The therapeutic relationship is paramount to using DBT with clients. Clients need to feel safe and secure before beginning the therapeutic journey. Thus, the pre-commitment stage of treatment focuses on forming the relationship, orienting the client to treatment, agreeing on goals, and obtaining a commitment to decrease and ultimately extinguish self destructive behaviors.
The first stage of treatment involves stabilization by helping the client acquire, internalize and generalize the four core skills needed to regulate emotion, tolerate distress, manage interpersonal relationships, and remain mindful of thoughts, feelings, and actions.
Clients move on to stage two when they demonstrate the ability to regulate their emotions. During stage two clients will begin to process their trauma and other factors associated with their high risk behaviors.