STLDBT’s Couples Program provides DBT to couples at all levels of commitment, whatever your sexual orientation, age,living arrangement, cultural or spiritual background..You will benefit from DBT couples therapy if you are:
- arguing or shutting down when tension arises
- avoiding tough issues
- committed to improving communication
- want to learn to manage conflicts in a healthy way
- want to bring back the romance
- planning to get married
- coping with empty nest syndrome
- deciding whether to live together
- deciding whether to stay together or get a divorce
- preparing for an amicable divorce
The Couples Program has three components: therapy, skills group and between session coaching in crises. Couples DBT builds on your strengths as a couple and focuses on here-and-now challenges in your relationship, recognizing the past cannot be changed.
Couples may do therapy, skills group or both. Many couples decide to do therapy before and/or after skills group – focusing on the skills first in order to make discussions of difficult issues more productive and less contentious.
The Couples DBT Skills Group is divided into four 6-week stand alone modules and meets Thursdays from 6:15 to 8:15 pm. Couples may take the modules in sequence or skip around. High conflict couples — those who argue or withdraw — are strongly encouraged to start with Module 1. Modules are:
Module 1: Stop Making Things Worse
Module 2: Managing Conflict Effectively
Module 3: Say What You Mean Mean What You Say
Module 4: Making It Last
Class size is kept small so each couple gets individualized coaching from a licensed therapist. In the first two modules, there is one therapist for each couple. In Modules 3 and 4, there is one therapist for every two couples.
Class time is spent practicing skills using issues from your own relationship — not the easiest nor the hardest issues but issues that enable you to learn to use the skills effectively. Skills are drawn from The High Conflict Couple: Dialectical Behavior Therapy Guide to Finding Peace, Intimacy and Validation by Alan Fruzzetti and Seven Principles for Making Marriage Work by John Gottman and Nan Silver. .
Between-session skills practice is essential to making progress. Replacing ineffective habits with new effective habits takes regular practice. Two hours in class once a week will increase knowledge but it will not change habits.
Couples therapy sessions range from 50-60 minutes to two hour in length. Longer sessions are more effective early in couples therapy. Couples therapy typically includes six elements.
Assessment: Assessment is both formal and informal. Before your first session, you will be asked to complete the Gottman Relationship Check Up. This formal assessment helps your therapist work with you to identify treatment goals and get off to a productive start. About once a month, your therapist will ask you to assess how far you have come, comparing where you are now to before you started therapy.
Validation. Every session you will be asked to report on skills your partner used effectively in the last week.
Learning and practicing skills. In each session, you will learn and apply skills to your here-and-now issues. Sometimes you will practice previously learned skills in new ways. Other times you will practice new skills.
Coaching. Your therapist will coach you as you practice the skills. She may stop you mid-sentence and say “what’s happening here?” or ask you to notice your body language or to share the emotion behind what you are saying. When you start to escalate, she will coach you to regulate your emotions.
Chain analysis. In weeks when you’ve had a major conflict at home, you may chain what happened. This starts with the assumption that no one is at fault. The goals are for both of you to accept responsibility for your part in what happened and to identify points at which you each could have used skills to alter the course of the conflict. The chain involves identifying what happened at each point from both perspectives (not assessing who is right/wrong) and the related thoughts and feelings at each point.
Between-session practice (aka homework); Daily practice is essential to changing habits and patterns of interaction. Homework primarily involves doing what you already do intentionally skillfully so shouldn’t take a lot of time you don’t have. One or two days a week you may be asked to keep a thought record.
Between Session Coaching.
A couple may call, email or text their therapist between sessions for coaching in a crisis situation. Couples are strongly encouraged to do conference calls or copy each other on email and text. Therapists do not keep secrets.
Calls are intended to last no more than 10-15 minutes. Your therapist will ask what skills you have attempted and suggest additional skills to try. Your therapist is not a mediator or referee.
Pros/Cons of Group vs Therapy
Ideally, couples will do therapy and skills group concurrently. We understand however that is not practical for most couples due to time constraints.
As a result, many couples have a chicken and egg problem. You need skills to work through issues that are affecting your relationship now. Do you learn the skills first or work on the issues first?
It’s not an either/or proposition. You learn skills and work on issues in both group and therapy. In group, the emphasis is on learning skills applied to issues. In therapy, the emphasis is on working through issues that affect your relationship right now by applying skills. Both approaches work.
Generally, we recommend doing the Couples DBT Skills Group either first or concurrently with therapy. We find that couples progress faster on their issues when they know the skills and practice them intentionally at home.
For more information about STLDBT’s Couples Program, contact Sandra Miller at firstname.lastname@example.org.