

  • Available between sessions

  • Helps clients apply skills in real-life situations

  • Intended to prevent crises rather than process them afterward

What skills will I learn?

DBT skills are organized into four modules:

Mindfulness: Learn how to stay present, focused, and aware without judgment.

Distress Tolerance: Build the ability to survive difficult situations without making them worse.

Emotion Regulation: Understand emotions and develop tools to manage them more effectively 

Interpersonal Effectiveness: Improve communication, strengthen relationships, and increase-self respect

Middle path (MFG only): Learn to balance acceptance and change, reduce conflict, improve communication, validate one another's experiences, and avoid extreme or rigid thinking

What is expected of me as a client or parent of a client?

DBT is an active treatment. Clients are expected to:

  • Attend weekly individual sessions

  • Attend weekly skills group (parent also participates in MFG)

  • Complete diary cards

  • Practice skills between sessions

  • Participate actively in treatment

  • Utilize phone coaching with therapist

You do not need to be perfect to benefit from DBT. In fact, many clients begin treatment feeling unsure or discouraged. What matters most is a willingness to keep working toward change.

What is a diary card?

A diary card is a daily tracking tool used throughout DBT.

Clients record:

  • Emotions

  • Urges

  • Problem behaviors

  • Skill use

Diary cards help identify patterns and guide treatment priorities during individual therapy sessions.

What if I am nervous about group therapy?

Feeling nervous about group is extremely common.

DBT skills groups are educational and supportive. They are different from traditional process groups because the focus is on learning and practicing concrete skills. Clients are never required to share more than they are comfortable sharing.

Many clients report that skills group becomes one of the most valuable parts of treatment.

Does DBT work?

DBT is one of the most extensively researched treatments for individuals experiencing severe emotional and behavioral dysregulation.

Studies have found that DBT can:

  • Reduce suicidal behaviors

  • Decrease self-harm

  • Lower psychiatric hospitalizations

  • Improve relationships

  • Increase emotional stability

  • Improve overall quality of life

Many clients enter treatment feeling hopeless and leave with skills that help them build lives that feel meaningful and worth living.

How long does Comprehensive DBT last?

Treatment length varies depending on individual needs.

Many clients participate in Comprehensive DBT for approximately one year, which allows enough time to learn, practice, and generalize DBT skills across multiple life situations. Some clients may benefit from a shorter or longer course of treatment.

How do I get started?

If you are interested in Comprehensive DBT at DBT Institute of Central Illinois, we encourage you to contact our office for a consultation or fill out a contact form. Our team will answer your questions, discuss your needs, and help determine whether DBT is the right next step for you.

Building a life worth living begins with a single step—and we would be honored to walk that path with you.