Here’s a detail from the DBT research that surprises almost everyone. In one of the key studies from Marsha Linehan’s own research team, every single participant was already using some DBT skills before treatment even started.
So knowing the skills wasn’t what made the difference. What changed people’s lives — fewer crises, less depression, better control of anger — was how much more often, and how much more skillfully, they used them over time.
That’s the whole case for a DBT skills refresher in two sentences. If you’ve been through DBT skills training and you’re still using some of the skills, you’re not starting over. You’re doing what the treatment was built for: going around again.
TL;DR: A 12-week DBT skills refresher helps people who already use DBT skills because the benefit of DBT comes from using skills often and well — not from having learned them once. Over time, most people narrow down to a few favourite skills, drift from how the skills actually work, and face new stressors the skills were never practised on. A structured refresher rebuilds range, accuracy, and automatic use — ideally while life is stable, not after a crisis.
But here’s what most people miss:
- Repetition isn’t a sign you failed. Standard DBT was designed to run the full skills curriculum twice. Going through it again is the model working as intended, not a remedial step.
- The skills you stopped using are usually the ones you need most. People tend to keep the skills that feel good (like distraction or cold water) and quietly drop the ones that feel hard (like asking for what you need or radical acceptance).
- The best time for a refresher is when you feel “fine.” Skills practised while you’re steady are the ones that show up when you’re not.
What this article covers — and what it doesn’t
This article is for adults in Saskatchewan who’ve already done DBT skills training — in a group, in individual counselling, through a workbook, or as part of a full DBT program — and are wondering whether a refresher is worth the time. It explains why skills fade or narrow, what a good 12-week refresher looks like, and how to tell if a refresher fits you or if you need something different.
A few honest limits up front. There isn’t a large research study that tests “a 12-week refresher after prior DBT skills training” as its own treatment. The case here is built from what we do know: how DBT skills work, how Linehan designed skills training, and what research shows about how long new behaviours take to become automatic. I’ll flag where the evidence is strong and where I’m applying clinical judgement.
And a practical note for this province: if you live in a northern or remote community, work rotating shifts at a mine or mill, or you’re a three-hour drive from the nearest in-person group, a refresher delivered by telehealth isn’t a watered-down option. For a lot of people here, it’s the only realistic one — and it works best when it fits around your actual schedule.
Why would I need a DBT refresher if I’m already using the skills?
Because using some skills isn’t the same as using the right skill, at the right moment, in the right way. That gap is almost invisible from the inside.
When clients come back to me a year or two after skills training, they usually say something like, “I still use my skills.” And they do. But when we look closer, “my skills” has often shrunk to two or three go-to moves. TIPP when things spike. STOP when they feel reactive. Maybe some distraction.
Those are good skills. They’re also mostly crisis survival skills — designed to get you through a hard moment without making it worse. They’re not designed to change the patterns that keep producing hard moments. That’s the job of emotion regulation and interpersonal effectiveness, and those are the modules people tend to let slide first, because they take more effort and the payoff is slower.
The research backs up why this matters. In Linehan’s team’s work, the increase in skills use over time was what explained the drop in suicide attempts and depression, and the gains in anger control. It wasn’t the teaching alone. It was the using. A later study that pulled DBT apart into its components found the skills training piece was especially important for reducing self-injury, depression, and anxiety.
So if skills use is the engine, then letting your range shrink to two or three skills is a bit like running a truck on two cylinders. It still moves. It just can’t handle the hills.
The three ways skills quietly erode
In practice, I see skills fade in three predictable ways. Most people have at least one going on.
1. Narrowing. You keep the skills that give quick relief and drop the ones that ask more of you. Over time, your toolbox becomes a single wrench.
2. Drift. You still use a skill, but the version you use has lost pieces. DEAR MAN turns into “just say what I want” — and the parts about staying mindful, appearing confident, and negotiating fall away. GIVE loses the validation. Check the Facts becomes “tell myself it’s not a big deal,” which isn’t the same thing at all.
