Building Secure Relationships

Therapeutic Approaches: Understanding CBT and DBT

To empower you with the tools for change, this program draws from two proven therapies: Cognitive Behavioral Therapy (CBT) and Dialectical Behavior Therapy (DBT).

• Cognitive Behavioral Therapy (CBT): CBT is a structured, goal-oriented approach that helps individuals identify and challenge negative thought patterns and behaviors contributing to anxiety. By examining how thoughts influence emotions and actions—especially in relationships—you'll learn to reframe unhelpful beliefs (e.g., "I'm unlovable if I show my anxiety") into more balanced perspectives. Backed by extensive research, CBT is highly effective for anxiety disorders, promoting lasting behavioral changes through practical exercises and homework.

• Dialectical Behavior Therapy (DBT): Developed by psychologist Marsha Linehan, DBT combines cognitive-behavioral techniques with mindfulness practices rooted in Zen philosophy. It focuses on four key modules: mindfulness (staying present without judgment), distress tolerance (coping with intense emotions), emotion regulation (managing feelings effectively), and interpersonal effectiveness (navigating relationships skillfully). Originally created for borderline personality disorder, DBT has been adapted for anxiety and relational issues, teaching you to balance acceptance of your experiences with active change—dialectically holding opposites like "I can accept my anxiety while working to reduce it." This makes DBT ideal for building resilience in high-emotion scenarios like conflicts or intimacy.

Together, CBT and DBT provide a comprehensive toolkit: CBT targets the "what" and "how" of anxious thinking, while DBT adds depth with mindfulness and relational skills, ensuring you not only think differently but also respond more adaptively in real-life connections.

 

The Power of Feedback in Group Therapy

Feedback is a cornerstone of this program, woven into every session to accelerate personal growth and strengthen group bonds. In a non-judgmental space, timed sharing followed by peer and therapist feedback creates a mirror for self-reflection—you gain insights into how others perceive your experiences, often revealing blind spots that individual therapy might miss. This process fosters empathy, reduces feelings of isolation (knowing you're not alone in your struggles), and builds real-world skills in giving and receiving constructive input. Importantly, feedback promotes exposure to vulnerability, gradually desensitizing anxiety around judgment while reinforcing intimacy and trust. Research shows that group feedback enhances outcomes by encouraging accountability, diverse perspectives, and mutual support, leading to deeper emotional processing and sustained change beyond the 8 weeks.

 

Key Benefits

• Skill-Building for Lasting Change: Gain DBT tools for mindfulness, emotion regulation, distress tolerance, and interpersonal effectiveness, alongside CBT techniques to reframe anxious thoughts.

• Safe Exposure and Sharing: Practice vulnerability in a structured, non-judgmental space, reducing anxiety through gradual exposure to relational triggers.

• Peer Support and Feedback: Timed "group time" allows for authentic sharing, followed by compassionate peer feedback and expert therapist guidance—promoting empathy and mutual growth.

• Affordable and Accessible: Fully covered under Oregon Health Plan (OHP) PacificSource Community Solutions for eligible members (no out-of-pocket costs). Sessions are held in a comfortable, confidential meeting space (in-person or virtual options available).

• Proven Outcomes: Participants often report reduced anxiety (measured by tools like GAD-7), stronger relationships, and increased self-compassion after completing similar DBT-informed groups.

• Group Size and Format: 6-10 participants for intimate discussions. Weekly 90-minute sessions over 8 weeks, with homework to reinforce skills.

 

Who Should Join?

This program is ideal for OHP PacificSource members aged 18+ with a diagnosis related to anxiety (e.g., generalized anxiety disorder, social anxiety) impacting relationships. It's forgiving on criteria—focus is on readiness to engage. If you're dealing with relational anxiety, attachment issues, or emotional overwhelm, this is for you. (Note: Not suitable for acute crises; contact 988 if in immediate need.)

 

Program Structure

Each session follows a consistent, engaging format to balance learning and processing:

• Check-In (15 minutes): Round-robin sharing of current emotions or wins/challenges to build group cohesion.

• Psychoeducation/Activity (20-25 minutes): Brief teaching of DBT/CBT concepts with interactive exercises to introduce practical skills.

• Group Time & Feedback (40-45 minutes): Timed sharing (3-4 minutes per person) on personal experiences, followed by peer feedback (1-2 minutes each, non-judgmental and supportive), and therapist synthesis (guiding insights, validating, and tying back to skills).

• Wrap-Up & Homework (10 minutes): Review key takeaways, assign practical homework, and preview next week.

Emphasis throughout: Creating a non-judgmental space where exposure to sharing builds tolerance for intimacy. Feedback model encourages phrases like "I appreciate your vulnerability because..." or "That resonates with me as...".

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Week-by-Week Curriculum

This detailed plan integrates DBT modules (Mindfulness, Distress Tolerance, Emotion Regulation, Interpersonal Effectiveness) with CBT elements. Sessions prioritize process time for sharing and feedback, with psychoeducation kept concise to allow for deep relational work. Materials include worksheets, DBT skill cards, and journaling prompts (provided digitally or in print).

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Week 1: Foundations: Understanding Anxiety in Relationships (DBT: Mindfulness Core)

• Build group rapport; normalize anxiety; introduce mindfulness as a tool for non-judgmental awareness in connections. Emphasize intimacy through initial sharing.

• Check-In: Share one relational strength and anxiety trigger.

