Dialectical Behavior Therapy (DBT) has changed the way many therapists assist and address suicidal and self-harming behaviors and intense emotions. One of the key elements that sets DBT apart is its emphasis on phone coaching, as well as the 24-hour rule. In this two part blog post, we’ll explore the significance of phone coaching and the 24-hour rule in DBT and why they are invaluable tools in balancing acceptance and change when it comes to self-harm.

Part 1: Phone Coaching

In DBT phone coaching, clients can reach out to their therapists via phone at any time during a 24-hour period, seven days a week (for the most part). Phone contact is brief, usually 5-10 minutes in length. These calls can be for crisis situations, difficulties with skills working/not knowing what skill to use next in a situation, and relationship repair with the therapist. This accessible support system can be a lifeline for individuals struggling with self-harm tendencies. Let’s delve into why it’s such a crucial component of DBT.

Creating Change

Phone coaching embodies the DBT principle of creating change by assisting clients outside of sessions to generalize skills. When we “generalize” skills, I mean we actively use them in the environments we experience distress. This is extremely important to get them to work! Phone coaching offers the option of instead of waiting until a crisis reaches its peak, individuals can proactively seek help when they sense distress building up in the environments and situations, as they occur. This preemptive approach can prevent self-harming behaviors from escalating, leading to a safer and more effective resolution of emotional turmoil. Simply by considering phone coaching instead of engaging in the normal pattern of behavior, you are creating change! When you implement and are willing to accept coaching, you have not only engaged in change behavior but also acceptance behavior.

Real-Time Support

When self-harming urges strike, they often do so suddenly and intensely. Phone coaching ensures that individuals have real-time access to support from their therapist. Being able to speak with your therapist or a trusted DBT professional, in the moment, can make all the difference in helping you manage your emotions and resist or distract from the impulse to self-harm.

Skill Application

DBT equips individuals with a toolbox of skills to cope with distressing emotions. Phone coaching allows clients to apply these skills in real-life situations, with the guidance of their therapist. This hands-on learning experience reinforces the effectiveness of the skills learned in therapy, making them more likely to be used in the future. I like to use the metaphor I was given by our CEO, Nikki Winchester, think of phone coaching like football. The players need to pay attention to what’s happening on the field and the coach takes more of a big picture view. The coach has a plethora of plays to consider, while the player has to figure out how to use those plays with what’s happening in the moment. Would the players be as successful without a coach? Would you expect a football game to happen without the coach there? That’s exactly how you should think about phone coaching and how helpful it can be to clients.

Phone coaching is a pivotal tool in DBT and has many benefits. I hope that if you engage or are engaged in comprehensive DBT, you utilize your phone coaching to generalize your skills and get closer to building the life you want!

Read Part 2 here

About the Author

Alyssa Eichhorn (she/her), M.A., LPCC-S, is a Licensed Professional Clinical Counselor that specializes in dialectical behavior therapy. Alyssa works with all ages in a radically genuine and nonjudgmental setting to help individuals identify more effective and balanced behaviors to create a life worth living. Alyssa provides a directive and warm approach with her clients to facilitate solutions, growth, and change where they want it. Click here to learn more about Alyssa and her therapeutic approach.

Linehan, M. M. (1993). Cognitive-behavioral treatment of borderline personality disorder.

Linehan, M. M. (2015). DBT® skills training manual (2nd ed.). Guilford Press.