The Society for Dialectical Behaviour Therapy’s Board of Accreditation is in the process of moving towards DBT Clinical Programme Accreditation as a way of signifying to the public, ie commissioners, service users, referrers, other practitioners etc, that your programme has the structure and practices consistent with the delivery of a comprehensive (or adapted) implementation of Dialectical Behaviour Therapy.
While DBT Clinical Programme Accreditation may not guarantee that every client will receive high fidelity DBT or that every treatment session is done to the level of adherence, it does indicate that a given programme has the capacity to provide treatment to the level of fidelity.
The aim of moving towards a system of DBT Clinical Programme Accreditation is to support and encourage the proliferation of high fidelity DBT programmes. Most importantly though, this guidance provides a blueprint of the critical element that should be present in every DBT Programme.
Thus, we are providing this information on programme adherence as a way for teams to consider their own practice and as part of a first step of moving towardsDBT Clinical Programme Accreditation. It is likely this will form the standards for SfDBT programme accreditation in the UK and Ireland in the future.
Programmes that wish to apply for accreditation must have two therapists on their team who are accredited individual therapists. One of these therapists must be the team leader.
In order to prepare for the next steps in the process and to assess where your team is in terms of adherence to the DBT model, please use this self-assessment tool.
Finally, we recommend as part of establishing your team and maintaining it that a Policy and Procedures Guidelines book is maintained and periodically reviewed. This book should include the following:
- An Operational Policy which is agreed at all necessary levels and is a summary of the following:
- Specify the structure, length of treatment and conditions for termination in the DBT Program.
3. Hiring practices for DBT therapists, students and interns.
a. Attendance requirements, duties
b. Primary Source Verification of:
i. Highest educational degree
ii. Professional registration such as HCPC
c. Note: if the clinician is currently Accredited by the SfDBT and when that is due to expire.
- Treatment contracts and Informed consent for treatment and recording of sessions;
- Policy in relation to other treatment providers
6. Policy for involving caregivers/others.
7. Policy for primary therapist’s role in decision-making for clients.
8. Policy for vulnerable or dependent clients.
9. Egregious behaviour protocol for things like suicide attempts, self-harm, assault, drop out, escape from facility.
10. Policy for how treatment continuation is determined. How progress is measured/evaluated.
11. Policy for 4-miss rule and 24-hour rule.
12. Policy for client discontinuation from treatment. Policy for re-entering treatment after being discharged for any reason.
13. Policy for client emergency and/or between-session contact with therapists.
a. Skills coaching policy
b. Crisis intervention plan – include a copy crisis/suicide risk assessment and management protocol
14. For milieu treatments – plans for coaching during clinic hours/after hours.
15. For any DBT adapted programs, please describe the need for the adaptation, the barriers to standard implementation, how you would describe the adaptation made, how you are preserving the principles of DBT. Describe any non-DBT elements and the ways in which they are delivered so as not to conflict with the principles of DBT.