18 CEs
CEU Course

4-Day Intensive Workshop: Flexibly and Responsively Providing Dialectical Behavior Therapy (June 2023)

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Cognitive Behavior Institute is excited to welcome Emily Wharton, PsyD, for a live interactive webinar on: Flexibly and Responsively Providing Dialectical Behavior Therapy


6/8/2023 11:00AM - 5:00PM EST


6/9/2023 11:00AM - 5:00PM EST


6/15/2023 11:00AM - 5:00PM EST


6/16/2023 11:00AM - 5:00PM EST


Emily Wharton, PsyD



Credit Hours

18 total CEs including: 17 clinical and 1 suicide prevention credits

Course Overview

Dialectical Behavior Therapy (DBT) was originally created to treat adults with Borderline Personality Disorder (BPD) and suicidal behaviors (Mehlum, 2021). The creation of DBT was ground-breaking in providing a highly effective approach for previously stigmatized presentations. DBT is a cognitive behavioral treatment that incorporates dialectics of acceptance and change, behavioral conceptualization, and concrete skills in mindfulness, interpersonal effectiveness, emotion regulation, and distress tolerance. DBT has been shown to be highly effective in reducing symptoms such as suicidal and self-harm behaviors and improving quality of life for adolescents and adults struggling with BPD (Gillespie et al., 2022).

The full adherent treatment model of DBT, called “Comprehensive DBT” consists of four components: weekly skills group (2 to 2.5 hours long, with modules consisting of Mindfulness, Emotion Regulation, Interpersonal Effectiveness, and Distress Tolerance), weekly individual therapy, 24/7 in vivo phone coaching, consultation team (attended by all DBT therapists) (O’Hayer, 2021). However, many patients do not have access to comprehensive DBT programs, and many clinicians are unable to provide every component of the model (Valentine et al., 2020). Thus, many clinics offer standalone DBT skills groups, and many providers offer DBT-informed individual psychotherapy.

Since DBT became the “gold standard” treatment for BPD, self-harm, and suicidal behaviors, numerous studies have emerged regarding the effectiveness of DBT for other disorders as well. Emerging studies have found strong outcomes in using DBT for substance use disorders (Warner & Murphy, 2022), Posttraumatic Stress Disorder and complex trauma (Bohus et al., 2020), and eating disorders (Brown et al., 2020). Researchers have developed cultural adaptations of DBT to more effectively support communities of color and marginalized groups that were not sufficiently represented in earlier DBT studies (Haft et al., 2022). DBT practitioners and critics have examined ways to challenge problematic aspects of DBT interventions and have suggested ways to hold an anti-racist DBT stance, such as ideas presented in the article, “You Didn’t Cause Racism, and You Have to Solve it Anyways”: Antiracist Adaptations to Dialectical Behavior Therapy for White Therapists (Pierson et al., 2022).

Given these multicultural, diagnostic, and practical considerations, flexibility and responsiveness are key in providing effective, individualized DBT. While some DBT trainings often focus on only the fully adherent, BPD-specific application of DBT, this training will teach the core DBT interventions and discuss how to provide DBT flexibly with responsiveness to different presentations and cultural populations. Experiential exercises, case examples, and multimedia will be used to provide applied, practical, clinical learning. An overview of the history, theory, and model of DBT will be presented, alongside discussions of diverse applications of DBT for different diagnostic presentations, populations, and settings. DBT-based conceptualization of behavior and symptoms will be discussed, and skills from each skills module (Mindfulness, Emotion Regulation, Interpersonal Effectiveness, and Distress Tolerance) will be presented and practiced. The primary focus of this training is on how to provide DBT in a flexible, responsive, and individualized manner, while maintaining fidelity to DBT core principles and practices.