• Psychoed/Activity: Overview of anxiety cycle (CBT model) and basic mindfulness (e.g., 5-minute breath exercise).

• Group Time: Timed shares (3-4 min each) on "How anxiety shows up in my relationships"; peer feedback on commonalities; therapist highlights non-judgment.

• Wrap-Up: Set group norms (e.g., confidentiality, no advice-giving).

• Homework: Practice 5-minute daily mindfulness; journal one non-judgmental observation about a relationship.

 

Week 2: Identifying Triggers & Patterns (DBT: Emotion Regulation – Labeling Emotions)

• Recognize personal patterns; learn to label emotions without judgment to reduce relational reactivity. Foster exposure by sharing triggers safely.

• Check-In: Emotion check using DBT "emotion wheel."

• Psychoed/Activity: Teach emotion labeling; group exercise mapping triggers to feelings/behaviors.

• Group Time: Timed shares (3-4 min) on a recent trigger; feedback focuses on empathy ("I hear your vulnerability..."); therapist models exposure by reframing.

• Wrap-Up: Discuss non-judgment as a group value.

• Homework: Track and label 3 emotions daily in relational contexts; note patterns without self-criticism.

 

Week 3: Challenging Anxious Thoughts (DBT: Distress Tolerance – Radical Acceptance)

• Use CBT restructuring with DBT acceptance to tolerate uncertainty in relationships. Build intimacy through vulnerable thought-sharing.

• Check-In: Share a "win" from homework.

• Psychoed/Activity: Introduce cognitive distortions and radical acceptance; worksheet on accepting anxious thoughts.

• Group Time: Timed shares (3-4 min) on a distorted thought; peer feedback validates ("That exposure took courage..."); therapist guides acceptance techniques.

• Wrap-Up: Link to building trust.

• Homework: Practice radical acceptance on one anxious thought; share in journal for next session.

 

Week 4: Effective Communication (DBT: Interpersonal Effectiveness – DEAR MAN Skills)

• Learn assertive skills to express needs, reducing anxiety-fueled avoidance. Emphasize non-judgment in feedback to deepen sharing.

• Check-In: Quick role-play prep.

• Psychoed/Activity: Teach DEAR MAN (Describe, Express, Assert, Reinforce, Mindful, Appear confident, Negotiate); paired practice.

• Group Time: Timed shares (3-4 min) on a communication challenge; feedback encourages ("Your sharing builds our connection..."); therapist reinforces skills.

• Wrap-Up: Tie to exposure in real life.

• Homework: Use DEAR MAN in one interaction; reflect on anxiety levels before/after.

 

Week 5: Managing Overwhelm in Connections (DBT: Distress Tolerance – TIPP Skills)

• Build tolerance for relational distress; use techniques like temperature change or paced breathing. Promote intimacy via shared coping stories.

• Check-In: Distress level rating (0-10).

• Psychoed/Activity: Demo TIPP skills (Temperature, Intense exercise, Paced breathing, Progressive relaxation); group trial.

• Group Time: Timed shares (3-4 min) on a high-anxiety moment; feedback focuses on support ("I'm inspired by your exposure..."); therapist normalizes.

• Wrap-Up: Emphasize non-judgment in self-care.

• Homework: Apply one TIPP skill during anxiety; journal the outcome.

 

Week 6: Boundaries & Building Trust (DBT: Interpersonal Effectiveness – GIVE Skills)

• Set boundaries to foster secure attachments; learn GIVE (Gentle, Interested, Validate, Easy manner) for trust-building. Exposure through boundary-sharing.

• Check-In: Boundary self-check.

• Psychoed/Activity: Discuss healthy boundaries; role-play GIVE in trust scenarios.

• Group Time: Timed shares (3-4 min) on a boundary need; feedback builds intimacy ("Thank you for trusting us..."); therapist synthesizes DBT ties.

• Wrap-Up: Preview conflict.

• Homework: Practice GIVE in a low-stakes interaction; note trust shifts.

 

Week 7: Navigating Conflict with Calm (DBT: Emotion Regulation – Opposite Action)

• Regulate emotions in disagreements; use opposite action to counter anxiety-driven withdrawal. Non-judgmental feedback to encourage deeper sharing.

• Check-In: Conflict readiness scale.

• Psychoed/Activity: Teach opposite action (e.g., approach instead of avoid); group brainstorm relational examples.

• Group Time: Timed shares (3-4 min) on a conflict experience; feedback empathizes ("Your story helps me too..."); therapist guides regulation.

• Wrap-Up: Celebrate progress.

• Homework: Try opposite action in a mild conflict; reflect on exposure benefits.

 

Week 8: Integration & Sustaining Growth (DBT: All Modules Review)

• Consolidate skills; create a personal plan for ongoing relational health. Closure with appreciative sharing to reinforce intimacy.

• Check-In: Overall progress share.

• Psychoed/Activity: Review key DBT/CBT tools; create individualized "skills toolkit."

• Group Time: Timed reflections (3-4 min) on growth; extended feedback round (gratitude-focused); therapist provides final insights.

• Wrap-Up: Resources for continued support; group farewell.

• Homework: Implement toolkit weekly; optional follow-up session scheduling.

 

Eligibility and Enrollment

• Verify OHP PacificSource coverage and complete a brief intake assessment.

• Contact Eric Richers, LPC CADC III at erichers.cuti@gmail.com to express interest. Groups start quarterly—or when filled. 

• Limited spots—reserve yours today!

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