Spotlight: John Lothes

What brought me to pursue DBT-LBC Certification?

“DBT was not on my radar until after I was out of grad school. I’m not even sure it was covered in any of my graduate classes, and if it was, it was brief. However, I was fortunate enough to land my internship at New Hanover County’s Behavioral Health hospital where my then, supervisor and now longtime friend and DBT mentor, Jane St. John was running a DBT partial hospital.

Immediately this style of therapy made sense to me. Help our patients change their behaviors while also helping them accept who they are, and the way things are. All while validating them. There was also this convergence of everything I learned about in grad school all bundled into one therapy modality: Freud’s theories of how history effects our patients today, Rogers unconditional positive regard for our patients, Skinner’s behavioral change theories, Ellis’s irreverence and focus on current behaviors.

We have a running joke in our office that DBT is if Skinner and Rogers had a child and Ellis was the uncle that would come over and baby sit from time to time. During my internship, I was also fortunate enough to have Jane encourage me to go to a weeklong training with Dr. Linehan in 2004 at the New England Education Institute.

After internship I took an adjunct teaching position for a year or two, then received a card in the mail from Jane one day that she left the hospital and started her own practice. She was wanting to offer DBT to the greater Wilmington community (I was in!!!).

I joined Jane’s practice, Delta Behavioral Health in Wilmington, NC. I helped her with traditional weekly skills groups and helped her start up a DBT outpatient partial hospital program, and then later, an Intensive Outpatient program. Jane and I ran groups, saw individual clients, and started taking on interns to train in DBT. Delta has since grown from the 2 of us to about 10 DBT clinicians working in all these settings: outpatient (traditional DBT), weekly skills groups, helping run the PH and IOP programs & DBT-PE. Numerous interns that have also gone on to PhD programs, other sites, etc. I’ve noticed over the years that DBT has not only helped the patients that come through our clinic, but it has changed my life through using the skills myself.

One of the biggest compliments I think I’ve ever received from a mentor was when Jane said to me one day, “the reason you do well with DBT is that you live the skills.” As per many of us have probably thought at some point in our DBT journey, “If I would have only known these skills when I was younger!!!”

As any diligent researcher and aspiring academic, I wanted to know if the DBT in PH and IOP we were doing was actually helping. So, after multiple DEAR MANs and Jane’s approval, I started collecting data on out of the PH and then later the IOP program. At this time only 1 person had published anything on DBT in either of these settings (they will show up later in this story). Me, Jane and others that have come through Delta also started attending ABCT and ISITDBT on a regular basis to present our research as well as enhance our DBT by learning from the best. I also found out at this time that I am more of a DBT nerd than I ever thought I would be. I remember a number of times at conferences with some of my fellow Delta clinicians (who’s names I will not mention to protect their nerdom confidentiality) conferences being like “that’s Melanie Harned, or Alan Fruzzetti, or I rode in the elevator with Marsha Linehan!!!”

Fast forward 10 years of doing DBT, collectively as a team we did the 10-day B-Tech intensive in 2014 with Dr. DuBose and Dr. Ritschel (guess who was the first to publish on DBT in IOP!!!). During this training is when DBT certification was first mentioned. I think that year they were rolling out certification for the B-Tech trainers. Since most of my DBT experience was in a PH program I was always a little reluctant and unsure if I was “doing real DBT”. Yes, I had a case load of individual clients that I did DBT with; did diary cards, chain analysis, coaching phone, consultation team, ran weekly DBT groups, read every DBT book I could find, but in the back of my mind I was asking myself, “are you REALLY doing it right?”. So, what better way to answer that question then to consult the experts. In 2017, I attended another DBT training with Dr. Ritschel and at lunch full of self-doubt I was asking her questions about certification. And like any good DBT clinician she suggested opposite action and to apply, while also being very validating. So, I did and completed my certification last fall. 

DBT certification not only assures me that I am offering effective DBT, but it allows patients that come through our clinic to know they are getting adherent DBT as well. This has also motivated other clinicians in our office to consider getting certified and a couple of them have already started the process. While it does take a lot of work to achieve this certification, it is one that allows you and your patients to know they are getting DBT the way Dr. Linehan intended it. I have had countless patients come in for intakes and tell me they’ve “done DBT before” only to find out someone handed them some skills handouts and most of the other parts of DBT were missing.

I wanted to make sure that what I was doing was in line with Dr. Linehan’s vision.