Dialectics represents the worldview of DBT. Teaching clients how to think and act dialectically can feel challenging, confusing, or overwhelming to therapists, particularly in the context of exquisite emotional sensitivity, heightened emotional reactivity, and a history of invalidation, as is typically the case with clients in DBT. In this one hour webinar, we will walk through the “Understanding dialectics in DBT” handout we developed to offer new tools in the instruction and application of dialectics. Using this handout, we will discuss and roleplay ways for therapists to teach dialectics through metaphors, which can make abstract dialectical concepts more concrete and relatable, enhancing client engagement and comprehension. In addition to ways to teach dialectics through metaphors, we will also present and discuss ways to teach dialectics through personal examples. By identifying and sharing real-life situations where two seemingly contradictory truths coexist (e.g., “I can be independent and still need support”), therapists can model flexibility and balance, guiding clients toward more nuanced perspectives and reducing black-and-white thinking. 

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

1. Describe an overview of what is meant by dialectics in DBT using the “Understanding dialectics in DBT” handout

2. Describe the principles of dialectics using the “Plaid Venn diagram metaphor” to explain what is meant by “synthesis” in dialectics and to distinguish “synthesis” from “compromise”

3. Describe the principles of dialectics using the “Cylinder metaphor” to illustrate how seemingly contradictory perspectives can coexist

4. Describe at least one personal and client-relevant example to demonstrate dialectical thinking in action

Instructor | Andrea Gold, PhD, is a clinical psychologist and Clinical Assistant Professor of Psychiatry and Human Behavior at the Brown University Alpert Warren School of Medicine and the Pediatric Anxiety Research Center (PARC) at Bradley Hospital. She is the Team Lead of the DBT-X Track in PARC’s Intensive Program for OCD & Related Disorders. Andrea is passionate about dialectical behavior therapy (DBT) and exposure and response prevention (ERP), while living the ‘exposure lifestyle’ and ‘DBT lifestyle’ as all-in life philosophies. At PARC, she is developing an adaptation of DBT targeting exposure (DBT-X) for the subpopulation of adolescents with obsessive-compulsive disorder and anxiety disorders co-occurring with emotion dysregulation, suicidal and self-injurious behaviors, and BPD. She is also on the Board of Directors for the National Education Alliance for Borderline Personality Disorder (NEABPD) and the DBT Bulletin.

Instructor | Jesse Finkelstein, PsyD, is a clinical psychologist and Instructor in Clinical Psychology at Columbia University Irving Medical Center (CUIMC) Day Program. He specializes in evidence-based treatments for complex, multi-diagnostic disorders, with expertise in Dialectical Behavior Therapy (DBT), Exposure and Response Prevention (ERP), Prolonged Exposure (PE), and Cognitive Behavioral Therapy (CBT) for grief and trauma-related conditions. 

Beyond clinical work, Dr. Finkelstein is a co-founder of Therahive, an e-learning platform for evidence-based psychoeducation, and co-editor of the DBT Bulletin. He is also the creator of The Game of Real Life, a DBT skills-based card game published by Penguin RandomHouse. His research focuses on digital applications of DBT skills training and the intersection of therapy, technology, and creative design. 

Follow-up Training! Dr. Gold will be providing a 3 hours follow up training on December 12, 2025. 

Follow-up Training

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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