3. Mismatch. Your life changed, and your skills didn’t come with it. You learned them while dealing with one set of problems — a breakup, a bad job, a family crisis. Now you’ve got a new supervisor, a parent moving in, a teenager, a diagnosis, a move up north. The skills were never practised on these situations, so they don’t fire automatically when these situations show up.
What most people miss: Distraction is the skill most likely to turn into its opposite. ACCEPTS is meant to get you through a short, intense wave. When it drifts, it becomes three hours of scrolling every night — which feels like a skill, looks like a skill, and is really avoidance wearing a skill’s name tag. A refresher is one of the few places where that gets gently noticed.
Isn’t repeating DBT skills just going backward?
No. Repeating the skills curriculum is how DBT was designed.
In standard DBT, it takes about 24 weeks to get through all four skills modules, and programs usually run the full cycle twice to make a one-year treatment. Linehan didn’t build it that way because people are slow learners. She built it that way because learning a skill once and being able to use it under pressure are two different things.
Here’s how I explain it to clients. The first time through, you learn what the skills are. The second time through, you learn when and why — which skill fits which moment, which ones you avoid, and what happens in your body right before a skill stops working.
That last part matters more than people think. DBT has a concept called the skills breakdown point — the level of emotional intensity where your thinking brain goes offline and complicated skills stop being available. The first time through training, most people don’t know where their breakdown point is. The second time, you’ve lived with the skills long enough to notice it. That knowledge changes everything, because now you can reach for the right skill before you hit that point instead of after.
There’s also a shame piece here worth naming. A lot of people avoid a refresher because it feels like admitting the first round “didn’t work.” That’s not how skills work. Nobody thinks a hockey player failed because they still go to practice. You don’t practise because you’re bad at something. You practise so the skill is there when the game is fast.
Why 12 weeks? Isn’t a weekend workshop enough?
A weekend workshop can remind you what the skills are. It usually can’t change how automatically you use them. Twelve weeks is long enough to do that — and short enough to fit a real life.
Habit research gives us a useful, if imperfect, reference point. In a well-known study on how habits form, researchers followed people for 84 days — exactly 12 weeks — while they tried to make a new daily behaviour automatic. The typical time to reach automatic was about 66 days, but the range was huge, from under three weeks to a projected eight months. And about half the participants hadn’t gotten there by the end of the study.
Two honest caveats. That study looked at simple health habits like drinking water or eating fruit at lunch — not emotional skills used under stress, which are almost certainly harder. So I don’t treat 66 days as a DBT number. What I take from it is the shape: real automaticity takes weeks of repeated practice, not a weekend, and it varies a lot from person to person.
The same study found something I share with every client: missing a single day of practice didn’t meaningfully slow things down. So if you miss a week of homework during calving season or a run of night shifts, you haven’t broken anything. You pick it back up.
Twelve weeks also has a practical advantage for people here. It’s short enough to plan around — one season, one rotation block, one school term — and long enough to cover all four modules with room for real practice between sessions.
What a 12-week refresher looks like in practice
Here’s how the DBT Skills Refresher at DBT Saskatchewan is built — twelve weekly 90-minute sessions, live online, for adults who already have a foundation in core DBT skills. Mindfulness opens every session and anchors the whole group, then the work moves through the other three modules and finishes with integration.
| Sessions | Focus | What’s different the second time around |
|---|---|---|
| 1 | Reconnecting: personal goals, Wise Mind, and the mindfulness “what” and “how” skills | You pick one behaviour to decrease and one effective response to strengthen — based on your life now, not the life you had when you first learned DBT |
| 2–4 | Distress tolerance: STOP, Pros and Cons, selected TIP skills, ACCEPTS, self-soothing, IMPROVE the Moment, Radical Acceptance, Turning the Mind, Willingness | Catching escalation earlier, building a coping menu that leads back to effective action instead of avoidance, and separating acceptance from giving up |
| 5–8 | Emotion regulation: Check the Facts, Opposite Action, Problem Solving, ABC PLEASE, Cope Ahead, Mindfulness of Current Emotions | Working on real, current emotional episodes — and finding your personal skills breakdown point |
| 9–11 | Interpersonal effectiveness: DEAR MAN, GIVE, FAST, validation, self-validation, Walking the Middle Path | Rehearsing real requests and refusals — with realistic pushback — using the full skill instead of the shortcut |
| 12 | Integration | Rehearsing a likely future difficulty, naming your warning signs, and planning how to restart after a setback |
The balance inside each 90 minutes is the real difference from a first course. Only about ten minutes goes to refreshing a skill. Most of the session goes to reviewing how practice went, troubleshooting what got in the way, and coached rehearsal on situations you bring. Progress on your personal goals gets reviewed at sessions 1, 6, and 12.
