Using Case Formulation to Optimize DBT for Autistic Clients

Lorie Ritschel, PhD, is a certified DBT therapist through the DBT-LBC and is an expert trainer of DBT and the DBT Prolonged Exposure protocol. She earned her doctorate in Clinical Psychology from the University of Kansas, and she completed postdoctoral fellowships at Duke University Medical Center and Emory University School of Medicine. She is a co-founder of the Triangle Area Psychology Clinic (TAP), an outpatient clinic in Durham, NC that specializes in DBT and other empirically supported treatments for adolescents, adults, couples, and families. She is also an Associate Professor at the UNC Chapel Hill School of Medicine in the UNC TEACCH Autism Program, where she works with autism experts on the development and implementation of DBT for autistic individuals.

Sami Ascanio, LCSW-C, is an Autistic clinician with extensive expertise in adapting Dialectical Behavior Therapy (DBT) to meet the needs of Autistic clients. As a neurodivergent individual, Sami possesses a unique understanding of the needs and experiences of Autistic clients, enabling her to effectively apply DBT principles to help clients achieve their life goals and educate others in this approach.

Sami currently serves as the Director of DBT Programming at Capital Youth Services. She is certified as a DBT clinician by the prestigious DBT-Linehan Board of Certification and leads the DBT-LBC Certified DBT program at Capital Youth Services. In collaboration with Britt Rathbone, Sami acts as a lead program reviewer for the Linehan Board, conducting comprehensive reviews of DBT programs worldwide seeking certification.

Sami is passionate about DBT adherence and establishing frameworks within practices to ensure clients receive this transformative treatment. She provides training and consultation for teams and clinicians aiming to enhance adherence and improve their ability to conceptualize complex cases through the DBT framework.

Committed to continuous learning, Sami was trained by leading experts in her field, including DBT Intensive Training through Behavioral Tech, and additional training in DBT for adolescents and families, DBT-C (DBT for Children and Parents) under Francheska Perepletchikova, PhD, DBT Prolonged Exposure Protocol for PTSD with Melanie Harned, PhD, and Lorie Ritschel, PhD. Sami was also trained in the SPACE protocol by Eli Lebowitz, PhD and pursues ongoing training in Acceptance and Commitment Therapy. Regardless of the clinical framework she is working from, Sami is continuously striving to ensure that every treatment she offers is adapted to the neurotype and learning style of the client in front of her.

Sami balances her time between clinical work, consulting, and advocacy. She has been invited to speak on key topics such as “Optimizing DBT for Autistic Adults” and “Assessing and Treating Self-Injury and Suicidality in Teens: Alternatives to Hospitalization in High-Risk Situations.” Alongside Lorie Ritschel, PhD, Sami conducts monthly small group consultations for clinicians working with Autistic clients and collaborates on various projects, including upcoming publications.

In her personal time, Sami enjoys watching her dog Morty (the Capital Youth Services facility dog) chase trains, spending time with her partner, tending to her many plants, and engaging in activities with her nieces and nephews.