Learning Objectives

  1. Participants will describe the core tenets, principles, and underlying theory of Dialectical Behavior Therapy (DBT).
  2. Participants will explain how the DBT model fits the presentation of Borderline Personality Disorder.
  3. Participants will illustrate how to incorporate cultural humility and responsiveness into DBT.
  4. Participants will demonstrate chain analyses and solution analyses.
  5. Participants will demonstrate how to present Wise Mind concept
  6. Participants will define distress tolerance and its purpose.
  7. Participants will explain core crisis survival skills
  8. Participants will demonstrate how to incorporate distress tolerance skills into safety planning.
  9. Participants will give examples of the interaction between radical acceptance and racism/bigotry.
  10. Participants will explain function of emotions and role of emotion regulation.
  11. Participants will explain how to incorporate values work into therapy.
  12. Participants will demonstrate how to create a Cope Ahead Plan.
  13. Participants will give examples of cultural considerations for teaching interpersonal effectiveness skills.
  14. Participants will identify target behaviors and how to incorporate them on a diary card.
  15. Participants will distinguish the three levels of treatment targets and how to prioritize them.
  16. Participants will list strategies for managing potential suicidality or self-harm in a client.
  17. Participants will demonstrate how to case conceptualize through a DBT frame.
  18. Participants will explain the applicability of DBT to specific presentations, such as PTSD, SUD, and eating disorders.

Course Bibliography

Bohus, M., Kleindienst, N., Hahn, C., Müller-Engelmann, M., Ludäscher, P., Steil, R., Fydrich, T., Kuehner, C., Resick, P. A., Stiglmayr, C., Schmahl, C., & Priebe, K. (2020). Dialectical Behavior Therapy for Posttraumatic Stress Disorder (DBT-PTSD) Compared With Cognitive Processing Therapy (CPT) in Complex Presentations of PTSD in Women Survivors of Childhood Abuse: A Randomized Clinical Trial. JAMA Psychiatry, 77(12), 1235–1245.

Brown, T. A., Wisniewski, L., & Anderson, L. K. (2020). Dialectical Behavior Therapy for Eating Disorders: State of the Research and New Directions. Eating Disorders, 28(2), 97–100.

Gillespie, C., Murphy, M., & Joyce, M. (2022). Dialectical Behavior Therapy for Individuals With Borderline Personality Disorder: A Systematic Review of Outcomes After One Year of Follow-Up. Journal of Personality Disorders, 36(4), 431–454.

Haft, S. L., O’Grady, S. M., Shaller, E. A. L., & Liu, N. H. (2022). Cultural adaptations of dialectical behavior therapy: A systematic review. Journal of Consulting and Clinical Psychology.

O’Hayer, C. V. (2021). Building a Life Worth Living During a Pandemic and Beyond: Adaptations of Comprehensive DBT to COVID-19. Cognitive and Behavioral Practice, 28(4), 588–596.

Pierson, A. M., Arunagiri, V., & Bond, D. M. (2022). “You Didn’t Cause Racism, and You Have to Solve it Anyways”: Antiracist Adaptations to Dialectical Behavior Therapy for White Therapists. Cognitive and Behavioral Practice, 29(4), 796–815.

Valentine, S. E., Smith, A. M., & Stewart, K. (2020). Chapter 15—A review of the empirical evidence for DBT skills training as a stand-alone intervention. In J. Bedics (Ed.), The Handbook of Dialectical Behavior Therapy (pp. 325–358). Academic Press.

Warner, N., & Murphy, M. (2022). Dialectical behaviour therapy skills training for individuals with substance use disorder: A systematic review. Drug and Alcohol Review, 41(2), 501–516.


Cognitive Behavior Institute, #1771, is approved as an ACE provider to offer social work continuing education by the Association of Social Work Boards (ASWB) Approved Continuing Education (ACE) program. Regulatory boards are the final authority on courses accepted for continuing education credit. ACE provider approval period: 06/30/2022-06/30/2025. Social workers completing this course receive 18 total credits including 17 clinical continuing education credits.

