Given the severity and suicide risk of patients typically treated by Dialectical Behavior Therapy (DBT) and the absence of guidelines regarding delivery of DBT via telehealth, it is crucial that the DBT treatment community gather and rapidly disseminate information about effective strategies for delivering DBT via telehealth. The current study surveyed DBT providers (N = 200) to understand challenges and lessons learned as they transitioned to conducting DBT via telehealth during the COVID-19 pandemic. Open-ended responses to challenges and lessons-learned were coded. Most frequently noted challenges were Therapy-Interfering Behaviors and elements related to the provision of Individual Therapy and Skills Training Group. The majority of providers offered advice for implementing group skills training, avoiding or overcoming therapist burnout, and emphasized continued adherence to treatment principles, even in the context of this new treatment modality. Overall, this qualitative study marks a starting point on identifying best practices delivering DBT via telehealth for which it is anticipated that clinical recommendations in this area will evolve, informed by clinician, researcher, and consumer input.
This course is based on the reading-based online article, Lessons Learned Conducting Dialectical Behavior Therapy Via Telehealth in the Age of COVID-19 created by Maureen Zalewski, Ph.D. , et al. in 2021.
Publication Date:
Cognitive and Behavioral Practice 28 (2021) 573-587 Apr 2021
Course Material Authors
Course Material Authors authored the material only, and were not involved in creating this CE course. They are identified here for your own evaluation of the relevancy of the material this course is based on.
Maureen Zalewski, Ph.D.
Dr. Zalewski is an assistant professor at the University of Oregon. Dr. Zalewski studies how child development and parenting is impacted by having a parent who struggles with mental health issues. Her work has included studies of parents who struggle with disorders rooted in emotion dysregulation (ex. borderline personality disorder, substance use). Furthermore, Dr. Zalewski is formally trained in Dialectical Behavior Therapy (DBT), an evidence based approach to treating individuals with Borderline Personality Disorder (BPD) and other disorders involving high emotional dysregulation. Her lab is currently completing a 5 year clinical trial on DBT Skills for mothers of preschool aged children. She also supervises a DBT Skills practicum at the University of Oregon Psychology Training Clinic.
Carla J. Walton, Ph.D.
Carla Walton, PhD is Service Director of the Centre for Psychotherapy, a specialist service for Borderline Personality Disorder and Eating Disorders within Hunter New England Mental Health Service in Australia. She has been involved in treatment provision to persons with Borderline Personality Disorder using DBT, in both public and private sectors in Australia for the past 15 years. Dr. Walton is the principal investigator on a large-scale randomized clinical trial of DBT and a psychodynamic therapy, the Conversational Model. She is a member of Marsha Linehan’s annual DBT Strategic Planning Meeting at the University of Washington. She has provided training and consultation in Borderline Personality Disorder and Dialectical Behaviour Therapy throughout public and private sector services throughout Australia. Her main research interests lie in the fields of Borderline Personality Disorder and translational research.
Shireen L. Rizvi, Ph.D., ABPP
Shireen L. Rizvi, PhD, ABPP, is a Professor of Clinical Psychology, Director of the Dialectical Behavior Therapy Clinic (DBT-RU), and Clinical Professor of Psychiatry at Rutgers University. She received her doctorate in clinical psychology from the University of Washington. She studied borderline personality disorder and DBT for more than five years under the direct mentorship of Dr. Linehan and worked as a research therapist in Dr. Linehan’s research lab, providing individual psychotherapy and skills training. Her dissertation research focused on the use of the DBT skill of “opposite action” to treat shame. She completed her predoctoral clinical internship at the Boston Consortium in Clinical Psychology and an NIMH postdoctoral fellowship at the National Center for PTSD at the Boston VA Healthcare System. Dr. Rizvi has written and presented numerous theoretical and research papers on BPD, DBT, and cognitive-behavioral therapy (CBT). Her areas of research and clinical expertise include shame, treatment development, trauma, and development of mobile technology applications to aid in skills generalization. Her research has been funded by the National Institute of Mental Health, National Institute on Drug Abuse, and the American Foundation for Suicide Prevention.
Elizabeth Mosco, Ph.D. is a licensed psychologist in Reno, NV. She opened a private practice
after 10 years of conducting home-based assessment and therapy with the VA Sierra Nevada
Health Care System. Dr. Mosco’s clinical interests include maternal mental health, older adults,
and third wave cognitive behavioral therapies.
Recommended For:
Counselors, marriage and family therapists, psychologists and social workers. This course is appropriate for all levels of knowledge.
Course Objectives:
After taking this course, you should be able to:
Describe the need for evaluating the effectiveness of DBT delivered via telehealth, in particular with regard symptom severity in the population served.
List at least 3 challenges DBT providers reported when implementing telehealth.
List at least 3 lessons learned by DBT providers implementing telehealth.
Disclosure to Learners
Disclosure of Relevant Financial Relationships
CE Learning Systems adheres to the ACCME's Standards for Integrity and Independence in Accredited
Continuing Medical Education. Any individuals in a position to control the content of a CE activity –
including faculty, planners, reviewers, or others ― are required to disclose all relevant financial
relationships with ineligible entities (formerly known as commercial interests).
The following relevant financial relationships have been disclosed by this activity's planners, faculty, and
the reviewer:
Planners and Reviewers
The planners of this activity have reported that they have no relevant financial relationships.
Commercial support
There is no commercial support for this distance-learning course.
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