Practical Tips for New DBT Clinicians
DBT FoundationalFirst of all, simply listening on team is so helpful. Hearing other therapists with more experience talk about cases, present cases, and also share their own struggles, their own emotions, their own vulnerability around clients, hearing other people use the language, hearing how people grapple with risk behaviors, strong emotions, therapy techniques, just hearing it in the room is so invaluable. Additionally, being early on in treatment and being able to present a case and really ask, like, what do I do here? Being able to really come to the treatment team being like, I am really stuck. I don't know what to do. Is this too high risk? When do I hospitalize?
What do I do here? Or a family is asking this. I'm not sure. This person is on the brink of dropping out of treatment, help me here, was also just so useful that having a place to go week after week where I could kind of tap into the hive mind of getting different people's perspectives and also just some reassurance that I was on the right track or having the team behind me so that I knew I didn't have to make these decisions alone was so... was so, so useful. If you have the thought, should I put this person on the agenda, always put them on the agenda. Practice presenting on team. Practice being fallible. Practice sharing your struggle.
Practice putting yourself out there, and I hope other team members do that as well. There is no shame and struggle. It helps us. The more vulnerable, the more open, the more stuck you are, put it on team. It's exposure therapy. Do it over and over and over again so that that initial hesitation or anxiety goes away. Keep putting yourself on team. Secondly, even if you're new to DBT, don't doubt your own wisdom.
Even if the most senior member of your team is presenting, if Alec Miller is presenting a case, I want our psychology extern to practice giving feedback, you can absolutely validate that therapist struggle. You can always offer validation. You can always offer problem-solving strategies even if you have the thought of there's no way I have anything useful to say. Talk anyway. Present anyway. DBT really is we try to be as egalitarian as possible, and your validation, your support, or your potential problem-solving strategy has a lot of merit. Throw yourself in over and over again as best you can.