Mental Health · Self-Reflection

Done With DBT Program: My Final Thoughts

Hello everyone, I have completed all 24 weeks of the DBT Skills Group program at my therapy center. In this program, everyone who completed all 4 modules “graduate” from the program. Just like in my Halfway Done blog post, I will be discussing things under an autistic lens. Please read that blog post for some background information on how the program is formatted and why I was in the DBT program.

In the first two modules discussed in the aforementioned blog post, we focused on “middle path” skills and interpersonal effectiveness. After that blog post, we focused on the modules that I felt were the most important to me: distress tolerance and emotion regulation.

For distress tolerance, we learned to do Pros and Cons, TIPP, ACCEPTS, IMPROVE, Radical Acceptance, and Willingness. I have a hard time with ACCEPTS and IMPROVE because those are long acronyms. TIPP has become my go-to skill and Pros and Cons helps me with decision-making as I have a hard time with making decisions.

For emotion regulation, we learned to identify emotions, identify myths about emotions and how to challenge the myths, checking the facts, opposite action, and problem solving. Identifying emotions is very difficult for me due to alexithymia (I talk about it here), so I liked that we got an emotion wheel to help out with identifying emotions on a deeper level than mad, sad, and glad (or in my case, anger and anxiety). Figuring out how to challenge myths was hard to the point of nearly impossible, mainly because the homework already included examples of how to challenge myths so I wasn’t able to come up with my own challenges.

Let’s go back to a question I asked myself: Is DBT autism-friendly? I feel like the emotion regulation and distress tolerance skills were a bit more autism-friendly, but DBT as a whole needs more work to be autism-friendly. Actually, therapy as a whole needs to be autism-friendly. Maybe I’ll write a post about it. So one thing about emotion regulation that I liked that fits my autism profile is the emotion wheel. I have trouble identifying my emotions, but I also find visual cues helpful. The emotion wheel helps me visually identify my emotions. I like the colors too. Smiley face. I also like the acronyms for distress tolerance skills as I can see the words to figure out what to do. Side note: I found this one poster at my autism evaluation center and bought a travel-sized version of it. Here’s the Generation Mindful product I bought. Again, I love the visual representation that I can easily refer to.

So what do I think about the program as a whole? I have seen progress in using these skills and I finally found skills that work! Before DBT, NO therapy skills worked! I would still do them to humor the therapist even though I knew there would be no results. I had therapy-resistant anxiety. While DBT was originally made for people with Borderline Personality Disorder, I feel like this type of therapy also works for people with therapy-resistant mental illnesses. Did nothing work in the past? Try DBT. DBT skills groups also teach skills by learning the skills and practicing the skills via homework or group activities. However, my DBT group also had diary cards you had to do each week, which I don’t know if all groups require it. This forces you to do the work to “get better” and to maybe put in more effort than you usually did in therapy.

There are many worksheets in the DBT book I used that weren’t assigned for homework. As my therapist is a part of a group of DBT therapists at my therapy center, she plans to give me occasional homework out of that book to continue my DBT practice.

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