The DBT skills concepts were created for individuals who experienced high levels of emotional, cognitive, and behavioral dysregulation. Unfortunately, the Standard DBT skills curricula are not accessible for people with significant learning challenges. Cognitive load demands are too high to allow for learning, free recall, and generalization in the natural environment. Most specifically:
- Language was too complex
- Divided into four modules – Difficult to integrate concepts
- Hundreds of discreet skills
- No mechanism for people to know what skill to use when
- No system for linking skills; no connective tissue; lily pads vs. chains
- No structure that differentiated skills you use at low/high levels of emotion
Skills System Adaptation of DBT:
The goal in creating the Skills System was to use a DBT-based framework that helped people experience a dialectical synthesis (the ability to be in pain AND be effective at the same time) versus polarization during emotional, cognitive, behavioral, relationship, and self-processes in complex life contexts.
Simultaneously, the framework had to be accessible for (1) Individuals diagnosed with moderate/mild ID (who often have limited reading abilities and impaired executive functioning) and (2) simple enough for collateral support providers to learn given the limited time/resources that are often available for training. Both of these groups had to be able to learn essential concepts, be able to recall them under-pressure, assemble adequate skills chains to manage the span of a dysregulation emotion, and generalize these capacities into diverse, real-life contexts.
The De-construction and Re-construction Process:
This process involved de-constructing essential DBT processes, re-labeling, and reorganizing the concepts in a way that (1) provided effective emotions regulation strategies in the re-constructed form and (2) minimized extraneous cognitive load demands. The work of James Gross, PhD (editor of the Emotion Regulation Handbook, 2007, 2014) was integrated to ensure that all aspects of emotion regulation processes were addressed in the Skills System model; Dr. Gross also reviewed and endorsed the Skills System prior to the publication of this model. The work of Sweller (Cognitive Load Theory, 1988, 2010) guided the design of both the Skills System model and teaching strategies.
The Skills System Design
- Framework breaks complex tasks into component parts – Task Analysis
- Integrates mindfulness strategies and goal directed thinking that lead the individual to execute goal-directed actions
- Provides clear, strategic steps (micro-transitions) to create adaptive chains of behavior
- The tools have to be flexible enough to be able to adapt to internal and external changes in the moment
- The skills and the “system” function as cognitive scaffolding to help navigation (being present & effective) across the spans of emotions