Cognitive Behavior Institute, LLC 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-0098 and the State Board for Social Work as an approved provider of continuing education for licensed social workers #SW-0646 and the State Board for Mental Health Practitioners as an approved provider of continuing education for licensed mental health counselors #MHC-0216.

Cognitive Behavior Institute has been approved by NBCC as an Approved Continuing Education Provider, ACEP No. 7117. Programs that do not qualify for NBCC credit are clearly identified. Cognitive Behavior Institute is solely responsible for all aspects of the programs.

Cognitive Behavior Institute is approved by the American Psychological Association to sponsor continuing education for psychologists. Cognitive Behavior Institute maintains responsibility for content of this program. Social workers, marriage and family therapists, and professional counselors in Pennsylvania can receive continuing education from providers approved by the American Psychological Association. Since CBI is approved by the American Psychological Association to sponsor continuing education, licensed social workers, licensed marriage and family therapists, and licensed professional counselors in Pennsylvania will be able to fulfill their continuing education requirements by attending CBI continuing education programs. For professionals outside the state of Pennsylvania, you must confirm with your specific State Board that APA approved CE's are accepted towards your licensure requirements. The Association of Social Work Boards (ASWB) has a process for approving individual programs or providers for continuing education through their Approved Continuing Education (ACE) program. ACE approved providers and individual courses approved by ASWB are not accepted by every state and regulatory board for continuing education credits for social workers. Every US state other than New York accepts ACE approval for social workers in some capacity: New Jersey only accepts individually approved courses for social workers, rather than courses from approved providers. The West Virginia board requires board approval for live courses, but accepts ASWB ACE approval for other courses for social workers. For more information, please see https://www.aswb.org/ace/ace-jurisdiction-map/. Whether or not boards accept ASWB ACE approved continuing education for other professionals such as licensed professional counselors or licensed marriage and family therapists varies by jurisdiction. To determine if a course can be accepted by your licensing board, please review your board’s regulations or contact them. State and provincial regulatory boards have the final authority to determine whether an individual course may be accepted for continuing education credit.

Accommodation Information: Our webinars are available to anyone who is able to access the internet. For those who are vision impaired graphs and videos are described verbally. We also read all of the questions and comments that are asked of our speakers. All questions and comments are made via the chat function. For those that require it, please contact us at info@cbicenterforeducation.com for more information on and/or to request closed-captioning.


Course Schedule

Course Date Course Start Time Course End Time Timezone
6/8/2023 11:00AM 5:00PM EST
6/9/2023 11:00AM 5:00PM EST
6/15/2023 11:00AM 5:00PM EST
6/16/2023 11:00AM 5:00PM EST

Course Agenda

Course Event Day or Date Course Agenda Time Block Course Content Covered
Day 1 11:00AM - 11:50AM

Lecture: Origins and Underlying theory of DBT

  • Historical context of the emergence of DBT for BPD
  • Marsha Linehan, Ph.D. on acceptance-oriented therapies and change-oriented therapies
  • Dialectics as core principle of DBT
  • Live reflection and discussion on change and acceptance dialectic
  • Day 1 11:50AM - 12:00PM


    Day 1 12:00PM - 1:00PM

    Lecture and Discussion: Comprehensive Model of DBT

  • Individual therapy, skills group, therapist consultation, phone coaching
  • Brief overview of four modules: Mindfulness, Emotion Regulation, Distress Tolerance, Interpersonal Effectiveness
  • Case example
  • What’s possible when “full-model DBT” is not accessible for client/therapist?
  • Incorporating DBT into trauma-focused work (CPT, PE) vs. DBT-PTSD
  • DBT integration with Acceptance and Commitment Therapy
  • Day 1 1:00PM - 2:00PM Lunch
    Day 1 2:00PM - 3:00PM

