Dialectical Behavioral Therapy

DBT is effective with a wide variety of diagnoses outside of Borderline Personality Disorder, which can include (but are not limited to) mood disorders, substance use, Attention-Deficit/Hyperactivity Disorder (ADHD), eating disorders, anxiety, self-harm behaviors, Obsessive-Compulsive Disorder (OCD), Post-Traumatic Stress Disorder (PTSD), and suicidal thoughts, urges, or attempts.

• Our DBT program is skills training only, so phone coaching is not offered. We have a 24-hour crisis team that can be called in times of crisis. We strongly encourage all clients to develop a crisis support plan with their therapist.
• All groups meet virtually via Zoom so each client will need a private e-mail address; a device capable of video calls; a consistent internet connection; and a private space to meet in to protect confidentiality for the group. If a reliable internet connection is a concern, please contact your therapist and DBT group leader since telehealth rooms are available at all CMMHC locations.
• Currently, only our Thursday Medicare group offers an in-person hybrid option.
• We maintain a waiting list for all our DBT groups. Clients are placed on a waiting list if they meet the eligibility requirements.
• We do not have the capacity to separate our groups by age or gender, so there are often people of differing age groups and gender identities within one group.
• DBT binders are available for all groups at the Elk River and St. Cloud offices. There is no cost for the binder, and each group member can keep their binder. We are unable to mail the binders to clients.

• Clients need to be open with CMMHC. This is documented with our comprehensive evaluation/diagnostic assessment or update completed within the past six months for new clients or annually for continuing clients. We also accept outside comprehensive evaluations conducted within the past six months for new CMMHC clients.
• A referral for a DBT group must be placed into our system, and can be done by the intake provider, reception support staff, or other CMMHC providers (ARMHS, case management, etc.).
• All DBT clients must attend individual therapy at a frequency suggested by their therapist, and the provider does not have to be at CMMHC. A minimum of every other week sessions is recommended.
• Referrals cannot be accepted until clients are engaged in individual therapy and have a valid comprehensive evaluation/diagnostic assessment or update on file with CMMHC.
• If the individual therapist is at an agency outside of CMMHC, we need a signed Release of Information form on file to communicate with the therapist about any missed groups and treatment planning as needed.
• Clients must sign the DBT Checklist/Contract, mailed out upon acceptance onto the waiting list.

• We start new members during the module change every eight to ten weeks if there is space in the group. People on the waiting list are called to see if they can start the group and can ask to remain on the waiting list if they cannot start at that time.
  • New referrals are called first, based on the order in which they were referred and approved for the group. If someone cannot start group when they are called, they remain on the new referrals list.
    • Clients can also ask to be removed from the DBT waiting list entirely if they are no longer interested in starting the program.
  • Not responding to a call to start group (even to say it does not work right now) or missing one of the first two weeks of group means the person is moved to a lower-priority waiting list, which often leads to longer wait times.
  • We generally leave several days for a response and cannot hold a spot past the deadline. This information is given to each client when they are called from the waiting list.
  • If a person declines the group twice or does not respond by the deadline twice, we will remove that person from the waiting list and ask that a new referral be submitted when they can participate in the group. This is done so that people on the waiting list can enroll in DBT group.

• Groups require a minimum six-month commitment, and clients are encouraged to attend the group for a year to integrate the skills fully.
• Each module (which includes two weeks of orientation/mindfulness) runs for 8-10 weeks. There are three modules: Distress Tolerance, Emotion Regulation, and Interpersonal Effectiveness.
• All our groups meet weekly except for holidays. In addition, each module has one week off “built-in” to the group, regardless of whether a holiday occurs during that module.
• Attendance at the first two groups, Orientation and Mindfulness, are required. Missing one of the first two groups leads to discharge from the group and being moved to a lower-priority waiting list, often leading to longer wait times.
  • If a client misses the first two weeks of the group for two separate modules, they are discharged from the program, and a new referral must be made.
• If clients miss three groups in a module, they are discharged from the group, and a new referral is needed. If space allows, that client can reenter the group when that module starts again in around six months.

• Medicare only and dual Medicare/Medicaid insurance coverage is accepted by our Thursday Medicare group only.
• We accept MA/Medicaid, PMAP, private/commercial insurance, and private pay in all of our groups regardless of age. We also offer sliding scale services at CMMHC.
• If you have concerns about insurance coverage for the DBT group, please call your insurance company directly.
• Please note that most insurance companies will not pay for both individual and group therapy sessions that occur on the same day. We strongly encourage our clients to schedule individual therapy sessions and group therapy on separate days; if your insurance does not cover both on the same day, you will likely receive bills you are responsible for paying.
  • If you receive individual and group therapy through CMMHC, we do not allow people to schedule individual and group therapy on the same day.
  • If your individual therapy is at an outside agency, you must schedule your individual and group therapy sessions on different days.

• Our all-virtual Adult DBT groups are for people aged 18+. They meet on Mondays from 4-5:30 pm and Tuesdays from 3:30-5 pm.
  • The adult groups utilize Linehan’s handouts and teaching methods and are relatively fast-paced.
  • Materials and links to the video calls are sent via e-mail weekly (unless the group is not scheduled that week). Please check the spam folder if the e-mail does not appear in the inbox! If you cannot find the e-mail, please call the Elk River or St. Cloud offices to connect to the group leader/verify the e-mail address on file.
• We also have an Adapted DBT group that accepts Medicare as the primary insurance. It is a hybrid group with an in-person option available on a case-by-case basis. This group meets on Thursdays from 3:30-5 pm.
  • This group is adapted for people who prefer a simplified approach to DBT skills. It is also suitable for those with a learning disability or other cognitive impairment. If you believe this group will be the best fit for you, please let us know when you request a referral, as referrals for people 18+ are automatically placed on the all-virtual DBT group waiting list.
  • As noted under the all-virtual group, materials and links to the video call are sent weekly via e-mail. If you cannot find the e-mail, please call the St. Cloud offices to connect to the group leader/verify the e-mail address on file.

• Teen DBT group is for adolescents aged 13-17. Teen DBT group meets Thursdays from 4-5:30 pm
  • This group utilizes Linehan’s handouts and is adapted for teenagers.
  • Clients who turn 18 during group will work with the group leader to determine if the teen group is still a good fit for them.
  • Materials and links to the video calls are sent via e-mail weekly (unless the group is not scheduled that week). Please check the spam folder if the e-mail does not appear in the inbox! If you cannot find the e-mail, please call the St. Cloud offices to connect to the group leader/verify the e-mail address on file.