Content & Trigger Warning Acknowledgment

A Life in Balance DBT Skills Training Program

This program teaches DBT skills using realistic case material — a story that follows a person living with borderline personality disorder. The material is used to teach skills, not for shock, but parts of it are emotionally heavy. This form names the difficult content you may encounter so you can make an informed choice before the group begins, describes how we protect you from the most graphic material, and documents your acknowledgment. Please read it carefully and ask any questions before signing.

1. About the material in this curriculum

The curriculum follows a single ongoing story across the 24 weeks. We use it as a shared “client” so you can learn and practice skills without being asked to disclose your own history. Throughout, the focus stays on the skill that could have helped in each moment — the difficult behaviors in the story are treated as experiences to understand, never as methods to detail or model.

Self-disclosure is always welcome but never required to take part.

2. Content you may encounter

I understand that the case material in this program includes depictions of the following:

•     Substance use — including alcohol use and misuse of medication.

•     Self-harm — including references to and signs of self-injury.

•     Sexual assault — one scene depicts a sexual assault.

•     Suicide, including a completed suicide — the story concludes with a character’s death by suicide.

I also understand that related themes — such as grief and loss, intense emotional crisis, dissociation, and disordered eating — may appear in the material or in group discussion.

3. How we handle the most difficult material

Your safety comes before any dramatic detail. To protect you:

• The most graphic sequences — including the ending and the scene involving sexual assault — are never shown or read aloud in detail. They are described in brief, clinical terms only, so you understand what happens without being exposed to the most charged material.

• We do not dwell on methods, means, amounts, or specifics of substance use, self-harm, or suicide. The teaching focus is always on the skill, not the act.

• For the heaviest sessions, a co-facilitator or designated support person is available.

• Your facilitator will tell you in advance when especially difficult material is coming up so you can prepare or make a different plan for that session.

4. Your right to step out and to skip material

I understand that:

• I may step away from any session at any time, without explanation, if I feel overwhelmed or need a break. A facilitator or designated staff member will check in with me shortly afterward (typically within about five minutes).

• There is no penalty for needing space, and stepping out is a supported use of skills.

• If I prefer, I may engage with brief summaries of the most difficult material rather than the material itself, and I can talk with my facilitator about how to do that.

5. If this material brings up distress

This program teaches skills and does not provide crisis or emergency services. If difficult content stirs up distress that feels beyond what I can manage safely, I am responsible for seeking immediate support through my individual therapist, emergency services (911), or a crisis resource such as the 988 Suicide & Crisis Lifeline (call or text 988). I understand that my facilitator may also recommend a higher level of care if clinically indicated.

6. Readiness and voluntary participation

I understand that taking part in this program is voluntary, and that engaging with this material is part of the program. If any of this content feels unsafe for me right now, I am encouraged to talk with my facilitator and my individual therapist before beginning. Some people are better served by joining a later cycle, after a period of stabilization, and choosing that is not a failure — it is a skillful decision about timing.

Acknowledgment

By signing below, I confirm that:

• I have been informed that the case material in this program includes substance use, self-harm, sexual assault, and a completed suicide, along with related difficult themes.

• I understand how the most graphic material is handled, and I understand my right to step out of a session or to engage with summaries instead.

• I have had the opportunity to ask questions and receive clarification.

• I voluntarily consent to engage with this material as part of my participation in the DBT Skills Training Group.