What most people miss: Sessions 5 to 8 are where refreshers tend to pay off the most. People who’ve been through DBT usually remember the crisis skills. They rarely remember that the ABC PLEASE skills — treating physical illness, balanced eating, avoiding mood-altering substances, sleep, exercise, and building mastery — are what make crises less likely in the first place. Cope Ahead is the other one people forget: rehearsing a hard situation before it happens. For shift workers especially, the sleep piece alone can be worth the whole course.
A composite example: what a refresher can look like in real life
The following is a composite. It blends details from several people, and names, jobs, and specifics have been changed. It doesn’t describe any single client.
Jolene is 41 and works as a lab tech at a potash mine in southeast Saskatchewan, on 12-hour rotating shifts. She did a DBT skills group about two years ago after a rough stretch, and she’d tell you it changed her life. She still uses TIPP when she’s flooded. She uses STOP at work when she feels herself about to snap at someone.
Then two things happened close together: her mom moved in after a fall, and her department got a new supervisor who micromanages. Jolene started snapping at home. She’d come off nights and spend hours on her phone “to decompress.” She told herself she was still using her skills. She was — just not the ones she needed.
In the refresher, the first couple of sessions made the gap obvious. Her crisis skills were solid. Her emotion regulation and interpersonal skills had almost disappeared. The scrolling she’d been calling distraction was really avoidance, and her sleep after night shifts had fallen apart.
The second time through Check the Facts landed differently for her. The first time, she’d learned it as a worksheet. This time, she used it on a real, current situation — the supervisor — and realized how much of her anger was about feeling like her competence was being questioned. That changed what she did about it. She used DEAR MAN, in full, to ask for a clear check-in schedule instead of constant drop-ins. She used GIVE with her mom to negotiate some quiet time after nights.
Her work situation didn’t transform. Her mom still lives with her. What changed was that Jolene went back to having a full toolbox instead of two favourite tools. That’s the realistic goal of a refresher — not a new life, but more range inside the one you’ve got.
How do I know if I’m due for a DBT skills refresher?
Most people who are due for a refresher don’t feel like they’re struggling. They feel like they’re coping. That’s exactly why a simple self-check helps.
Read through the list below. This isn’t a screening tool or a diagnosis — it’s a practical rule of thumb I use with clients. If three or more of these sound familiar, a refresher is worth a conversation.
Signs you may be due:
- You use the same two or three skills for almost everything.
- You can’t remember the steps of a skill you used to rely on (try writing out DEAR MAN or ABC PLEASE from memory).
- You use skills after things go wrong more often than before.
- Something big has changed since you did skills training — a new job, a new relationship, a loss, a move, a health issue, a new baby.
- Distraction has started to look more like avoidance.
- Your sleep, eating, or substance use has slipped, and you haven’t treated that as a skills issue.
- You’ve stopped doing any kind of diary card or tracking.
- You’re coping, but it takes more effort than it used to.
- You notice old patterns coming back — even small ones.
If that list sounds familiar, you can start a DBT intake through the STG portal — intake is where we look at whether a refresher, individual DBT, or something else fits where you are right now. You don’t need to have done your first round of DBT with STG; training elsewhere can count after a clinical review.
Is a DBT refresher right for me, or do I need something else?
