Dialectical Behavior Therapy Intensive Training

Training Description

Purpose: DBT Intensive training is a comprehensive team-based program of study designed to provide teams with the knowledge and skills necessary to provide DBT. It serves as the entry point for clinicians to conduct standard DBT. 

Content: The course includes the foundational theory, conceptualization, structure, strategies, procedures, and protocols of standard DBT. It assists teams with the clinical work of DBT and the establishment of DBT programs.

Length & Schedule: The length of the course can vary from 6 months to 1 year, and includes 60 hours of instructional time. Participants spend 2 separate weeks in training with instructors for a total of 10 days. The 2 weeks are separated by a minimum of 6 months to a 1 year.

For Whom: Intensive training is intended for teams of mental health providers who are interested in implementing DBT programs with a high level of fidelity to evidence-based models.

Core Training Description 

Since its initial development in the 1980s DBT has been shown to be effective for an array of problems related to emotion dysregulation. We know severe emotion regulation difficulties result in persons facing multiple problems across many areas of life and that these problems manifest in a variety of ways. The principles of DBT were specifically designed for cases which often present therapists with novel challenges. One of the benefits of a principle-based treatment is that it can be versatile enough to accommodate the specific situations, cultures, and contexts of the persons it serves. DBT has been studied and implemented in multiple countries across the globe.

DBT Intensive Training focuses on both the establishment of comprehensive DBT programs and the clinical skills necessary to provide the treatment to persons with complex mental health problems. Intensive training in DBT includes 4 hours of content specific to risk assessment, management, and treatment of suicidal behaviors.

The program is divided into 2 main parts that are designed to guide teams to accomplish four phases of DBT program implementation in a single program of study. 

Part 1 (Foundational; 30 instructional hours) 

• Preparation – self-directed readings and discussions
• Knowledge Acquisition – instructor-led training

Part 2 (Practice Improvement & Sustainability; 30 instructional hours) 

• Implementation – completion of assigned homework, establishment of DBT program, and clinical case work
• Practice Improvement & Sustainability – instructor-led consultation regarding programs, teams, and clinical work

In the Knowledge Acquisition segment of Part 1, lectures, demonstrations of treatment, and small group exercises are used to teach DBT theory and strategies in-depth. In the Implementation phase of the training that happens upon conclusion of Part 1, participants consolidate and apply what they have learned with the help of practice assignments that are intended to guide the implementation process. Teams design and begin to implement their own DBT programs or to integrate DBT into an ongoing treatment setting. Based on their work in the implementation phase of the training, each team receives expert consultation on specific cases and on their program in the Practice Improvement & Sustainability segment of Part 2, including protocols for specific treatment problems and adaptations of DBT.

Before reconvening for the final 20 modules of Practice Improvement & Sustainability: Practice in Crisis Intervention

During the implementation (homework) phase of the training, each team meets with one of the trainers to practice crisis intervention according to provided guidelines.

Practice Improvement & Sustainability

Part 2 of DBT Intensive Training involves a series of tasks in the service of implementing DBT programs and clinical work. Structured didactic training shifts primarily to consultation directed at the specific needs of the teams in training while addressing training targets and advanced topics. The Practice Improvement & Sustainability segment focuses on team-based consultation & advanced topics. Each team receives focused consultation from the trainers that is observed by all participants, and each consultation is followed by a discussion among the full group of participants. While the team has an opportunity to have its specific questions addressed by DBT experts, it is expected that the observation and discussion among the whole group will result in sharpening the assessment and intervention skills of all participants, and that vicarious learning will occur that will generalize across teams and programs. Consultations are based on program and team development documents and a case formulation that is prepared by each team. Trainers use the information from these documents, a knowledge exam, and the consultations that occur across Part 2 to assess the needs of trainees and weave advanced topics into the discussions of the consultations. The final module engages teams in a series of exercises designed to solidify their learning and to strategize ways to keep their learning vibrant over time.

This instructor-led program of study consists of 10 days of training, divided into 2 parts of 5 days each, delivered onsite in conjunction with a learning management system (LMS) for a total of 60 instructor-led hours. The typical length of the full course of study is 6 months to 1 year. 

Primary Objective: 

As a result of this training participants will be able to provide DBT. 

