Dialectical Behavior Therapy with College Students (Part 2)

February 17, 2021

This feature by Carla Chugani, PhD, LPC is Part 2 of 2 in a series about DBT with college students. In the first part, Carla began by looking at offering DBT in college counseling centers. Here in part 2, she will explore bringing DBT skills to the masses with college coursework.

In part one (read here), I introduced you to DBT as offered in college counseling centers and the student needs that have led to increased implementation of DBT within the college counseling practice setting. 

Given the prevalence of mental health problems among college students, another recent trend has been the advent of “wellness” courses. Wellness courses are college courses (i.e., credit-earning courses with homework, readings, exams, and anything else you’d expect in a college class) that focus on teaching students about wellness topics. A particularly popular example of this is Yale University’s course “The Science of Wellbeing,” which has been featured widely in the media due to its popularity with students.

Although DBT, as a comprehensive treatment, was originally developed for chronic suicidality and self-injury, many of us recognize the utility of the DBT skills as life skills. The average person may not have severe emotion dysregulation, but everyone can probably benefit from knowing how to regulate their emotions. Drs. Jim Mazza and Lizz Dexter-Mazza are pioneers in the work to take DBT skills out of the clinical context and implement them in schools as an up-stream solution for suicide prevention and mental health promotion. Their model, known as “Dialectical Behavior Therapy Skills Training for Emotional Problem Solving for Adolescents” or DBT STEPS-A, is designed to be implemented in middle and high schools as part of education (e.g., lessons can be delivered by health teachers during health class).  To learn more about their incredible work, click here to visit www.dbtinschools.com.

Jim is also a Professor of School Psychology at the University of Washington (UW). In his work at UW, Jim developed a college course titled “Wellness and Resilience for College and Beyond” (i.e., the Wellness and Resilience Course). The Wellness and Resilience course teaches students skills from DBT, as well as a few select skills from acceptance and commitment therapy (ACT) and positive psychology. The course is designed to teach a range of evidence-based skills with broad appeal to student needs. And Jim’s course has been wildly popular with UW students – his team currently delivers the Wellness and Resilience Course to more than 1,200 students per year.

One of the things that I think is really special about the Wellness and Resilience Course is that it is structured with the original DBT model in mind. Students learn skills each week during lecture and then practice, discuss, and role play in small groups, which is very similar to group skills training. Reflective homework assignments encourage students to reflect on their skills practice, how the skills relate to their lives, and set concrete goals for skills practice during the coming month (similar to some of what might happen in individual therapy). Students also complete weekly diary cards. While diary cards do not have therapeutic targets on them, as in standard DBT, they help students track which skills they are practicing and how effective the skills practice has been. Students receive feedback on their skills practice in class during discussions, on their homework, on diary cards, and occasionally during their professor’s office hours if needed and desired by the student (coaching). Finally, teaching teams meet regularly to ensure that everyone is on the same page about upcoming content and activities as well as to discuss any needs among team members, including help problem-solving issues with students.

At this point, I know some of you might be thinking that the Wellness and Resilience Course blurs the line between education and treatment, and I want to assure you that this is not the case! Although course instructors are often clinically-trained professionals (e.g., psychologists, counselors, or social workers), they are also trained to maintain their role as an educator and avoid clinical interaction with students. For example, if we are concerned about a student, we follow the procedures that any other professor on our campus would follow (e.g., refer them or walk them over to the counseling center). 

It has been a pleasure to work with Jim on beginning the research and dissemination of the Wellness and Resilience Course. Moreover, teaching this course has been one of the greatest joys of my life. I truly hope that as our research progresses, we will be able to show that providing young people with universal access to DBT skills through education can improve or even save lives. If you are interested in receiving training to teach the Wellness and Resilience Course at an institution of higher education, please contact me at carla.chugani@chp.edu.

If you are interested to learn more about the process of implementing a DBT program in a community mental health system as opposed to a college setting, read here for a three-part feature from Gwen Abney-Cunningham, LMSW.

Carla Chugani, PhD, LPC, is an Assistant Professor in the Department of Pediatrics, Division of Adolescent and Young Adult Medicine at the University of Pittsburgh and licensed professional counselor currently practicing DBT at Western Psychiatric Hospital, Pittsburgh, PA. Read Carla’s full bio here.


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