A refresher is the right fit when your skills foundation is solid but your use has narrowed, drifted, or fallen out of step with your life. It’s the wrong fit when you need more support than a refresher can give. Here’s how I think about it.
| Your situation | What likely fits | Why |
|---|---|---|
| You finished DBT skills training, you’re mostly stable, and your skill use has narrowed | 12-week refresher | This is the ideal case — you’re rebuilding range while you have the capacity to practise |
| A big life change has hit, and your skills aren’t keeping up | 12-week refresher, possibly with a few individual sessions | You need to practise the skills on the new problems |
| You learned skills from a book or app and never had structured practice or feedback | Full DBT skills course, not a refresher | A refresher assumes a foundation that may not be there yet |
| You’re coping well and your skills feel automatic | Occasional check-ins or self-guided review | A full refresher may be more than you need right now |
| You’re having suicidal thoughts, self-harm urges, or repeated crises | More intensive support — individual therapy or comprehensive DBT | A refresher is not a crisis treatment |
| Your skills are fine, but your situation is unsafe or unworkable | Skills plus changes to the situation | Skills help you cope, but they don’t replace fixing a harmful workplace or relationship |
When a refresher isn’t enough
I want to be direct about this part. A refresher is a maintenance and rebuilding tool. It’s not designed to carry someone through an active crisis. Our refresher is a skills group — it isn’t comprehensive DBT, and it doesn’t include individual therapy, between-session coaching, or crisis support. Intake looks at whether the group format matches what you need right now.
If you’re having thoughts of suicide, if self-harm urges are back, if you’re drinking or using to get through the day, or if you feel like you’re in over your head, you deserve more support than a 12-week course. Reaching for that support is a skill in itself, not a sign that DBT didn’t work.
If you’re struggling right now: Call or text 988 any time, day or night. Call 811 to talk with a Saskatchewan HealthLine nurse or mental health professional. If you or someone else is in immediate danger, call 911.
If-then: matching the refresher to your situation
- If your crisis skills are strong but your relationships feel strained, then bring real conversations to sessions 9 to 11 — that’s where you’ll rehearse them.
- If you work shifts or live somewhere with long, dark winters, then treat the ABC PLEASE and sleep skills as a priority, not an extra. Our sleep regularity article for shift workers on SaskSleep pairs well with this part of the course.
- If you’ve noticed distraction turning into avoidance, then say so in session one. It’s easier to work with once it’s named.
- If you originally learned DBT for burnout, then revisit our article on DBT skills for high-functioning burnout alongside the refresher — the emotion regulation module is where most of the burnout-specific work happens.
- If you can’t commit to 12 weeks right now, then don’t force it. Pick one module you’ve let slide and practise one skill from it daily for two weeks. A partial start is still a start.
What does a refresher actually ask of me?
Less than your first round of skills training, but more than showing up. Here’s a realistic picture of the time and effort involved.
| Task | Difficulty | Time investment |
|---|---|---|
| Attend the weekly live online session | Low | 90 minutes a week, for 12 weeks |
| Set your personal goals in session 1 (one behaviour to decrease, one response to strengthen) | Low | Done in session; a few minutes of thinking beforehand helps |
| One main applied task each week (one skill, one real situation) | Medium | Varies — usually short, repeated attempts through the week |
| Brief check-ins in STG Track (emotions, urges, skills used) | Low–Medium | A few minutes, most days |
| Practise a skill you’ve been avoiding | High | This is where the real work is |
| Build your continuation plan in session 12 | Medium | Done in session, with follow-through after |
Enrolled participants also get access to STG Online Clinic resources to revisit skills between sessions. The tracking is there to help you notice what’s working — not to produce a perfect diary. And it’s not monitored around the clock, so it’s never a way to reach help in an emergency.
The real-world reality: The hardest part of a refresher isn’t the time. It’s practising the skills you dropped for a reason. Usually those skills were dropped because they felt uncomfortable — asking for something, saying no, sitting with an emotion without fixing it. Expect some resistance around week three or four. That resistance is usually a sign you’ve found the part worth working on.
A few timing tips that matter in Saskatchewan:
- Start before the dark months if you can. A November start means you’re practising emotion regulation skills right as the days get short — and they’re in place for January and February, when a lot of people in this province need them most.