Part 1 – Learning Objectives: 

1. Incorporate DBT assumptions about clients, therapists, and therapy into treatment.
2. Conceptualize the importance of balancing change and acceptance in providing consultation.
3. Identify DBT principles and strategies used during DBT consultation team meetings.
4. Increase the motivation and capability of therapists on your consultation team.
5. Describe how the scientific method is used in both treatment development and conducting DBT.
6. Use DBT research data to engage stakeholders in DBT.
7. Adopt and practice a dialectical worldview in treatment and case formulation.
8. Engage clients in treatment by providing dialectical balance between change and acceptance.
9. Accurately describe the content of the Core Mindfulness skills training module.
10. Convey the rationale for DBT Mindfulness skills.
11. Explain how Core Mindfulness skills are key (core) to all skills taught in DBT.
12. Explain the Biosocial Model of Borderline Personality Disorder (BPD) and other severe disorders in all required treatment contexts.
13. Conceptualize the manner in which suicidal behavior is an attempt by patients to solve problems.
14. Incorporate hypotheses to include in DBT case conceptualization (formulation) based on dialectical dilemmas experienced by persons with BPD.
15. Accurately describe the content of the Emotion Regulation skills training module.
16. Describe the evidence for the use of DBT Emotions Regulation skills.
17. Convey the rationale for DBT Emotion Regulation skills.
18. Describe the functions of comprehensive treatment and the corresponding modes employed in DBT to accomplish these functions.
19. Describe how levels of disorder and stages of treatment guide treatment planning and targeting.
20. Identify client’s life goals that can be used as motivation for engaging in DBT.
21. Structure treatment according to the target hierarchies for each modality (e.g., individual, skills training, phone).
22. Set target hierarchies for clients with multiple problems.
23. Complete DBT pre-treatment tasks (e.g., identify client’s goals, orient to DBT, obtain commitments).
24. Describe the key elements that should be addressed in individual DBT sessions.
25. Structure individual DBT sessions.
26. Describe the function of DBT skills training.
27. Define the roles of the leader and co-leader in DBT skills training.
28. Explain how to structure a DBT skills training class.
29. Identify the contents of the DBT Interpersonal Effectiveness skills module.
30. Describe the evidence for the use of DBT Interpersonal Effectiveness skills.
31. Convey the rationale for DBT Interpersonal Effectiveness skills.
32. Identify the contents of the DBT Distress Tolerance skills module.
33. Describe the evidence for the use of DBT Distress Tolerance skills.
34. Convey the rationale for DBT Distress Tolerance skills.
35. Define problem behaviors specifically and behaviorally.
36. Conduct a chain analysis of an episode of a target behavior.
37. Conduct missing links analyses of needed behaviors that did not occur.
38. Describe the DBT problem-solving strategies (skills training, cognitive modification, exposure, contingency management).
39. Generate and evaluate solutions for specific problematic links from a chain analysis.
40. Describe the use of validation in DBT.
41. Implement the levels of validation in DBT.
42. Employ dialectical strategies to motivate patients to actively work toward their goals.
43. Implement DBT stylistic strategies (reciprocal and irreverent communication).
44. Assess long-term and acute risk for suicide.
45. Talk with individuals in a manner that facilitates assessment of suicide risk.
46. Describe the steps involved in crisis management.
47. Apply DBT suicide crisis protocols.
48. Respond to ongoing suicidal behavior during treatment.
49. Coach clients to generalize skills in all relevant contexts.
50. More effectively coach clients with skills specific to their needs.
51. Competently help patients employ difficult-to-use skills.
52. Implement the DBT case management strategies.
53. Balance case management strategies of consultation to the client and environmental intervention.
54. Explain the importance of observing personal and professional limits in DBT.
55. Describe the steps for observing limits in DBT.

Part 2 – Learning Objectives: 

