Adherence Matters
The Chicago DBT Institute® is one of only 16 Linehan Board Certified DBT Programs in the nation. We chose to pursue DBT-LBC Certification because we wanted to ensure for all of our patients, families, and loved ones that we are offering DBT in a way that conforms to evidence-based research, is adherent to the model developed by Dr. Marsha Linehan, and contains all the necessary components and organization to deliver DBT with fidelity to the model.
We do this because we know adherence matters.
Recent data presented at the International Society for the Improvement and Teaching of DBT (ISITBT) in November 2019 showed that adherence to DBT decreased suicide attempts by almost double and predicts a lower likelihood of treatment droput. We also know that adherence to the model increases patient outcomes.
We value adherence because we want to help people build lives worth living and we know that data shows time and time again that DBT decreases self-injury, suicide attempts, suicidal ideation, emotion dysregulation, and other symptoms commonly associated with Borderline Personality Disorder. In fact, DBT is recognized as tte Gold Standard Treatment for individuals who are suicidal and have Borderline Personality Disorder (Miller, 2015).
We value adherence because we know that the lives of people seeking DBT are painful as they are currently being lived.
We find that many of our patients have been through different types of treatments before coming to CDBTI. They may have even been exposed to some DBT skills in other programs. However, that is not adherent, comprehensive DBT. All four components must be present for it to be truly considered evidence-based and empirically supported DBT.
Adherent DBT consists of a (1) once-weekly 2-hour skills training group which works from the Linehan Skills Training Manual , (2) weekly individual sessions, (3) 24/7 availability for phone coaching with a DBT clinician to aid in skills generalization in vivo, and (4) your individual clinician’s participation on a DBT Consultation Team. These components must all be present to be considered adherent DBT. Further, research shows that the best treatment outcomes are from DBT that contains all four components. “DBT-informed” treatment is not the same as Comprehensive DBT. Treatment outcomes are not equivalent when only doing parts of the treatment.
CDBTI became one of the first DBT-Linehan Board of Certification Certified Programs because we value adherence to the model and are committed to providing the best possible care to all of our patients and families. We were independently reviewed by the DBT-Linehan Board of Certification. DBT-LBC reviewed our policies, procedures and documentation in addition to an on-site visit which included individual clinician interviews, Skills Group observation, Consultation Team observation, and individual and family interviews about CDBTI’s practices. DBT-LBC Program Certification is a rigorous process and we are so proud to be one of very few programs in the Nation to have this important Certification. We can say with certainty that we do adherent DBT because we have been observed by independent experts in the field. Additionally, all of our clinicians have completed over 40 hours of training in DBT and continue to receive regular weekly supervision by a DBT-LBC Certified Therapist.
Adherence matters because providing the best possible treatment matters. We know that DBT can aid in reducing suffering and building lives worth living. We want nothing more than for our patients and families to receive adherent, empirically-supported, evidence-based treatment.
The following questions are a helpful guide to finding a therapist who does adherent, comprehensive DBT:
Are you a DBT-LBC Certified Individual Therapist?
Are you part of a DBT-LBC Certified Program?
Have you completed an Advanced Intensive or Foundational Training sponsored by Behavioral Tech?
Behavioral Tech, LLC is the training company founded by Dr. Marsha Linehan, the developer of DBT. It is highly regarded for adherence in DBT training.
How many hours of training in DBT do you have?
For example, our clinicians have completed a minimum of 40 hours of training in DBT through Behavioral Tech, LLC before even beginning work at CDBTI.
Have you ever been independently evaluated for your adherence to DBT?
Do you videotape or audio record sessions to code for adherence?
Are you a member of a DBT Consultation Team? Are they in-person or virtual? How often do you meet? Do you ever skip weeks?
DBT Consultation Team must meet weekly in order to be adherent to DBT. An in-person team means that clinicians may be more likely to be invested in treatment outcomes and have 24 / 7 access to consultation with providers who know your case. In-person Consultation Team also ensures that your case is covered effectively, even if your therapist is out of town, etc.
Have you been supervised by an expert DBT therapist?
How often do you receive regular DBT supervision?
All of our clinicians receive a minimum of 1 hour weekly individual supervision with a DBT-LBC Certified Clinician in addition to group supervision, weekly research meetings, and twice weekly Consultation Team.
Do you have a skills group? How long is it? What materials do you use? Can I see a schedule?
Adherence to DBT means utilizing original Linehan materials (found here) on an approximately 6-month schedule.
What 4 modules do you teach?
Adherent DBT covers Mindfulness, Distress Tolerance, Emotion Regulation, and Interpersonal Effectiveness
Do you do diary cards?
Do you teach chain analysis?
Do you do phone coaching? Is phone coaching available 24/7? As a parent, do I have access to parent phone coaching?
How are parents supported in treatment? Do you provide parent training or multifamily groups?