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Dialectical Behavioral Therapy

Upstate’s Adult Psychiatry Clinic offers DBT Skills groups to individuals who qualify, based on availability. The Adult DBT Program Director, Jean Shook, RN, NPP, PMHNP-BC, has been working at Upstate since 2000 and has more than 4 decades of experience treating patients as an advanced practice nurse. In addition to treating patients, as an expert in DBT, Ms. Shook is actively involved in multidisciplinary education of trainees within the department.

Dialectical Behavior Therapy (DBT) is an evidenced based practice developed by Dr. Marsha Linehan to treat individuals who engage in impulsive frequently self-abusive or self-destructive behavior. This may include many psychiatric diagnoses such as borderline personality disorder, depression, PTSD, anxiety and eating disorders. Comprehensive DBT involves weekly individual therapy for 1 hour and weekly 2-hour DBT Skills Group, which uses Dr. Linehan’s DBT Skills Training Manual, 2nd edition (2015).  The focus of DBT is to help individuals develop skills to manage their emotional sensitivity more effectively, which results in a life worth living, as described by Dr. Linehan. DBT has been shown to decrease the number of self-abusive incidents, decrease the number of psychiatric hospitalizations and decrease the length of the psychiatric hospitalization, should it occur.

Individuals who have a therapist outside the Upstate Adult Outpatient Psychiatry Clinic may participate in one of the DBT Skills Groups offered by the Clinic, as long as they continue their individual therapy.  There may be a waiting list to patriciate in a DBT Skills Group.

In the DBT Skills Group, 4 modules are covered. The Mindfulness module focuses on developing skills to nonjudgmentally, in the moment, notice your thoughts, feelings, urges and sensations.  These core skills are reviewed between the other 3 modules. The Distress Tolerance module focuses on skills to help one through a distressing situation that they cannot change in the moment, without making the situation worse. The Emotion Regulation module discussed the process of experiencing an emotion, the function the emotion is serving and ways to effectively manage that emotion and not react impulsively. The Interpersonal Effectiveness module focuses on relationships.  It takes about 6 months to get through these 4 modules and the research has shown that hearing each module twice is most effective.

Individuals commit to DBT Skills Group for 1 year and may stay an additional 6 months to hear the material a third time, but at the end of 18 months they are discharged from DBT Skills Group.  Individual therapy may continue after graduation from DBT Skills Group.

In order to participate in a DBT group, patients must be currently receiving individual therapy.

For more information about availability, please call the Adult Psychiatry Clinic at 315-464-3100.