1. Structure team-based consultation sessions.
2. Determine the best course of clinical application based on consultation and extrapolation from the evidence-base for DBT.
3. Discuss the exam assigned in Part 1 and consequently better understand important concepts in DBT.
4. Discuss homework assignments involving the application of the treatment and consequently better understand how to apply the treatment.
5. Design DBT service programs, appropriately implementing and modifying DBT protocols for my particular setting and patient population.
6. Effectively balance adaptation and adoption in implementation of DBT.
7. Utilize implementation outcome variables to increase the sustainability of DBT programs.
8. Conceptualize clinical cases and problems from a DBT perspective.
9. Formulate cases with emotion at the heart of problem behavior.
10. Engage in DBT case formulation as an iterative means of treatment planning, intervention, and measurement.
11. Demonstrate the ability to apply important concepts in DBT.
12. Write DBT case formulations with behavioral specificity.
13. Actively participate in a DBT consultation team.
14. Set targets for DBT consultation team meetings and manage time accordingly.
15. Balance change and acceptance in providing consultation.
16. Formulate cases with attention to the transaction of the individual-environment system.
17. Incorporate the biosocial model of BPD into case formulation.
18. Treat suicidal behaviors as attempts by patients to solve problems.
19. Describe how levels of disorder and stages of treatment guide treatment planning and targeting.
20. Link client targets to goals.
21. Link client’s goals to the tasks of treatment.
22. Organize DBT sessions based on a target hierarchy for each modality (e.g., individual, skills training).
23. Overcome obstacles of both therapists and clients in setting treatment goals and targets before starting the treatment.
24. Measure outcomes on specifically defined problem behaviors.
25. Identify the critical variables influencing a problem behavior.
26. Clarify program elements that support the functions of a comprehensive treatment program.
27. Evaluate whether a DBT program addresses the 5 functions of comprehensive treatment.
28. Explain the difference between chain and solution analyses.
29. Conduct solution analyses.
30. Identify solutions to address the critical variables influencing problem behaviors.
31. Select and suggest specific skills to fit a situation or context.
32. Implement the DBT problem-solving strategies (skills training, cognitive modification, exposure, contingency management).
33. Evaluate the use of DBT strategies in my own and others’ cases.
34. Describe the relationship between secondary targets and primary targets.
35. Determine when to focus on secondary targets.
36. Identify options for intervening in secondary targets.
37. Implement DBT case management strategies (consultation-to-the-client and environmental intervention).
38. Generate solutions to address barriers to implementing DBT in my program.
39. Demonstrate the ability to evaluate the use of DBT strategies in others’ cases.
40. View and discuss DBT as modeled by expert therapists (e.g. video, demonstrations) and be better able to describe and apply treatment strategies.
41. Practice the techniques of DBT via behavioral rehearsal, as coached by the instructors and be better able to describe and apply treatment strategies.
42. Provide solutions when consulting that are pertinent to the problem and likely to be effective.
43. Apply the treatment after my team’s consultation.
44. Apply DBT principles and strategies during DBT consultation team meetings.
45. Identify team problems and use DBT strategies to resolve them.
46. Employ techniques for strengthening the DBT consultation team.
47. Clarify expected long-term outcomes for my DBT program.
48. Identify methods of measuring outcomes for my DBT program.

Schedule

Part 1: January 13-17, 2025

Part 2: July 14-18, 2025 

Days 1-5 (Part 1): 7:00am–2:30pm PST/9:00am–4:30pm CST/10:00am–5:30pm EST  

Days 6-9 (Part 2): 7:00am–3:00pm PST/9:00am–5:00pm CST/10:000am–6:00pm EST 

Day 10 (Part 2):  7:00am–1:30pm PST/ 9:00am–3:30pm CST/10:00am–4:30pm EST 

Trainers

Study Resources

This list includes readings that are required for comprehensive training (Foundational or Intensive) in DBT. Each DBT provider should have a personal copy of the primary texts. Bold text corresponds to the abbreviations for the pertinent readings for each module.

1. Primary texts required for DBT training

• Linehan, M. M. (1993). Cognitive-behavioral treatment of borderline personality disorder. Guilford Press.
• Linehan, M. M. (2015). DBT Skills Training Manual (2nd ed.). The Guilford Press.
• Linehan, M. M. (2015). DBT Skills Training Handouts and Worksheets (2nd ed.). The Guilford Press.

2. Additional texts/articles required for comprehensive DBT training

• Sayrs, J. H. R., & Linehan, M. M. (2019). DBT teams: Development and practice. The Guilford Press.

3. Behavior Therapy (At least one)

• Farmer, R. F., & Chapman, A. L. (2016). Behavioral interventions in Cognitive Therapy: Practical guidance for putting theory into action (2nd ed.). American Psychological Association.
• Heard, H. L., & Swales, M. A. (2016). Changing behavior in DBT: Problem solving in action. Guilford Press.
• Pryor, K. (2002). Don’t shoot the dog: The new art of teaching and training (Revised edition). Ringpress Books Ltd.
• Ramnerö, J., & Törneke, N. (2008). The ABCs of human behavior: Behavioral principles for the practicing clinician. New Harbinger Publications.

4. Required for DBT for Adolescents

• Miller, A. L., Rathus, J. H., & Linehan, M. M. (2007). Dialectical behavior therapy with suicidal adolescents. Guilford Publications.

5. Exposure Procedures

• Harned, M. S. (2022). Treating trauma in dialectical behavior therapy: The DBT prolonged exposure protocol (DBT PE). The Guilford Press.

6. Specific chapters required for adaptations of DBT

• Dimeff, L. A., Rizvi, S. L., & Koerner, K. (2021). Dialectical Behavior Therapy in clinical practice: Applications across disorders and settings (2nd ed.). The Guilford Press.

