DBT Therapists Agreements
Therapists in the Missoula DBT Collaborative agree to make every reasonable effort to conduct the DBT program as competently as possible. This includes working within the limits of their scope of practice, and also abiding by the requirements of their professions’ ethical codes.
Beyond this, clients can expect DBT therapists to make their best effort to be helpful, to help them gain insight and learn new skills and to teach them behavioral tools they need to deal more effectively with their current living situation. They agree to provide respect, nonjudgement, and validation towards the client, assuming that clients are doing the best they can in every moment and can also learn to do better by learning new skills. They agree to provide a dialectical stance, balancing the need for acceptance and the need for change.
They agree to come to every scheduled appointment, to cancel sessions in advance when needed, and to reschedule whenever possible. They agree to provide reasonable backup coverage when they are out of town or unavailable and to provide reasonable telephone support.
DBT therapists agree to respect the integrity and rights of their clients and to keep confidential all information that is revealed in therapy (with the exceptions outlined below). The DBT model includes therapist involvement in a treatment team, so client information may be shared within the context of team meetings. However, therapists agree to keep sensitive, potentially embarrassing, information confidential unless there is a compelling need to do otherwise. Legally, therapists are not bound to confidentiality when a client is threatening suicide or in other circumstances where therapists are required by law to report things clients say to them. When doing so is necessary to maintain the client’s safety or that of others, such threats may be communicated to other people – either those in the client’s home environment or members of the legal or mental health professional community.
DBT therapists agree to obtain consultation on a regular basis. In DBT, the client can count on the therapist to get help when needed rather than continuing with ineffective treatment or blaming the client for problems in the therapy.
They also make it clear that they cannot “save” clients, nor can they solve their problems or force them to cease suicidal behaviors. Clients need to solve their own problems. Although therapists can help clients develop and practice new behaviors that may help them build a life worth living, they cannot, in the final analysis, build their clients’ lives for them. The analogy of therapist as guide is helpful: They can show someone the way, but they cannot walk the path for them.