Services for Agencies and Systems

Behavioral Tech has nearly 20 years’ worth of experience in providing DBT training. As the organization founded by DBT treatment developer Marsha Linehan, PhD, we have the experience and expertise to assist your agency or system in implementing, growing, and sustaining your DBT program.

On this page:

Why Implement DBT?

Improved Patient Outcomes

Most often, agencies choose to implement DBT in order to better target the needs of their patients and clients. As a principle-driven treatment, DBT provides a flexible framework in which to treat persons with complex, severe disorders. Research also supports DBT Skills groups, both as stand-alone offerings and in conjunction with DBT individual therapy (Linehan et al, 2015). Read more about the research on DBT and for whom it has shown to be effective.

Reduced Treatment Costs

There is considerable evidence that standard outpatient DBT reduces the overall cost of mental health treatment. The results of a recent systematic review (Botanov et al., under review) of studies examining the costs of DBT found the following:

  • Overall, DBT is associated with about a 40% reduction in mental health treatment costs.
  • The most pronounced cost savings are due to about a 70% reduction in inpatient treatment costs ($25,000 per person).
  • After accounting for all mental health treatment costs, the total cost savings across trials was almost $20,000 per person.

For more information, please review the following:

Overview of Training Options

Implementing DBT Skills groups or a full DBT program typically requires a blend of learning formats with Behavioral Tech.

Send staff members to a public training

If you have a few staff members to train, it will probably be most economical for you to send your group to training(s) already scheduled on our event calendar. You may also consider online training as a flexible way to introduce DBT to your team.

Co-host a DBT training in your community

Co-hosting a public training can be a good fit if you have up to 10 staff members who you’d like to train, and you meet a few additional criteria:

  • You have a large training space and electronic equipment (projector, sound system, etc) to help facilitate an event
  • You would like to champion DBT in your community and/or cannot send your staff offsite (perhaps due to funding limitations)
  • You are connected with local care providers and can help us build interest in the event
  • You are mutually committed to the success of the event for participants beyond your staff members
  • You are located near a medium- to large-hub airport

Contract with Behavioral Tech for private training

If you have 30 or more staff members whom you’d like to train, private training may make sense from a financial perspective. Travel costs to send your staff to an offsite training add up quickly; it can be more cost-effective to bring our expert trainers to you. This option also offers increased flexibility for your timeline and training goals. Read the section below, titled “Implementing DBT in Large Systems,” for more information.

Contact us to discuss options

To discuss which training arrangement will work best for your agency, contact us about services for agencies and systems.

Implementing DBT in Large Systems

Behavioral Tech has extensive experience in helping large mental healthcare systems implement DBT programs and train staff at all levels. Our implementation experience includes:

  • Public and private hospitals
  • Public and private mental health treatment centers
  • Substance use treatment centers
  • Correctional and forensic settings
  • Community mental health centers
  • Adolescent treatment settings
  • University graduate programs
  • And extensive experience in training in non-English speaking settings

Achieving true implementation of any evidence-based practice requires a significant commitment of time and resources from dedicated staff. Whether your goal is raising the level of staff clinical skills, building a continuum of care for a specific client population, or responding to the demands of a licensing or legal entity, we will work with you to design an effective training and implementation model.

We actively attend to the science of implementation and use these principles to guide our recommendations. Our implementation model aims to train providers and administrators at a level appropriate to their backgrounds and goals, while also examining the impact of the broader organizational context in which trainees work. This model takes into account a number of factors that may impact a successful adoption and implementation, including client and practitioner factors, organizational support, and training program quality (Turner & Sanders, 2006; Beidas & Kendall, 2010).

Below, we outline the considerations for new teams and administrators considering how to start a DBT program in a larger mental health system:

Getting Administrative Support

Any group implementing any type of program, DBT or non-DBT, must have five key types of administrative support to ensure development and stability of the program:

  1. Financing, including a budget, for the program
  2. Adequate staffing levels
  3. Designated time to learn and implement the treatment
  4. Confidential meeting space (e.g., offices and group rooms)
  5. A leader and team who are granted authority over the plan for design and implementation of the program

Before starting any program, we encourage you to identify the administrators whose support is crucial to your program. Speak with them informally to talk over the possibility of a new program. Continue to gather feedback from people within the system to inform your program goals.

Building Your Program Goals
The following questions will guide your thinking and provide answers to the next steps:

  • What specific goals or problems are being addressed with training?
  • Is training the appropriate intervention for the problem you need to solve?
  • What time frame will you have from the beginning to the end of your project?
  • What funding is in place or will need to be in place in order to bring training to your setting?
  • Who are your stakeholders and how can they assist you?
  • Do you have buy-in from all the stakeholders?

Behavioral Tech can work with a system of any size or nature to tailor the most effective training and/or implementation plan. Depending on outcome goals, funding, and staff to support the initiative, full implementation of DBT typically takes one to four years.

Training Components for Systems Implementations

While implementation science is still developing, several key training components appear to be consistent across the literature. These components include:

  • A thorough orientation and preparation
  • A strong implementation team within the organization
  • A thoughtful pairing of the appropriate staff/participants with appropriate curricula
  • The coordination of training with coaching and feedback from expert consultants, which includes frequent and timely performance assessments with expert consultants throughout the implementation process
  • Strategic plans for sustainability

Keeping in mind that we can tailor a training plan for your organization, there are three main paths for system implementation:

  • OPTION ONE: Onsite orientation and strategic planning, combined with one or more teams attending an offsite Dialectical Behavior Therapy Intensive Training™, paired with consultation.
  • OPTION TWO: Onsite orientation and strategic planning, Dialectical Behavior Therapy Intensive Training™, supplemental training, and follow-up training, paired with consultation.
  • OPTION THREE: A series of onsite trainings designed to promote a cultural shift within the milieu; teach all staff (both clinicians and direct care staff) the principles of dialectics, validation, and behavior change; and ensure that all staff are versed in DBT skills. In addition, one or more teams would receive Dialectical Behavior Therapy Intensive Training™ and consultation.

Your goals, budget, and timeline will influence which of the three paths is best for your organization.

Program Sustainability
Behavioral Tech is prepared to help you address the challenges and barriers that come with sustaining and growing your DBT program. This is best done through our expert consultation services and through booster training for your staff. Common challenges to program sustainability include:

  • Funding constraints or funding cuts
  • Staff turnover
  • Time constraints
  • Lack of support from key administrators

Our experience with diverse agencies and systems allows us to work with you to assess the challenges affecting your program and develop a plan for overcoming programmatic and training issues.