Two things can be true: Dialectical behavior therapy (DBT) is an effective treatment and clients can find it challenging to access the modality. DBT’s evidence-based approach to treatment is a game-changer for some clients. At the same time, as many practitioners have discovered, others struggle to learn and integrate DBT skills.

Research shows that clients may drop out of DBT skills training due to difficulties in tolerating and regulating emotions, staying engaged in content, and comprehending the material. If you utilize DBT in your clinical or educational work, you may have encountered these barriers.

Fortunately, preliminary research suggests that incorporating specific strategies when teaching DBT skills can significantly improve client retention and skill acquisition. Facilitators are encouraged to create a supportive environment, personalize skills to individual needs, and integrate creative interventions such as storytelling.

For the purposes of this post, I will use story as an umbrella term that encompasses various story-based interventions, including metaphor, poetry, and personal narratives.

In therapeutic and educational settings, it is widely known that using metaphorical stories can help clients better understand concepts, gain insight, and ultimately change behaviors. Additionally, incorporating stories into treatment can lead to a more connected, enjoyable, and interactive group process. When teaching DBT skills, facilitators can use story to help clients:

Erickson and Rossi (1979) were among the first clinicians to investigate the ways in which story could be utilized in therapy. They believed that using metaphors was an effective way for therapists to communicate with clients at both the conscious and unconscious levels. These researchers proposed that metaphorical meaning activated unconscious processes and brought them to conscious awareness, leading to insights that may not have been accessible otherwise.

Additionally,........

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