7. Supplemental Readings

• Aitken, R. (1982). Taking the path of Zen. North Point Press.
• Barlow, D. H. (Ed.). (2007). Clinical handbook of psychological disorders (5th ed.). The Guilford Press.
• Craske, M. G., Treanor, M., Conway, C. C., Zbozinek, T., & Vervliet, B. (2014). Maximizing exposure therapy: An inhibitory learning approach. Behaviour Research and Therapy, 58, 10–23.
• Feil, N., & de Klerk-Rubin, V. (2003). V/F validation: The Feil method, how to help disoriented old-old. Edward Feil Productions. ISBN 1-878169-00-9
• Foa, E. B., Hembree, E., & Rothbaum, B. O. (2007). Prolonged exposure therapy for PTSD: Emotional processing of traumatic experiences therapist guide (Treatments That Work). Oxford Press.
• Linehan, M. M., & Schmidt, H. (1995). The dialectics of effective treatment of borderline personality disorder. In W. O. O’Donohue & L. Krasner (Eds.), Theories in Behavior Therapy (pp. 553-584). American Psychological Association.
• Linehan, M. M. (1997). Validation and psychotherapy. In A. C. Bohart & L. S. Greenberg (Eds.), Empathy reconsidered: New directions in psychotherapy (p. 353–392). American Psychological Association. https://doi.org/10.1037/10226-016
• Rathus, J. H., & Miller, A.L. (2017). DBT Skills Manual for Adolescents. The Guilford Press.
• Rizvi, S. L. (2019). Chain Analysis in Dialectical Behavior Therapy. The Guilford Press.
• Swales, M. A., & Heard, H. L. (2017). Dialectical behaviour therapy: Distinctive features (2nd ed.). Routledge.
• Swales, M.A. (Ed.). (2019). The Oxford Handbook of Dialectical Behaviour Therapy. Oxford University Press.

Attend

How To Register
Please designate your Team Lead for the purposes of registering your team members and payment of application fee for all team members. Both applications and payments are made as a group. Once the application fees have been submitted, Team Leads should remind all team members to complete their Individual Applications as soon as possible.

How To Apply
Once you pay your application fee, please complete the SurveyMonkey Application.

Submit your Application

How Long Will It Take To Apply?
You can review a PDF example of the application first as an indicator of how much time you’ll need to complete it.

Behavioral Tech’s Application Review Process

• Your Team must submit the full set of applications, 1 Team Application and all Individual Applications for all team members, before your team’s information can be reviewed. Delays in receipt of applications from any member of your team will delay your team’s review process.
  • Applications will be reviewed on a rolling basis. Once all spots have been filled, all additional applications will be deferred to the waiting list or to another training.
• All application fees must be paid in full for the entire team prior to application review.
• Accepted teams have 30-days from date of acceptance to pay the tuition in full. Full payment is due before Part 1.

Tuition Information

• Tuition Information
  • Application Fee: $50 per participant (U.S. dollars)
  • Standard Tuition: $15,500 per Team (U.S. dollars)
  • Application fees and tuition are non-refundable.
  • Teams larger than 8 require BTECH preapproval. Please contact support@behavioraltech.org.
• FINAL DEADLINE: All completed applications must be received by December 16th, 2024 (final cut-off date).
• IMPORTANT: Tuition must be paid to confirm training registration. The Due Date of the invoice is two weeks prior to the training start date. If payment is not received in a timely manner, we may release your space to another applicant. Please reach out to support@behavioraltech.org as soon as possible if you have any concerns.’

Cancellations, Substitutions and Refunds: If there are changes to the DBT team applying to the DBT Intensive Training, BTECH permits substitutions of team members upon review of the written request. New team members are required to submit their applications and an email notice should be provided to BTECH about the change in the team. If extenuating circumstances arise that prevent full attendance, please contact us as soon as possible to discuss your situation. We will do our best to provide alternative options for completing the training curriculum.

Payment Terms: We accept credit cards (Discover, MasterCard, Visa, and American Express), U.S. checks, and bank transfers. All payments must be in U.S. funds; we are unable to accept foreign checks. Please contact Customer Service at 206.675.8588 or at support@behavioraltech.org for more information about ACH or wire transfer payment options.

Special Accommodations: If you require special accommodations due to a disability, please contact Behavioral Tech at 206.675.8588 four weeks prior to the training so that we may provide you with appropriate service.

IMPORTANT: Two weeks prior to the training, participants will receive an email from our Online Portal (powered by Thinkific) with a sign-in URL for this training. Please follow the instructions in the email to log in to our Online Portal and set your password, ONE week prior to the training.

Participants will retain access to the online course until 1 month after the last training session date. All course requirements must be completed before course access expires.

Please email support@behavioraltech.org if you have any questions about accessing your training.

Technical Requirements

Continuing Education