- Check your rotation against the session time. The November group meets Wednesday evenings. If you work 12-hour rotating shifts, map out your next three months before intake and raise any conflicts early, so you can plan practice around the sessions you’ll miss.
- Test your connection early. If you’re joining from a remote community, do a trial video call before week one. A dropped connection in the middle of a hard conversation is frustrating, and a phone backup plan helps.
The bigger picture: DBT skills are a practice, not a course you finish
If there’s one idea to take from this article, it’s this: DBT skills work the way physical fitness works. You don’t get fit once and stay fit forever. What you built is real — and it’s also something you maintain.
That shift in thinking takes a lot of pressure off. It means needing a refresher doesn’t mean the first round failed. It means you’re treating your skills like something worth keeping sharp. The people I see do best over the long run aren’t the ones who never struggle again. They’re the ones who notice early when their skills are slipping and go back to practice before a crisis forces them to.
What’s changing in this space
DBT skills training has moved well beyond its original form. Shorter, skills-only programs are now common, telehealth delivery has made skills groups reachable for people who couldn’t drive to one, and DBT skills are being used for a much wider range of concerns than they were first designed for.
What we still don’t have is strong research on maintenance — how often people should revisit skills, which format works best for a refresher, and who benefits most. I expect that research to grow. Until then, the most honest guide is what we do know: skill use drives change, repetition is built into the model, and automatic habits take longer than most people expect.
Frequently asked questions
What is a DBT skills refresher course?
A DBT skills refresher is a structured review of the four DBT skills modules — mindfulness, distress tolerance, emotion regulation, and interpersonal effectiveness — for people who’ve already had DBT skills training. Instead of teaching the skills from scratch, it focuses on rebuilding the range, accuracy, and automatic use of skills you already know.
Why do people need a refresher if they’re already using DBT skills?
Because most people narrow down to a few favourite skills over time, drift from how some skills actually work, or face new life stressors they never practised their skills on. The benefit of DBT comes from using the right skills often and well, so rebuilding range makes a real difference.
Is repeating DBT skills training normal?
Yes. Standard DBT takes about 24 weeks to cover the full skills curriculum and usually runs it twice over a year. Repetition is part of how DBT was designed, not a sign that the first round didn’t work.
How long should a DBT refresher be?
There’s no single research-backed length for a refresher. Twelve weeks is a practical choice because it’s long enough to cover all four modules with real practice between sessions, and short enough to fit around work, family, and shift schedules.
Can I do a DBT skills refresher online in Saskatchewan?
Yes. DBT Saskatchewan, a program of STG Health Services, runs a 12-week DBT Skills Refresher live online for adults anywhere in the province. The next group starts November 18, 2026, meeting Wednesdays at 7:00 p.m. Saskatchewan time.
How much does the DBT Skills Refresher cost?
For private-pay participants, each 90-minute session is $70, for a total of $840 in group-session fees across all 12 sessions. There’s no fee for First Nations participants with NIHB approval for the program. STG Online Clinic resources and STG Track access are included.
Do I need to have done DBT with STG first?
No. Core DBT skills training completed with another provider, or substantial equivalent work, can be accepted after a clinical review at intake. You don’t need perfect recall of every skill — just a working foundation and a willingness to practise.
When is a DBT refresher not the right choice?
A refresher isn’t enough if you’re having suicidal thoughts, self-harm urges, or repeated crises — those call for more intensive support. It’s also not the best fit if you never had structured DBT skills training in the first place; a full skills course is usually better. If you’re in crisis, call or text 988, or call 911 in an emergency.
Ready to sharpen what you’ve already built?
You did the hard work of learning DBT skills once. A refresher is about protecting that work — getting back the skills you’ve let slide, updating them for the life you have now, and practising while you’re steady so they show up when you’re not.
Our next group starts November 18, 2026 — twelve Wednesday evenings, 90 minutes each, live online from anywhere in Saskatchewan. You can see the full 12-session outline, fees, and practical details for the November DBT Skills Refresher, or go straight to starting a DBT intake. Intake doesn’t reserve a spot or commit you to anything — it’s where we look at where your skills are now and whether the group is the right next step.
