Dialectical Behavior Therapy (DBT) is a supportive, skills-based, empirically based therapy that involves several forms of treatment within one program. Because it is different from traditional supportive therapy in some ways, we have compiled a list of frequently asked questions to help explain some aspects of the program to family members & friends who are directly or indirectly impacted by the individual’s DBT treatment. The DBT program is a rigorous empirically-based program.
At DBT California, we are aware of the difficulties of having a loved one with emotional and behavioral difficulties. While many of these people are often described as “difficult” or “manipulative,” the DBT California team perceives them differently and understands the core of their emotional struggles. Our Friends and Family program is designed to help with medical and behavioral problems and learn skills to cope more effectively with the chaos and burnout that can accompany these problems. The 6-month program covers the following topics:
- Education on Emotional Regulation Problems and DBT
- Family Perspectives and Experiences
- Mindfulness Skills
- Emotion Regulation Skills
- Effective Communication Skills
- Distress Tolerance Skills
- Validation Skills
Our Friends and Family Program also utilizes the Family Guidelines, published by the New England Personality Disorder Association to teach friends and families the following:
- Set realistic expectations
- Manage the family environment
- Manage crises
- Address problems
- Observe limits
Our Friends and Family Program is offered at our Torrance, Beverly Hills, and Newport Beach locations. Please contact us at 800-624-1475 or by using the form on this page.
DBTC Family/Payor Frequently Asked Questions
I am paying for treatment for my loved one. How does payment work?
DBT is an intensive outpatient treatment that has four components; individual therapy, group skills training class, in-between session coaching and a therapist team meeting. Treatment generally lasts a year. Both providers and patients make an initial six-month commitment and, if treatment is progressing, recommit for the second six months. Individual therapy is paid at the time of session, and the tuition for group skills class is paid per module (8 weeks) in advance. Like tuition for most courses, there are no refunds for skills class. The patient is offered two 10 min or less coaching calls a week. If this is exceeded, coaching calls will be billed at the prorated session rate. Credit Card billing agreements are signed once per treatment cycle. We do not accept insurance as payment, although we are happy to provide monthly statements to submit to insurance and health care spending accounts upon request.
My family member/spouse is learning all these new DBT skills and I want to understand what he/she is working on. What can I do?
Our Friends and Family Group is a great place to start. Like many mental health issues, coping with anxiety, depression, emotion regulation problems, and interpersonal chaos are not just one individual’s problem. Emotional sensitivity and associated behaviors greatly impact friends, family, girlfriends, boyfriends, spouses and co-workers. We encourage those individuals to become educated to better understand and cope with these issues. Along with seeking out information from online sources (www.bpddemystified.com ) and books (see “Borderline Personality Disorder Demystified” by Dr. Robert O. Friedel and Perry D. Hoffman or “Loving Someone with Borderline Personality Disorder” by Shari Manning, Ph.D.) we encourage anyone impacted by these issues to also join our skills-based Friends and Family group. Friends and Family groups meet weekly to learn and practice new DBT skills that can help those impacted effectively understand and cope with issues as they arise. You can also visit www.dbtselfhelp.com for an excellent, user-friendly overview of the DBT skills.
If my family member can call for coaching, why can’t I call to speak with the individual therapist to describe problems, update them, or check on the progress of therapy?
If the patient is an adult (18 or over), the “privilege” of information being shared with anyone rests with the patient. This means any information discussed in session, group, or over the phone is strictly between the patient and therapist. Even if a family member or spouse is paying for another person’s DBT treatment, the content of sessions still remains confidential by law.
A patient can choose to sign a release of confidentiality to include others; at the same time, the DBT stance is that we do not do things for the patients that they can do for themselves. Our goal is to teach patients to communicate effectively with their network. We strive to teach patients to learn how to keep the lines of communication open with interested friends and family members in a skillful way. DBT therapists, therefore, do not have conversations that are outside of the awareness of the patient, meaning although you are free to share whatever you like with the therapist, the patient will be made aware of the communication.
What if there is a crisis? Who should I call? Are you a 24 hour service?
If you or your loved one are experiencing a life-threatening emergency, do not wait to speak to us, call 911 immediately. Although we want to be available to our patients for coaching, we are not a 24 hour service, nor do we supply formal emergency services. Again, if this is a life threatening emergency, CALL 911. Otherwise, it is best if you encourage your loved one to call for coaching themselves. It may also be advisable to contact your loved one’s psychiatrist, if s/he has one. Since everyone needs a day off, CBTC therapists will develop a crisis plan for their patient to cover any times when they are away.
Why pay for eight DBT skills classes at a time?
A large aspect of DBT treatment is making and keeping commitments. Joining the DBT program is a serious commitment, both in time, energy, and resources. Much like paying tuition for a class at a university, paying for two months of weekly skills training ahead of time helps motivate members to work towards consistent attendance, participation, and cohesion of the group throughout each module.
What about missed sessions?
We have a 48 hour cancellation policy for individual sessions. Missed sessions are not eligible for reimbursement by insurance companies and will be reflected as a missed session on billing statements. If a patient misses four individual sessions in a row or four group sessions in a row, s/he will no longer be in the DBT program and is considered to have dropped out. Patients who drop out are not eligible to return to treatment with us for three months.
Do you take insurance?
We are an out-of-network provider for insurance which means that we do not accept insurance as payment. However, many of our clients do get reimbursed by their insurance providers (please check with your company for information regarding rates and reimbursement). Upon request, we are happy to provide monthly statements to submit to insurance, as well as health care spending accounts. We have a range of fees and several reduced fee slots for patients in financial need.