What's Included in a"Fidelity" DBT Program?

Kat Schultz
3 hours ago
2 min read

women sit in chairs in a semi circle with notebooks on their laps

Dialectical Behavior Therapy (DBT) is a synthesis of Cognitive Behavior Therapy and Zen Buddhism. It incorporates the foundation of CBT with mindfulness skills. It's used to treat emotion dysregulation and self-destructive behaviors, among other mental health struggles.

There are many different ways to learn DBT, from teaching yourself to participating in a "fidelity" DBT program. These "fidelity" programs are considered "full" DBT programs because they offer all the components that Dr. Marsha Linehan, the creator of DBT, originally laid out and studied and they teach DBT strictly by the book. Some programs may take certain health insurances, others may not, which makes these programs often inaccessible to those who need them. They are usually in person programs and they include the following components. Note that different programs may differ in the details.

DBT Skills Group

Two hours or so a week, participants in the program meet to learn DBT skills. Group starts with a mindfulness exercise and a diary card check in. Then there is skills lecture. It is not a process group, meaning it's not a place to talk about past trauma or work through personal problems. The focus is on learning the DBT skills to be used outside of therapy.

Individual Therapy

Once a week for an hour, clients meet with their individual DBT therapist to personalize and problem solve skill use. This is the time to talk about personal struggles and get individualized support. Participants may also complete behavior chains if there are treatment-interfering behaviors present.

Phone Coaching

When participants experience crises outside of session, they can call a provider from their program at any time of day. Someone is always on call, even if it isn't the client's individual therapist. When a client calls, they explain the situation and the provider suggests a few skills to use. The client is meant to then use those skills and call back if the distress does not reduce. This feature is intended to reduce target behavior usage.

Consultation Groups for the Therapists

The therapists involved in the DBT program will meet as a group weekly to consult on their cases. This is not a feature that clients participate in but it does help therapists ensure they are providing the best care possible. Being able to confidentially consult and get support for any roadblocks they have with their clients or get new ideas is a crucial part of providing ethical and effective psychotherapy.

These are the traditional components of a "fidelity" DBT program. Additionally, the therapists providing therapy will typically be certified by the Linehan Board of Certification which is a very intensive and expensive process, which is why you'll often only see officially certified therapists at DBT clinics where the clinic helps subsidize training expenses. Not being certified by the LBC doesn't mean a therapist doesn't know DBT, however. There are many great DBT therapists out there who are not LBC-certified.

We do not offer a "fidelity" DBT program however we teach DBT skills as part of our DBT trainings for mental health providers and you can learn them for yourself in our self-paced DBT skills course.