The DBT-Linehan Board of Certification (DBT-LBC) has launched the recognition of DBT Programs with the active participation and endorsement of Marsha M. Linehan, Ph.D., founder and developer of DBT. Programs that pursue the certification process elect to have experts in the treatment observe, review and evaluate the practices of their DBT program. Such review can confirm sound practices and indicate areas of departure or drift from program standards, both core elements of effective treatment dissemination. DBT-LBC Program Certification designates that a program has a Team Leader who is certified as a DBT Individual Clinician and that the DBT Program has successfully implemented the core practices of DBT. This distinction may also be a factor for clients or families selecting a provider, for referral networks guiding consumers, or for determining therapist reimbursement rates from third-party payers.
The goal of Program Certification is to support and encourage a proliferation of DBT programs providing adherent treatment. Importantly, it provides a ‘roadmap’ for programs to follow, highlighting critical elements that should be present in every DBT program. The process discriminates between recommendations to the program that must be addressed for the program to be certified versus suggestions made by site reviewers, which may share creative solutions and common practices observed in other programs. Programs are encouraged to address deficiencies using the recommendations and continue with the site review process to ultimate certification. Thus Program Certification is another element in the broad set of resources for clinicians and programs implementing DBT.
Purpose of Program Certification
The awarding of DBT®-LBC Program Certification indicates that the program has the structure and practices consistent with the delivery of a comprehensive (or adapted) implementation of Dialectical Behavior Therapy. It has undergone an extensive review that consists of scoring of responses to a Program Fidelity Scale questionnaire, program document and file review to see the structure of the DBT program, interviews with treatment providers and clients, and on-site observations of the DBT program practices in action. This award does not guarantee the quality that every client will receive in the Dialectical Behavior Therapy Program, or that every treatment session is done with a high level of fidelity. (DBT-LBC Individual Clinician Certification reviews the practice of clinicians.). Certified Programs have demonstrated that they have the capacity and intent to provide Dialectical Behavior Therapy adherently. The goal of Program Certification is to support and encourage a proliferation of DBT programs providing adherent treatment. Importantly, it provides a ‘roadmap’ for programs to follow, highlighting critical elements that should be present in every DBT program.
For a DBT Program to be eligible to apply for certification, the Team Leader must have completed certification as an individual Clinician. The Team Leader will be the person responsible for completing the application on line. We suggest that every program considering applying first complete the Program Fidelity Scale (PFS). This is an overall review of your program and the degree to which you currently meet the requirements we will be looking for. Once there is confidence that those expectations are met, the application can then be initiated.
Steps in the certification process
The Team Leader is responsible for identifying two or more clinicians who are representative of the treatment provided overall within the clinic and ensuring that there are sufficient charts (5) for each of these clinicians to discuss with the Reviewers during their interviews; these charts are selected from those clients who have consented to have their files used in external reviews. Clinicians who are already certified are not included in the interviews with the exception of the Team Leader, who is interviewed for Programmatic elements only. When the majority of Team members are certified, clinician interviews may be unnecessary. All employees (treatment providers and office staff who work with clients) must agree to have some aspects of their personnel records reviewed, including verification of ID, criminal background check, educational degree, licensure and training.
Many teams will be eager to receive feedback or to know ‘whether they passed’ by the end of the visit. Reviewers will not provide definitive answers regarding pass/fail until all the data has been reviewed, follow-up questions are identified and answered, and a clear consensus that all needed information has been obtained. Nonetheless, there will be opportunity to validate the hard work and anxiety that may accompany the process of submitting for certification in an end-of-day debriefing meeting. A final response on whether or not the program has passed will be sent in the weeks following the site visit after all necessary review and consultation with the larger Program Certification committee has been done. If any data is missing, additional contact with the Program will occur to obtain needed information. Once the site visit is scheduled, the final fee of $2000 will need to be paid.