    Lecture and Discussion: Diverse Applications of DBT

  • Biopsychosocial model of BPD and how DBT targets each “deficit”
  • How the biopsychosocial model of invalidation is applied to other presentations and populations (SUD, PTSD, ED, cultural groups, DBT for adolescents)
  • Racism, discrimination, system invalidation, racial trauma
  • Basic assumptions of DBT and challenges: practicing cultural humility
  • Case study and group discussion
  • Day 1 3:00PM - 3:10PM Break
    Day 1 3:10PM - 4:20PM

    Lecture/Practice: Function of Behaviors and Conducting Chain Analysis

  • Functional analysis of “target-behavior”
  • Chain analysis: validating, curious approach rather than punishing
  • Building insight into vulnerability factors, prompting event, emotions/thoughts/behaviors, short-term/long-term consequences
  • Using a chain for oneself to understand function and consequences of our own behaviors
  • Breakout rooms: Chain Analysis practice
  • Day 1 4:20PM - 4:30PM Break
    Day 1 4:30PM - 5:00PM Review, Questions, Homework
    Day 2 11:00AM - 11:15AM

    Day 1 and Homework Review

  • Questions and reflections from previous day
  • Homework review
  • Day 2 11:15AM - 11:45AM

    Solution Analysis and Contextual Use of DBT Skills

  • Completing a Solution Analysis
  • How each core skill address part of chain
  • Day 2 11:45AM - 11:50AM Break
    Day 2 11:50AM - 1:00PM

    The Why, How, and What of Mindfulness

  • Buddhist origins
  • The WHY: Goal of accessing Wise Mind (observer self, self-as-context in ACT)
  • Mindfulness as awareness, not “tool” for productivity or way to “relax”/get rid
  • Presenting Wise Mind
  • Breakout room practice
  • How to incorporate mindfulness practice into DBT group/individual therapy
  • Day 2 1:00PM - 2:00PM Lunch
    Day 2 2:00PM - 3:00PM

    Distress Tolerance Part I: Crisis Survival Skills

  • Creating effective, realistic suicide (or other crisis) safety plans
  • Distress Thermometer: Skills to use when you’re at a 7-10
  • Presenting window of tolerance, distress tolerance, challenge zone vs. overwhelm zone
  • Review Core Crisis Survival Skills
  • Developing your own Distress Tolerance toolkit
  • Day 2 3:00PM - 3:15PM Break
    Day 2 3:15PM - 4:20PM

    Distress Tolerance Part II: Reality Acceptance Skills

  • Common traps/myths of Radical Acceptance
  • Experiential practice
  • Reality Acceptance Skills practice: Practice Willing Hands and Turning the Mind
  • Radical Acceptance and Trauma and Racism
  • Day 2 4:20PM - 4:30PM Break
    Day 2 4:30PM - 5:00PM Day 2 Review, Questions, Homework
    Day 3 11:00AM - 11:15AM

    Day 2 and Homework Review

  • Questions and reflections from previous day
  • Homework review
  • Day 3 11:15AM - 12:00PM

    Emotion Regulation: Function of Emotions and Skills

  • How to discuss function of each emotion
  • Reducing Vulnerability to Emotion Mind
  • ABC Please Skills
  • Behavioral Activation
  • Coping Ahead: consider unique application to different presentations
  • Day 3 12:00PM - 12:10PM Break
    Day 3 12:10PM - 1:00PM

    Values and Problem-Solving

  • Incorporating Values work: creating a vivid picture of A Life Worth Living
  • Group intervention demonstration: Values and Willingness, Two Sides of a Coin
  • Clarifying values and problem-solving at distress of 1-6 level
  • Day 3 1:00PM - 2:00PM Lunch
    Day 3 2:00PM - 3:00PM

    Interpersonal Effectiveness Part I

  • Why interpersonal effectiveness is so tricky: barriers, myths, others’ responses
  • Balance between aggressive, passive: assertive
  • How patterns of invalidation lead to escalated response: breaking the cycle
  • Clarifying priority: Objective, Relationship, Self-respect
  • The crowd favorite: DEARMAN
  • FAST skill
  • Day 3 3:00PM - 3:10PM Break
    Day 3 3:10PM - 4:20PM

