Dialectical Behaviour Therapy (DBT) Frequently Asked Questions:
What is DBT?
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DBT is an evidence based, intensive model of therapy, initially created to treat borderline personality disorder. It requires four (4) separate components. Any offering that doesn't included all four (4) components, is not DBT. These components include:
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Skills training groups
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Structured individual DBT therapy (weekly or biweekly basis)
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Phone coaching
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A DBT consultation team
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Why do some therapists I have seen online offer just DBT individual therapy, but you require I take group skills in order to access individual DBT therapy?
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It can be confusing to sort out what's what, because, as DBT gains in popularity, there has been a disturbing trend where many therapists and websites now claim to offer DBT when they don't. It is important to be informed about what DBT is and is not. DBT is NOT simply individual therapy that teaches some DBT skills.
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Skills are not solely taught in individual therapy. this is done for various reasons. It has been found to be more effective when taught in a group format, and it leaves room for other important components of the DBT model to be addressed in individual therapy. For DBT individual therapy to do what it needs to do, it is more effective when a person is learning skills in group.
For more information about DBT, check out: https://behavioraltech.org/resources/faqs/dialectical-behavior-therapy-dbt/
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What is involved in training a DBT therapist?
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There are vastly different levels of training available to therapists to learn DBT. These range from 1-2 day workshops, which give a therapist a basic overview of the model but do not train them to implement DBT, to what is considered standard DBT training, which involves five (5) days of training and five (5) days of consultation with a significant amount of homework and practice in-between sessions. The gold standard training is BTech's Intensive or Foundational training (Behavior Tech: https://behavioraltech.org/).
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DBT certification is yet another level of training, which is not just getting a certificate for completing a training, but involves a therapist going through a stringent process of mindfulness training, providing comprehensive DBT for a certain period of time, passing an exam, submitting a case conceptualization, and having videotapes of sessions reviewed by experts in DBT in order to pass fidelity measures.
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When looking into getting DBT, ask your therapist about what training they have received.
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How do I know if a provider is actually offering me DBT?
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Aside from inquiring if the therapist is adequately trained to be able to deliver DBT, you should inquire as to whether you will have the benefit of a DBT consultation team. If there is no consultation team, you are not receiving DBT. The reason the model includes this, is because it has been found to increase therapists' fidelity to the model, and fidelity to DBT is what ensures effectiveness. DBT is all about balancing seemingly contradictory or opposite truths. This can make clinical decision-making difficult without a team who can help a therapist identify the things that they may not be seeing. Because clients who need DBT may be in significant amount of distress and pain, and sometimes engaging in life-threatening behaviour, it is easy for therapists doing DBT to get burnt out without a consultation team for support.
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Also, you should inquire about the presence of phone coaching as an adjunct to the therapy. If there isn't access to some phone coaching, it isn't DBT.
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I have heard that you do allow people to do skills group on its own. Is this DBT?
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On a case-by-case basis, based on 1 - 4 individual meetings in which we determine whether we think it could benefit you, we do open our skills group to people who are not financially or otherwise able to do both group and individual therapy together. This is not DBT, as you would only be getting one component of the whole model. In some cases, though, that may be all you need. We will give you an honest assessment in those initial meetings of what we think is best for you. If you do not need comprehensive DBT (i.e., all 4 components), but may benefit from attending one or more of our three different modules, we will direct you towards that option. We don't believe in providing unnecessary services!
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Why do you allow people to do only the skills groups but not the individual DBT therapy component on its own?
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The answer to this is in the research. The evidence has shown that the biggest improvements are obtained from skills groups, meaning that if you had to choose one component to do, that is the one to choose. Individual DBT therapy helps to keep people engaged and committed, using the skills in solving their unique problems. Phone coaching helps to generalize and reinforce the skills in daily life.
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What are the steps for deciding whether DBT at Lesley Hartman & Associates is right for me?
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To know whether DBT is the right fit for you, please fill out an online referral form to set up an appointment to speak with our intake worker. After speaking with the intake worker, they can give you an initial sense of whether it may be a fit. If it seems like it has potential to assist you, the intake worker will book you for an orientation meeting. These are held once per month, online, in a group format. It is a learning opportunity, as the facilitator will begin teaching you more about DBT and things to get to you to understand yourself better. There is a fee for orientation, which is like a class. After that, you will have a much better sense of whether DBT is a fit for you. At this point, if you think it is, you can contact intake again to be set up for 1-4 individual assessment and commitment sessions. These sessions will go deeper into your goals and assess the suitability of our program for your needs. They will also help you to understand and clarify your needs and goals better. There is a cost for these sessions. After these, your commitment therapist will make recommendations for you.
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