Individual DBT therapist

The therapist is able to:

• Independently take on the role of individual therapist within a DBT program according to the basic rules of DBT.
• Work in according to the hierarchy of symptoms, to vary between acceptation and change-oriented work, and to change these.
• Can alternate reciprocity and irreversibility.
• Encourage the client to train DBT skills during the individual therapy.
• Coach the client regarding generalising skills during telephone consultation.
• To transfer and apply the theoretical basis of DBT, among which the biosocial theory, learning theory and in especially validation (ZEN).

Entry requirements

• The aspiring DBT therapist has to have a registration as gz-psychologist in the BIG register (or comparable registration).
• Possess at least two year of experience in the mental health care.
• Has demonstrable experience in individual treatment of patients with borderline problems
• Has demonstrable experience in working with cognitive behaviour therapy.

Procedure for acquiring acknowledgement

• Following the intensive training of Dialexis, which lasts 10 days.
• Individual supervision by a certified trainer/supervisor on the basis of a competence-oriented checklist. The duration of supervision is decided by the speed with which the aspiring therapist is able to meet all the requirements. The checklist is filled in by means of footage of at least five DBT sessions with individual clients.
• Requester records two videos of an individual DBT conversation (naturally with consent of the patient) and sends the recordings to secretariat of Dialexis, including a verbatim report of the conversations.
• The secretariat sends the footage and verbatim report to the adherence coder.
• The adherence coder pays attention to following elements:
  • Level of validation
  • Way of executing the behaviour analyses and bringing forward solution strategies and finding the final solution. Adequate application of reinforcement naturally plays a role.
  • The application of DBT strategies and the extent to which they are applied (level of tension during the session).
  • The basic attitude.
  • Structuring the session (applying mindfulness, discussing the diary card, determining the agenda and to close the session)
  • Paying attention to the skills, perhaps in combination with a focus on generalisation of those skills (telephone consultation)
• The coder subsequently fills in the adherence questionnaire, but also makes a verbal report of the sessions that indicates which interventions have been used.
• Consequently the coder decides what level the requester has reached.
• This decision is written down in an assessment.
• The head trainer watches by random sample the recordings and assessments.
• The assessment and the verbal report are sent to the requester, after which there is an opportunity to discuss the assessment. The requester decides if he/she pursues improvement, whether or not by supervision.
• All adherence coders are expected to take an aptitude test once every two or three years, identical to the certified therapists. The head trainer looks into the footage and assessment.