    Interpersonal Effectiveness Part II

  • Cultural considerations
  • GIVE skill
  • Five levels of Validation (for us as therapists and patients to practice)
  • Day 3 4:20PM - 4:30PM Break
    Day 3 4:30PM - 5:00PM Day 3 Review, Questions, Homework
    Day 4 11:00AM - 11:15AM

    Day 3 and Homework Review

  • Questions and reflections from previous day
  • Homework review
  • Day 4 11:00AM - 11:15AM

    Day 3 and Homework Review

  • Questions and reflections from previous day
  • Homework review
  • Day 4 11:15AM - 11:45AM

    Individual Therapy: Using a Diary Card

  • Tracking target behaviors, daily mood, skills use
  • Help client identify patterns of how behaviors and skills affect mood
  • Use as impetus for chain analysis/identifying skills to incorporate into session
  • Day 4 11:45AM - 11:50AM Break
    Day 4 11:50AM - 1:00PM

    The DBT Targets Hierarchy

  • Life-threatening, therapy-interfering, quality-of-life interfering behaviors
  • Radical genuineness
  • Therapist-interfering behaviors
  • Using Target Hierarchy for case consultation
  • Running a DBT Case Consultation team
  • Day 4 1:00PM - 2:00PM Lunch
    Day 4 2:00PM - 3:00PM

    DBT for Specific Presentations

  • PTSD and complex trauma
  • Substance Use Disorders
  • Eating Disorders
  • Mixed messages about controlling internal experience (for anxiety, depression)
  • Day 4 3:00PM - 3:15PM Break
    Day 4 3:15PM - 4:20PM

    Individual DBT-Informed Therapy and Case Conceptualizing

  • Bringing in skills as individual therapist, as needed vs. set timing
  • What a Dialectical Behavior Therapy (DBT) Session looks like
  • Determining stage of treatment
  • Six dialectical dilemmas
  • Cultural context, using Bronfenbrenner’s Ecological Model, systemic invalidation
  • Day 4 4:20PM - 4:30PM Break
    Day 4 4:30PM - 5:00PM

    Reflection and Wrap-up

  • Resources, ongoing support and DBT Community
  • Answering questions/case-specific needs
  • Group reflection
  • Frequently Asked Questions

    Questions about Zoom and Webinars

    What platform will be used for the webinar? CBI Center for Education has invested in Zoom for Webinars. You do not need a Zoom account to join the webinar and you can join from your computer or mobile device. As an attendee, the presenter will not be able to see your video or hear you unless they give you special permission during the webinar.

    What time will the webinar begin and in what time zone? Please see the event page on https://www.cbicenterforeducation.com/ for information about the webinar, such as the start time. In addition, when registrants receive the email for the event, the date and time of the event is included.

    When will I receive the link to attend the webinar? After you’ve signed up for the event through our website, you will receive an automated email from Blue Sky. At the bottom of this email is a blue button labeled “Join” that you can click on the day of the event. Or log in directly to your Blue Sky account and join from there.

    Why can’t I get into the webinar? Once you have joined the webinar, you might see a message that states that the webinar has not yet started. The webinar will start once the presenter has joined and clicks “start the meeting.” We hope this happens on time, but it may be several minutes late. Please be patient while you are waiting for the webinar to start.

    lined internet or being physically located close to your router. Technical support will not be provided by CBI for any connection issues on the day of the training. CBI will not issue refunds due to technical issues experienced by participants. Our presenters are connected to hard-lined business-grade internet when presenting.

    What happens if my internet briefly freezes? If you become disconnected during the event, log back on immediately. A brief interruption of connectivity will not impact your eligibility for a CE certificate.

    Will there be a recording? No, there will not be a recording or replay.

    Will you know that I am logged in and active in the webinar? Yes, Zoom’s platform monitors the attendance and activity of the attendees. Additionally, there will be a chat feature and various forms of participation monitored throughout the training.

