Staring Down the Beast: Am I Good at DBT?

Five years ago, I jumped in a river of new learning. Ominous. Vulnerable. Putting myself out there.

I had been practicing DBT in a comprehensive program for about two years, and had lived for that whole time with a sneaking feeling that I was doing it all wrong. It wasn't clear to me if this was merely an imposter syndrome that I needed to act opposite to, or if these worry thoughts were accurately signaling that I should improve my DBT.

A close colleague of mine (Jesse Homan) was also having the same questions of himself. We decided that we were going to stare down the beast and find out the answers for ourselves. Were we doing Good DBT?

Jesse and I decided we would begin recording our DBT sessions, exchange and listen to them, and then meet together to review and discuss. Ugh, the first few times I sent him one of my session recordings I remember the sense I had of being out on a cliff, totally exposed to the elements, and about to slip off into oblivion. Of course, in hindsight this seems so extreme. But truly, deciding to do this felt to me as though I was opening up my career for someone to tell me "meh, you're not that good at it," and I wasn't sure if I could bare it.

As you've likely guessed, that didn't happen. Certainly, there were lots of points of feedback that didn't feel great, and which pushed me to re-think aspects of my work that I had always held to be "good therapy."  I got feedback about where I was not consistent with the principles or protocols of DBT. But I did not fall into oblivion. I did not discover any unchangeable or inherent aspects of my therapist-self that doomed me to be a "Bad Therapist", or required me to find a new career. What happened instead is that I learned-through all the feedback-just how to be good at DBT.

Perhaps you are at a similar point in your own career where you find yourself wondering "Am I good at DBT?" yet feel scared and a bit avoidant of taking a closer look. Here are two steps I would encourage:

  1. Be brave and stare down the beast! Start recording your sessions today: watch them and share them with a teammate or trusted colleague. This is straight up exposure, so be kind to yourself. You will notice two universal truths about DBT therapists: 1) you will surely find areas where shaping is needed to improve strategies/protocols, and 2) you will surely find that the same principles of behavior therapy you use with your clients will help you get where you want to be.
  2. Be SMART as you proceed. There are many resources out there to help you not only logistically get set up to record but also help you assess and evaluate your work more effectively. Check out the DBT Therapist Wiki for some practical tools.

If you feel anxious, you are completely normal. In your wise mind you know you need to do it; and rest assured, I know just how hard it is! If a structure would help you make this bold move, you are warmly invited to join myself and Jesse Homan for an upcoming Session Rating Bootcamp (see below for details).

Let's stare down the beast together!

-- Kathryn Patrick, LCSW


Is this Good DBT? Session Rating Bootcamp

April 14th - August 25th, 2017 (6 Sessions)
6 CE Credit Course with an additional/optional 3 CE Credits

We will use the DBT Therapist Rating Form developed by Alan Fruzzetti, PhD to train your eyes and ears to recognize effective DBT in action by throwing yourself into intensive practice. The course includes 6 live webinar sessions, supplemented with short instructional content via emails with video clips and examples to help you sharpen your observation skills to notice strategies as they occur, as well as intensive practice assignments in which you will use your own session recordings to master coding of DBT strategies. Two optional online practice sessions will allow you to practice coding with expert guidance as the instructors review a session recording in real-time.

Participants are strongly encouraged to join this course with members of their consultation team and close colleagues, with whom you can exchange your own session tapes for the practice assignments. This will allow you to review sessions that are not your own. You will be asked to review a minimum of 1 full-length DBT session every two weeks, using a specific format for review to be provided during the kick-off session.

Get all the details and register now!