DBT Teams of Therapists
Why do therapists doing DBT need to be on a DBT Team?
Dialectical Behavior Therapy is designed to effectively treat pervasive emotion dysregulation. DBT teams provide fellow therapist with the necessary support to maintain the high level of motivation and skillfulness needed for successful treatment. The team members also help each other stay in the DBT frame with adherence to the Linehan model that has been established as an evidence-based practice.
What is the function of a DBT Consultation Team?
The typical DBT team has 6 to 8 members and meets for 60-90 minutes weekly or every 2 weeks. Members on a DBT team usually make two major commitments to each other. First, team members agree to participate in team meetings. Teams should clearly define the specifics of "participation" such as expectations about attendance, being on time, whether the therapist must carry individual DBT cases to be on the team, and so on. More importantly, teams should establish the general spirit behind agreeing to participate: to join the team means we agree to make every effort to increase our own and others' effectiveness as DBT therapists. In other words, the purpose of a DBT consultation team is to help team members apply the principles of DBT, not an alternative treatment. This means that while working together in consultation team members strive to help each other develop adherence and competence with DBT rather than offer ideas or debates from alternative models. In essence, the team agrees, during the meeting, to speak a common language and work from a shared model, even if therapists on the team may use other treatment models in other contexts.
- Kelly Koerner, Doing Dialectical Behavior Therapy
What do team members agree to when participating on a team?
Marsha Linehan recommends that team members discuss and agree to the following commitments...
1. To keep the agreements of the team, especially remaining compassionate, mindful and dialectical.
2. To be available to see a client in whatever role one has joined the team for, e.g., individual therapist, group skills trainer, clinical supervisor, pharmacotherapist.
3. To function as a therapist in the group (to the group) and not just be a silent observer or a person that only speaks about his or her own problems.
4. To treat team meetings in the same way one treats any other group therapy session, i.e., attending the weekly meetings (not double scheduling other events or clients), on time, until the end, with pagers, PDAs and phones out of sight and off or, if necessarily on, on silent.
5. To come to team meetings adequately prepared.
6. To be willing to give clinical advice to people that have more experience than you (especially when it’s hard to imagine yourself as being able to offer anything useful)
7. To have the humility to admit your mistakes/difficulties and the willingness to have the group help you solve them
8. To be nonjudgmental and compassionate of your fellow clinicians and clients. To ring the bell of nonjudgmentalness to remind yourself to not be judgmental or mindful, but not to ring it as a proxy for criticizing someone. The bell is a reminder, not a censor.
9. To properly assess the problem before giving solutions (Do unto others as you wish they would more often do unto you).
10. To call out “elephant in the room” when others are ignoring or not seeing the elephant
11. To be willing to go through a chain analysis even though you were only 31 seconds late and you would have been there on time if it wasn’t for that traffic light that always takes all day to change and is nothing but a huge pain in the (I digress...) -- show up on time or call.
12. To participate in team by sharing the roles of Leader, Observer, Note Taker or other tasks critical to team functioning.
13. If you feel that the consult team is not being useful or you don’t like the way it is being run, to say something about it rather than silently stewing in frustration.
14. To ask the team for permission when planning to go out of town
15. To repair with the team in some way when team meetings are missed.
16. To carry on even when feeling burnt out, frustrated, tired, overworked, underappreciated, hopeless, ineffective (easier committed to than done, of course).
- Marsha Linehan, DBT Consultation Team Commitment Session
What is the difference between a consultation team and a training team?
In the Triangle Area, in addition to the standard consultation teams, we have DBT training teams that allow for therapists interested in learning and applying DBT to begin to do so. These training teams have an Intensively trained leader who may be paid, meet monthly and are committed to learning effective, comprehensive DBT. Consultation teams are peer led as its members have typically been intensively trained, meet several times each month and are committed to applying the DBT model.
We are currently working on systems to connect therapists with training and consultation teams. Please check back for more information!