    Will I have to show my face on camera? Zoom’s webinar platform does not capture participants on video unless specifically requested during the meeting by the host. Instead, participants will view the presenter and the presenter's slides on their screen.

    Is there Audio? Yes, the webinar will have sound. Please test that your device’s sound is working prior to the event. A good way to do this is to go to YouTube and play a

    Questions about the Event

    Will I receive the presenter's slides? It is up to each presenter if they wish to share their slides. If slides are being shared, they will be uploaded as a document within the course in Blue Sky and can be downloaded and printed as necessary. We are unable to respond to emails asking for the slides ahead of the presentation.

    Questions about the Survey

    When will I receive my course evaluation survey? Following the completion of the event, the survey will be unlocked and located within the course.

    You must complete the survey within 14 calendar days following the event if you would like to receive a CE certificate.

    We are unable to respond to emails from participants asking for confirmation that their course completion survey was received. If you clicked the SUBMIT button your survey was received.

    Do I need to fill out the course evaluation survey if I don’t want a CE certificate? If you do not wish to receive a CE certificate, you do not need to complete this survey. The CE certificate is the only type of certificate that will be issued.

    Questions about Continuing Education & Certificates

    What is the criteria for receiving CE? If you attend the whole webinar and complete the course evaluation survey, we will issue you the CE that you are eligible for.

    How many suicide and ethics CE's will be issued? Please see the event page on https://www.cbicenterforeducation.com/for information about the training, including how much continuing education is offered and what type.

    Will these CE's count toward my individual state licensure or another credential that I currently hold? It is the responsibility of the licensee to determine if trainings are acceptable as continuing education to their state’s licensure board or other credentialing body. Some of our trainings are individually approved for continuing education, such as through the Association of Social Work Boards individual course ACE Program. In addition, CBI is an approved provider of continuing education through the American Psychological Association CESA program and is an approved provider of continuing education to counselors, social workers, and psychologists in the state of New York. Many boards accept trainings that are individual approved or are offered by approved providers for continuing education. Please see the event page for the training you are interested in on our website https://www.cbicenterforeducation.com/for approvals that apply for each specific training.

    Will you issue partial CE credits? No, we do not issue partial CE credits and therefore if you do not attend the training in its entirety, you will not be receiving a CE certificate. This is an APA and ASWB ACE requirement and is non-negotiable. Please refrain from emailing us explaining why you were unable to login to the event on time (this includes mixing up time zones and technical difficulties).

    When will I receive my CE certificate? Upon completion of the event and survey, your certificate will immediately be available.

    How will I receive my CE certificate? Your CE certificate will be available through your Blue Sky account and will also be directly sent to your email associated with your Blue Sky account. It will automatically be accessible to you once all previous criteria have been met.

    I filled out the wrong email address or misspelled my name on my account registration. How do I get a new certificate? In the registration, it asks for the participant to fill out
    their name, licensure, and license number. These fields automatically populate within our certificates. PLEASE NOTE: Any requested changes to the email entered after
    registration or after the survey is complete will require a $5 processing fee. Additional changes to the produced CE certificate based off of information provided by the attendee will also require a $5 processing fee. CBI Center of Education is extremely lean administratively and utilizes technology to streamline our events in order to keep our trainings free to low cost. When we receive manual requests post registration, additional staff is needed to assist with these manual requests, thus the reason for the
    change fees. Please reach out to info@cbicenterforeducation.com

    Questions about Accommodation

    How can I access accommodations for my disability? Our webinars are available to anyone who is able to access the internet. For those who are vision impaired graphs
    and videos are described verbally. We also read all of the questions and comments that are asked of our speakers. All questions and comments are made via the chat function.

    For those that require it, please contact us at info@cbicenterforeducation.com for more information on and/or to request closed-captioning.

    Additional Questions

    I have a question that isn’t in the Q&A. If you have any additional questions or concerns, please email us at info@cbicenterforeducation.com.

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