6 Essential Questions to ask a DBT Therapist or Program
DBT-Linehan Board of Certification™ (DBT-LBC™) provides consumers with a clear way to know whether a DBT clinician or program offers DBT in a manner that adheres to evidence-based research. We encourage clients to ask if their clinicians or programs are DBT-LBC™ certified. At the same time, we recognize that DBT-LBC™ certified clinicians or programs may not always be accessible to you for a variety of reasons. We also recognize that there are DBT clinicians and programs providing adherent, high-quality DBT who are not yet certified by DBT-LBC™. Therefore, we believe it is important for clients and families to have strategies to determine whether a DBT clinician or program is providing comprehensive, high-fidelity DBT, as it has been researched, when DBT-LBC™ certification is not present.
We suggest that clients or families ask a potential DBT therapist or program the following questions:
- What training in DBT have you received? Have you completed a ten-day intensive/foundational DBT training?
- Are you a member of a DBT consultation team?
- Do clients complete diary cards for each individual therapy session?
- Do you offer all the following elements of a comprehensive DBT program?
-
- DBT individual therapy (one hour weekly): Individual sessions in a comprehensive DBT program follow a specific structure, starting with review of the diary card from the past week, and then setting an agenda based on the behaviors the client is working on and their goals.
- DBT skills training class: skills training typically occurs in a group setting, but it may be conducted individually in a separate session focused fully on skills training. Adherent skills training requires teaching new skills AND review of homework practice assigned the previous week. Adherent skills groups have a leader and a co-leader, use the DBT Skills Training Manual by Dr. Marsha Linehan, and cover four skills modules: mindfulness, interpersonal effectiveness, emotion regulation, and distress tolerance. For adolescents in DBT, parents should also participate in skills training, and there is an additional skills module – Walking the Middle Path.
- DBT consultation Team (weekly for clinicians): DBT consultation team provides support and enhances the skills of the therapists on the team, so that they can continue to provide adherent DBT.
- Phone consultation (as-needed for the client, and provided by the individual therapist outside of session times): phone coaching is not the same as a crisis line; phone coaching is meant to help clients apply the skills they are learning in DBT to real-time situations in their lives. It is very difficult to engage in new, skillful behaviors in moments of distress or high emotion, and so DBT therapists are available to provide coaching that encourages clients to use their new skills to manage emotions and urges and to solve problems.
- Do you routinely audio/video record your DBT individual therapy sessions for your supervisor or DBT consultation team to listen to and provide feedback, to make sure you are doing adherent therapy?
- Do you engage in continuing education focused on DBT while staying up to date on research and practical advances?
These suggested questions are based off a list curated by Linda Dimeff, PhD and Portland DBT Institute.
Why is adherence important? Because adherent DBT saves lives. Visit the DBT-LBC website for a list of certified clinicians here.
A big Thank You to our editors who make this Blog happen:
Co-Editor – Amy Kalasunas, LPCC-S, CCMHC
Co-Editor – Emily Vanderpool, LPC-MHSP, LBA, BCBA
Co-Editor – Tali Wigod, Psy.D.
Co-Editor – Casey Anderson, LCPC, RPT
Co-Editor – Liz LoTempio, Psy.D.
