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.
This workshop provides an overview and introduction to DBT. Participants will learn the foundation of DBT, its theoretical basis, and core components. This workshop is ideal for therapists who are new to DBT and are hoping to learn more. An overview of the history, theory, and model of DBT will be presented, Each skills module (Mindfulness, Emotion Regulation, Interpersonal Effectiveness, and Distress Tolerance) will be presented. This is an introductory workshop that will be expanded upon at greater depth in the upcoming DBT intensive. Thus, this workshop is a great first step to complete before the intensive or if unsure whether to sign up for the intensive, however it is not a prerequisite for the intensive.
Learning Objectives
- Participants will describe the core tenets, principles, and underlying theory of Dialectical Behavior Therapy (DBT).
- Participants will explain how the DBT model incorporates skills of Distress Tolerance, Emotion Regulation, Mindfulness, and Interpersonal Effectiveness.
Course Outline
| Module | Topic |
|---|---|
| Lecture 1 | Lecture: Origins and Underlying theory of DBT |
| Lecture 2 | 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 |
| Lecture 3 | Case example What’s possible when “full-model DBT” is not accessible for client/therapist? Biopsychosocial model of BPD and how DBT targets each “deficit” |
Instructor Bio
Dr. Emily Wharton is a Clinical Psychologist providing psychotherapy to individuals and couples in her private practice, and a Clinical Instructor at the Cognitive Behavior Institute, where she teaches courses in Acceptance and Commitment Therapy, Motivational Interviewing, and Dialectical Behavior Therapy. Dr. Wharton has also served in roles of Clinical Assistant Professor (Affiliated) of Psychiatry and Behavioral Sciences at Stanford University School of Medicine, and licensed clinical psychologist in the Palo Alto VA. She has provided supervision and training for VA and Stanford psychiatry residents, medical students, and psychology trainees in ACT, DBT, and MI. Dr. Wharton trained at the PGSP-Stanford PsyD Consortium, San Francisco VA, UCSF, and Palo Alto VA. Dr. Wharton has also served as the Member-At-Large Director for the San Francisco Bay Area Chapter of the Association for Contextual Behavioral Sciences. Dr. Wharton has given lectures and trainings for the Palo Alto VA, Stanford University, and the Association for Contextual and Behavioral Science. Dr. Wharton has published papers and book chapters on ACT for PTSD, ACT for moral injury, mindfulness practices for anxiety disorders, and group trauma-focused CBT for parents of preterm infants.
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.
Germer, C. & Neff, K. (2013). The Mindful Self-Compassion training program. In T. Singer & M. Bolz..Compassion: Bridging theory and practice: A multimedia book (pp. 365-396). Leipzig, Germany: Max-Planck Institute.
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.
Harned, M. S., Korslund, K. E., & Linehan, M. M. (2014). A pilot randomized controlled trial of Dialectical Behavior Therapy with and without the Dialectical Behavior Therapy Prolonged Exposure protocol for suicidal and self-injuring women with borderline personality disorder and PTSD. Behaviour Research and Therapy, 55, 7–17.
Harrell, S. P. (2014). Compassionate confrontation and empathic exploration: The integration of race-related narratives in clinical supervision. In Multiculturalism and diversity in clinical supervision: A competency-based approach (pp. 83–110). American Psychological Association.
Lenz, A., Taylor, R., Fleming, M., & Serman, N. (2014). Effectiveness of Dialectical Behavior Therapy for Treating Eating Disorders. Journal of Counseling & Development, 92.
Linehan, M. (2014a). DBT Skills Training Handouts and Worksheets: Second Edition. Guilford Press.
Linehan, M. (2014b). DBT Skills Training Manual, Second Edition. Guilford Publications.
Linehan, M. M. (1993). Cognitive-behavioral treatment of borderline personality disorder (pp. xvii, 558). Guilford Press.
NEA BPD (Director). (2020, June 18). Racism is an extreme invalidating environment.
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.
Rathus, J. H., & Miller, A. L. (2014). DBT Skills Manual for Adolescents. Guilford Publications.
Safer, D. L., Telch, C. F., & Agras, W. S. (2001). Dialectical behavior therapy adapted for bulimia: A case report. International Journal of Eating Disorders, 30(1), 101–106.
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.
Approvals
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 2 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.