DBT Consultation Team

The DBT consultation team (“team”) is a vital aspect of providing comprehensive DBT treatment. People new to DBT often have a lot of questions about team, so we’ve listed some of the most common ones here.

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What is a DBT consultation team, and do I really need one?

A DBT consultation team is a group of DBT providers who work together to treat clients. A team has 3 to 8 people, and it could include a combination of providers who may have different roles or professional credentials (e.g., psychologists, social workers, counselors, and psychiatrists). Providers meet regularly with their team – often weekly – to help one another and manage the high stress and potential burnout of treating clients at high risk of suicide.

Therapists treating clients with life-threatening or life-interfering behaviors can easily lose their balance, at times being too accepting of clients’ problem behaviors and at others being too demanding that clients change immediately. Your DBT team is a key resource for maintaining motivation to deliver effective treatment, enhancing your clinical skills, and monitoring fidelity to the treatment model. You (the DBT provider) need support to stay effective.

It is assumed that anyone doing DBT can only do effective DBT in the context of a team. Active participation in a DBT team is also required for our comprehensive trainings and by the DBT Linehan Board of Certification.

How do I get a DBT team? What are my options?

Therapists who want to implement DBT often ask how they can find a DBT team. This is a crucial step in your DBT path, since membership on a team is required in order to provide DBT. Here are some suggestions to find a team and complete your training.

Start a New DBT Team: Attend Dialectical Behavior Therapy Intensive Training™

Some therapists might form a DBT team with existing colleagues in the same practice setting, or they may network with other professionals who also want to offer DBT. In some instances, a therapist might form a virtual team with at least two other members. This is a viable option for people who are committed to functioning as a team, even if they treat separate groups of clients or live in different areas.

New DBT teams are eligible to apply to the Dialectical Behavior Therapy Intensive Training™, a ten-day course designed to prepare teams to develop and implement a DBT program.

Join an Existing DBT Team: Attend Dialectical Behavior Therapy Foundational Training™

Some therapists are able to join an existing DBT team. This might happen if you are hired to work at an organization with an existing DBT program or you find a team that is already functioning. You can search for established DBT teams in our BTECH-trained teams directory or through networking.

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 full requirements for our DBT Foundational Trainings will be available in the event descriptions as new DBT Foundational Trainings are added to our calendar here.

This five-day training is designed specifically for individual or group therapists who are members of an Intensively trained team, but who have not completed Intensive training themselves. It is not a substitute for Intensive training, but is meant to assist teams with a new member (eg. hired new staff or experienced turnover). This training allows newer team members to get trained up at a five-day training that will cover the standard content of DBT.

If I don’t have a team, can I still integrate DBT within my practice?

The majority of the research on DBT’s effectiveness has tested the standard model of DBT and includes the DBT consultation team. This means that in order to do DBT to fidelity, you must be on a DBT consultation team.

Why does BTECH require DBT training teams to have at least 3 people, but no more than 8?

There are several reasons why we require that teams in training have at least three people, and that teams larger than eight people are encouraged to split into smaller teams.

Reason 1: Asking What is Being Left Out

Team members can often get polarized in the context of discussing difficult cases and administrative concerns. Creating a team with more than two members helps increase the likelihood that alternative perspectives are raised and helps teams identify what is left out during times of conflict or confusion. Having multiple ears on a difficult case is often a useful assessment tool.

Reason 2: Finding Dialectical Synthesis

When two team members are polarized, it is difficult to step back and see the truth in the other’s perspective. Having several team members available to point out polarization and help to create a dialectical synthesis between the two positions is central to a well-functioning consultation team.

Reason 3: Fulfilling Team Roles

Pragmatics dictates that more than two team members are needed; there is simply too much to do to run a well-functioning consultation team! A consultation team requires a meeting leader, observer, and note-taker. If you have ever sat on a consultation team, you know that trying to simultaneously fill more than one role is difficult, particularly if you want to increase the efficiency and undivided attention of your team members.

Reason 4: Modeling and Skill-Building

There is a great deal to be learned from other team members; your consultation team is a place to conceptualize cases, assess suicide risk, and address problems with openness, humility, and vulnerability. It is also a place to practice your DBT skills. Consultation team meetings are the perfect setting for behavioral rehearsal, chain analysis, using behaviorally specific language, validation, targeting team-interfering behaviors, and regulating intense emotions.

Reason 5: Meeting Team Members’ Needs

Training teams larger than eight people are discouraged. This is because the weekly consultation team meetings are intended to support the needs and development of the consultation team members. If a team is too large, team members do not have sufficient room in their agenda to attend to the needs of each individual.

My team can’t all afford to go to training – what can we do?

If you have between 3 and 8 people to form a DBT team but your budget won’t allow all members to attend at once, we would recommend you consider staggering your attendance.

For example, if you have a team of 7 providers and none of you are Intensively trained, consider having three to four of the team members attend a Dialectical Behavior Therapy Intensive Training™. Then, the remaining members can attend a separate Intensive or Foundational training later. In the meantime, all team members can work together to enhance their DBT practice by such things as self-study of the texts we use in trainings, completing online trainings, attending workshops, observing and reviewing each others’ sessions, and completing homework assignments together.

If I want to run a DBT skills training class, do I have to be on a DBT team?

DBT assumes that effective treatment, including skills training, must pay as much attention to the behavior and experience of providers working with clients as it does to clients’ behavior and experience. Thus, attention to the capabilities and motivations of the providers is an integral part of any DBT program, and DBT skills trainers are part of the DBT team. The skills trainer must be on the team voluntarily, agree to attend team meetings, be committed to learning and applying DBT, and be equally vulnerable to team influence.

For more information on this topic, please see the DBT Skills Training Manual: Second Edition (pp. 25-26).