The desired outcome of skills training it to learn positive skills for changing negative, dangerous or unwanted behaviours, emotions and thinking, and helping us avoid events that cause harm or further distress. The core method of treatment in DBT is skills training, which incorporates the four key skills learned in DBT:

• mindfulness
• interpersonal effectiveness
• emotional dysregulation
• distress tolerance

Although DBT is very reflective, and relies a lot on you to commit to the work, the skills training is structured but adaptable. This means it can work with multiple people in the same, yet personalised, way.

Because not all mental health facilities, or health authorities, have enough DBT-trained staff, often one trained staff member can work with other staff to help implement skills training in group settings. There is strong evidence that the use of skills training is effective in helping patients with a wide range of mental health symptoms.

Usually, the patient would have individual and group sessions while undergoing DBT. In group settings, skills are taught in a classroom style, with generalised exercises among peers. These skills are then enhanced through ‘homework’ (practice exercises to do at home) between sessions.

Groups usually meet once per week – this involves discussing the work from the previous session, doing new exercises and setting tasks for the patient to do at home.

There are times when group sessions may not be available due to lack of staffing or funding, or group sessions might not be suitable for you if, for example, you work full time or find it distressing to work in a group. In these instances, the individual therapist will work through the skills training with you as you go along.

The skills learned in DBT can be invaluable to times of distress, but during those times – which can occur at any time of the night of day – our more destructive behaviours are likely to show up. The constant reinforcement of how to use skills in the moment means that, over time, you can naturally turn to the more positive methods of dealing with the situation, without resorting to behaviours that might cause you harm or distress.