Dialectical Behavior Therapy Foundational Training

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

The training requires that participants work in an active DBT program, currently participate in a consultation team, and will continue learning DBT with a mentor. Only people who have attended an approved comprehensive training in DBT (e.g., Intensive or Foundational) may serve as mentors for team members attending Foundational Training. The following specific requirements must be documented in your application:

• Membership in a comprehensively trained DBT Consultation team that has been functioning for at least 1 year past completion of comprehensive training.
• A member of the same consultation team as you must serve as your mentor during the training and for 1 year after completion of your training.
• Mentors must meet the following qualifications:

Either:

• Certification by the DBT-Linehan Board of Certification (DBT-LBC)

Or

• Be an active member of a functioning DBT consultation team for at least 2 years post their own comprehensive DBT training,
  • Note that if the mentor has less than 2 years of experience post-comprehensive DBT training, an exception may be made if the mentor receives monthly consultation from a BTECH consultant until they are 2 years post-comprehensive training or the trainee completes their DBT Foundational Training.

• Must have received their comprehensive training from one of the following groups or be specifically recommended by a BTECH Trainer
• Behavioral Tech or its International Affiliates
• Cognitive & Behavioral Consultants, LLP, New York
• German Association for DBT (DDBT)
• Portland DBT Institute
• Treatment Implementation Collaborative, LLC
• University of Toronto, Centers for Addiction & Mental Health
• University of Washington, Behavioral Research & Therapy Clinics

Preparation & Training Requirements
Please note that DBT Foundational training is a rigorous program (similar to an advanced university course of study) intended to provide the necessary basic skills to provide a complex treatment to persons with complex problems. A significant amount of dedicated time beyond the scheduled instruction time is required for successful completion. We estimate that participants should plan for 2 hours of additional time for each hour of scheduled instructional time over the course of the training to complete the readings, homework tasks, and post-training assessments required for successful completion. Specific time estimates can be found in the details for the modules contained in the training.

Participants are asked to reserve time and dedicate mindful attention to the training tasks; in essence to engage in the training in the spirit of the DBT mindfulness skill of “one-thing-in-the-moment”. This requires time uninterrupted by mobile phones and regular work duties.

Readings, Homework, and Examination
Reading assignments are designed to ensure complete reading of the primary DBT texts. Participants should read the primary texts prior to the training and complete all additional reading before the homework completion due date. Homework assignments are designed to strengthen the clinical application of DBT and are completed in the months following the week of didactic training. A final knowledge test is required upon completion of the training. The test is conducted online, and participants are provided immediate feedback on their scores. Successful completion for CE/CME requires passing the post-training exam with a score of 75% or higher. The primary purpose of the exam is to solidify learning. Participants are expected to take the final exam as indicated in the Learning Management System.

This offering meets the requirements for the following hours by discipline. Licensing and continuing education requirements vary by state. Please contact your state’s regulatory authority to verify if this course meets your licensing or continuing education requirements. Inquiries regarding CE for other disciplines not listed may be directed to Behavioral Tech at (206) 675-8589 or via email to [email protected]. And for general CE questions, you can review answers to Continuing Education Credits – Behavioral Tech Institute or contact us.

CE NOTE: Behavioral Tech calculates the continuing education credits for this training by the start time and end time. 100 percent attendance is required, as is signing IN and OUT each morning and afternoon, to receive CE credits. Partial credits cannot be issued. Only participants with 100% attendance, and who have completed the Post-Event Evaluation and passed their Final Exam with a score of 75% or higher will receive credit. Behavioral Tech cannot offer partial credit. Please remember to sign in and sign out each day to document your attendance. Continuing Education documentation will be emailed to you 2-3 weeks after the homework due date.

Alcohol and Drug Abuse Counselors
Behavioral Tech is approved by NAADAC – the Association for Addiction Professionals, Provider #77431. You will receive a letter via email documenting your attendance upon successful completion of the activity. The allotted contact hours for this activity = 30.

Mental Health Counselors
Behavioral Tech is approved by an NBCC-Approved Continuing Education Provider (ACEP™) and may offer NBCC-approved clock hours for events that meet NBCC requirements. The ACEP solely is responsible for all aspects of the program.
Behavioral Tech will email you a letter documenting your attendance upon the successful completion of the activity. The allocated clock hours for this activity = 30.

Nurses
Behavioral Tech is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. Nurses should only claim credit commensurate with the extent of their participation in the activity. Continuing Medical Education is accepted by the ANCC for nursing certification renewal. The maximum AMA PRA Category 1 Credits™ designated by Behavioral Tech for this activity = 30.

Psychiatrists
Behavioral Tech is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. Physicians should only claim credit commensurate with the extent of their participation in the activity. The maximum AMA PRA Category 1 Credits™ designated by Behavioral Tech for this activity = 30.

