As a consumer researching Dialectical Behavior Therapy (DBT), you may have come across the term “certification” or “DBT certified.” This blog post is meant to help you understand a bit more about the term “program certification” and what we mean when we say that the TAP Clinic DBT programs (Adolescent and Adult) are DBT-LBC certified.
The concept of board certification itself is relatively uncommon in mental health in general (as opposed to in medicine, where Board certification is very common). In the United States, mental health professionals must obtain licensure as a practitioner in a particular field (e.g., clinical psychology, social work, marriage and family therapy) and must abide by the laws and regulations that govern their field. Licensure assures a minimal amount of training and knowledge in general, but does not give a consumer information about a practitioner’s training or expertise in any one modality or therapeutic skill. Certification boards were created to fill this gap and help consumers know that clinicians have the specific training, skill sets, treatment structure, and oversight to provide a particular therapy to a standard of adherence (providing the treatment as it was designed by the treatment developers and tested through empirical science). You may be familiar with certification organizations that do exist in mental health such as the American Board of Professional Psychology (ABPP) or the Academy of Cognitive Therapy (A-CBT). Board certification in Dialectical Behavior Therapy (DBT) is a relatively new phenomenon and was created so that consumers have a mechanism to determine a provider’s or program’s level of competence in DBT specifically, as determined by a team of external reviewers.
The only certifying body in DBT designed with and approved by DBT’s creator, Dr. Marsha Linehan, is the Linehan Board of Certification (or DBT-LBC). The DBT-LBC is generally considered the “gold standard” for DBT certification due to the rigorous nature of the review process, which includes external verification of competence and fidelity by DBT experts. The DBT-LBC offers both individual and program level certification, both of which have their own eligibility requirements and evaluation processes. Any individual DBT therapist who meets the training requirements (which are available on the DBT-LBC website) may apply, regardless of whether their program plans to apply for certification. You can learn more about the individual certification process by reading our blog post on this topic.
In this post, we will speak in more detail about DBT program certification. Program certification requires the participation of all members of a program’s DBT team, though not all members must have individual certification. Eligible DBT programs are those that: (1) have an individually certified Team Lead (for TAP, Dr. Lorie Ritschel), (2) implement all four modes of comprehensive DBT (individual therapy, group therapy, phone coaching, and consultation team meeting), and (3) can demonstrate that their program is implementing DBT with fidelity to the model. The team lead submits an extensive application that describes all components of the program and includes consent forms and documentation of program procedures, data collection processes, and team meetings. Teams that successfully complete this part of the process (the “desktop review”) are then invited to host two expert DBT therapists who conduct a site visit. These reviewers evaluate the competence and fidelity of the team through a series of interviews with the team lead, team clinicians, and current and former clients and families. They also review select charts and records, and they observe the DBT consultation team and at least one DBT group. The site reviewers then meet to discuss their observations, make a recommendation to the DBT-LBC board, and provide feedback to the program. Achieving program certification means that “the program has the structure and practices consistent with the delivery of a comprehensive (or adapted) implementation of Dialectical Behavior Therapy” (LBC website). Certified DBT Programs must annually complete a Maintenance of Certification process and are re-evaluated by the LBC every 5 years.
The TAP Clinic is incredibly proud that both DBT programs (Adult and Adolescent) became DBT-LBC certified in October 2021! We became the first (and at time of writing only) LBC certified program in North Carolina. We joined the ranks of two other certified programs in the entire southeastern US and an elite group of certified programs nationally and internationally. We believe this achievement affirms our commitment to evidence-based practice at the highest level.
We hope that certification is seen by our clients as our continued commitment to helping them build lives worth living through DBT. We would not put the time, effort, or resources into certification if we did not wholeheartedly believe that DBT works and that doing it well matters. We are aware of the great financial, logistical, and emotional lengths that clients and families go to in order to get themselves the treatment they need and we hope that designations such as certification signal that we take those sacrifices very seriously and are consistently looking at ways we can become more effective, more efficient, and more compassionate in helping them reach their goals. In addition, with the changing landscape of insurance reimbursement, we are hopeful that certification will provide our clients and families additional leverage in negotiating reimbursement with their insurance carriers.
If you have questions about TAP’s DBT programs or program certification, please reach out to your individual clinician (if a current client) or to the program leads, Dr. Ritschel (adolescent program; AdolescentDBT@tapclinicnc.com) or Dr. Byars (adult program; AdultDBT@tapclinicnc.com).