Dialectical Behavior Therapy (DBT) was originally developed to treat chronically suicidal and self-injuring individuals with multiple mental disorders and pervasive emotion dysregulation. From its inception, DBT has highlighted the role of trauma as a common etiological factor and posttraumatic stress disorder (PTSD) as an important treatment target for many clients who receive this treatment. The first two decades of DBT treatment development and research primarily focused on Stage 1 DBT to target behavioral dyscontrol, and DBT’s Stage 2 in which PTSD is targeted was left largely undeveloped. As a result, formal treatment of PTSD during DBT has historically been the exception rather than the norm. The DBT Prolonged Exposure (DBT PE) protocol, an adapted version of Prolonged Exposure (PE) therapy, was developed specifically to provide a structured method of treating PTSD within DBT. In this webinar, the rationale for and structure of the integrated DBT and DBT PE treatment will be described and the criteria for determining when a Stage 1 client is ready to begin DBT PE will be reviewed. The core procedures of DBT PE will be explained, including how in vivo exposure, imaginal exposure, and processing are used to treat PTSD. Finally, research findings supporting the safety and effectiveness of the treatment will be presented.

Learning Objectives  
By the conclusion of this event, participants will be able to:

1. Describe the rationale for integrating PTSD treatment into DBT.

2. Explain the core procedures of the DBT PE protocol.

3. Review research findings evaluating the safety and effectiveness of the treatment.

Instructor | Melanie Harned, PhD, ABPP is a Psychologist and Coordinator of the DBT Program at the VA Puget Sound Health Care System as well as an Associate Professor in the Department of Psychiatry and Behavioral Sciences and Adjunct Associate Professor in the Department of Psychology at the University of Washington. Dr. Harned has previously worked as the Research Director of Dr. Marsha Linehan’s Behavioral Research and Therapy Clinics at the University of Washington (2006-2018), Director of Research and Development for Behavioral Tech, LLC (2014-2017), and Director of Behavioral Tech Research, Inc. (2013-2016). Dr. Harned’s research focuses on the development and evaluation of the DBT Prolonged Exposure protocol for PTSD as well as methods of disseminating and implementing this and other evidence-based treatments into clinical practice. She regularly provides training and consultation nationally and internationally in DBT and DBT PE and has published extensively on these treatments. She is a certified DBT therapist, a certified PE therapist and consultant, is board certified in Behavioral and Cognitive therapy, and is licensed as a psychologist in the state of Washington.

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Registration for Intensive Training on DBT-PE

DBT is a comprehensive, principle-driven treatment that requires therapists to learn and apply many strategies. Some strategies are needed in all sessions, whereas other strategies are dependent upon session context. Adherent delivery of DBT (i.e., delivery of DBT in a way that is consistent with the treatment manual) requires that therapists know which strategies are needed when and how to apply them effectively. The DBT Adherence Checklist for Individual Therapy (DBT AC-I; Harned, Schmidt, & Korslund, 2021) was developed to help therapists evaluate and improve their own and others’ delivery of DBT. This webinar will provide a brief overview of the development of the DBT AC-I, including core therapeutic strategies that are used to evaluate adherence, as well as tips and tricks for reviewing sessions with an eye towards adherence.

Learning Objectives  
By the conclusion of this event, participants will be able to:

1. Describe the difference between adherence and competence

2. Identify required vs. context-dependent strategies in DBT

3. Apply knowledge from the DBT AC-I to current practice of DBT

Instructor | Sara Schmidt, PhD is a licensed clinical psychologist in private practice in Washington state and a clinical instructor in the Department of Psychology at the University of Washington. Until 2021, she served as the Associate Director of the Trauma and Suicide Treatment Research Lab at the Seattle Institute for Biomedical and Clinical Research, part of the VA Puget Sound Health Care System, where she was a Co-Investigator on NIMH-funded research focused on the evaluation and implementation of DBT and DBT PE. As part of this work, she co-developed the DBT Adherence Checklist for Individual Therapy (DBT AC-I), a tool that can be used by DBT therapists to evaluate the degree to which they are delivering DBT in a way that is consistent with the treatment manual. Dr. Schmidt completed her postdoctoral training with Dr. Melanie Harned at the University of Washington. While there, she directed the graduate training program in DBT at Dr. Marsha Linehan’s Behavioral Research and Therapy Clinics. She also previously worked as a Research Scientist at Behavioral Tech (2017 – 2020), where she is currently a trainer and consultant. Dr. Schmidt regularly provides professional trainings and consultation in DBT and DBT PE nationally and internationally and has published several peer reviewed articles and book chapters on these topics. She is a DBT-Linehan Board of Certification, Certified Clinician.

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Registration for DBT Adherence Training