Psychologists
Behavioral Tech is approved by the American Psychological Association to offer continuing education for psychologists. Behavioral Tech maintains responsibility for the program and its content. Behavioral Tech will email you a letter documenting your attendance after the successful completion of the program and homework. The number of hours Behavioral Tech has allocated within APA guidelines = 30.

Psychologists – New York
Behavioral Tech is recognized by the New York State Education Department’s State Board for Psychology as an approved provider of continuing education for licensed psychologists, #PSY-0063. Behavioral Tech will email a certificate of attendance upon 100% completion of this activity. The total contact hour allocated for this activity = 30.

Social Workers- WA
Behavioral Tech will apply to the NASW, Washington State Chapter, Provider Number 1975-166, to offer continuing education for Certified Social Workers. Behavioral Tech will email a certificate of attendance upon 100% completion of this activity. The hours of CE allocated for this activity = 30.

Social Workers – NY
Behavioral Tech is approved by recognized by the New York State Education Department’s State Board for Social Work as an approved provider of continuing education for licensed social workers, #0040. Behavioral Tech will email a letter documenting attendance to participants with 100% completion of the program and homework. The hours allocated for this activity = 30.

General CE/CME Disclosures and Policies

Conflict of interest definition: A conflict of interest may be considered to exist if a continuing education course faculty is affiliated with, or has any significant financial interest, in any organization(s) that may have a direct interest in the subject matter of the presentation or may be co-sponsoring or offering financial support to the course. Situations involving a potential conflict of interest are not inherently bad or wrong, but in accordance with standards for continuing medical education we would like you to be aware of the affiliation/financial interest of your instructors.

Faculty Disclaimer: When an unlabelled use of a commercial product, or an investigative use not yet approved for any purpose is discussed during an educational activity, we shall require the speaker to disclose that the product is not labeled for the use under discussion or that the product is still investigative.

Notice of requirements for successful completion: For all trainings (both in-person and remote), participants must attend 100% of the training and complete the Final Evaluation to receive a certificate of successful completion. This includes signing in and out each day/session of the event. For remote, Instructor-led online training, participants have to pass the Post Assessment(s) with a score of 75% or higher.

Commercial support or sponsorship: There is no commercial company support for this CME/CE event.

Noncommercial Sponsor Support: There is no noncommercial sponsor support for this CME/CE activity.

Non-Endorsement of Products: The Behavioral Tech approval status refers only to continuing education activities and does not imply that there is real or implied endorsement of any product, service, or company referred to in this activity nor of any company subsidizing costs related to the activity.

Off-Label Product Use: This CME/CE activity does not include any unannounced information about off-label use of a product for a purpose other than that for which it was approved by the Food and Drug Administration (FDA).

Disclosure of Relevant Financial Relationships: Faculty members are required to disclose all conflicts of interest and any relevant financial relationships that may affect the training content. Unless specified on Behavioral Tech’s website or on other printed materials/media, none of the individuals in a position to control the content of this CE/CME activity (including planners, editors, CE/CME Review Committee members, faculty presenters, moderators/facilitators, reviewers, etc.) have any relevant financial relationships to disclose.

CE Reprint Policy: For missing/lost CE documentation, an administrative fee of $50 is required for all CE/CME activities after 2017. For CE reprints prior to 2017, please refer to the website or contact [email protected]. Please refer to the CE FAQ webpage: Continuing Education Credits – Behavioral Tech Institute

Readings for the DBT Foundational Training

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.

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• Our Online Portal (powered by Thinkific) will be used to share materials and collect participants’ surveys and assignments. For live, remote, instructor-led trainings, the online portal will also host the live Zoom sessions. For onsite training, the online portal will be used in conjunction with the training content covered during the onsite event.
  • If needed, participants are responsible for printing out their materials in the online portal.
• All Trainings require each participant to have:
  • A high-speed Internet Service Connection with a minimum speed of 5Mbps. Test your internet speed. 
  • The most recent version of any of the following web-browsers: Google Chrome, Firefox , Safari , Microsoft Edge (Please note Internet Explorer will not be supported) 
  • Web-browser configurations must have Javascript enabled and popup blockers disabled.
  • The following software applications: Zoom, Microsoft Word, Microsoft Excel, A PDF reader such as Adobe Acrobat Reader, or the ability to view PDFs in a web-browser. To test your internet connection, camera, and microphone for Zoom, you can use Zoom’s testing application.
  • No firewall restrictions. If a firewall is installed, please be aware that may interfere with the training content and materials, as it may be blocked. Please include the following 3rd party services to trusted sites list(s):
    • Thinkific Learning Management System: https://behavioraltech.thinkific.com/
    • SurveyMonkey: https://www.surveymonkey.com/

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