Obtain Specific DBT Knowledge:

1. Understanding of DBT Framework: Familiarity with the theoretical underpinnings of DBT, including its roots in behavioural therapy, mindfulness practices, and dialectics.

2. Target Populations: Knowledge of which populations DBT is typically used for, such as individuals with borderline personality disorder (BPD), but also for other conditions like mood disorders, eating disorders, and substance use disorders.

3. Modes of Treatment: Awareness of the four modes of DBT treatment:

   • Individual Therapy: One-on-one sessions focusing on achieving therapeutic goals.
   • DBT Skills Training: Group sessions teaching specific skills in areas like mindfulness, distress tolerance, emotion regulation, and interpersonal effectiveness.
   • Phone Coaching: Providing clients with skills coaching outside of scheduled sessions.
   • Consultation Team: Regular meetings among DBT therapists to support one another in delivering effective treatment.

4. Assessment Tools: Knowledge of assessment tools and measures used to evaluate progress and outcomes in DBT, such as the Diary Card and other self-report measures.

5. Ethical Guidelines: Understanding of ethical considerations in delivering DBT, particularly in terms of boundaries, confidentiality, and informed consent.

Obtain DBT Strategies:

1. Behavioural Analysis: Ability to conduct functional behavioural analysis to understand the antecedents and consequences of maladaptive behaviours.

2. Individual Therapy Skills:

   • Structuring sessions effectively to balance validation and change-oriented strategies.
   • Application of behavioural techniques and cognitive restructuring.
   • Coaching clients on applying skills learned in DBT Skills Training.

3. Group Facilitation Skills:

   • Planning and leading DBT Skills Training Classes.
   • Managing group dynamics and promoting a supportive learning environment.
   • Teaching mindfulness practices and behavioural skills effectively.

4. Mindfulness Training: Competency in teaching mindfulness techniques and practices to enhance emotional awareness and regulation.

5. Crisis Management: Skills in managing crises and suicidal ideation using DBT-specific strategies like chain analysis and safety planning.

6. Collaboration and Consultation: Ability to collaborate with other healthcare providers involved in the client’s care and participate in DBT consultation team meetings.

Implementation of Outpatient DBT Model:

1. Treatment Planning: Collaboratively developing treatment plans with clients, setting specific goals, and outlining strategies for achieving them.

2. Session Structure: Following the structured session format in individual therapy and DBT Skills Training Classes, including review of diary cards, teaching new skills, and assigning homework.

3. Skills Training: Systematically teaching and reinforcing DBT skills across modules (mindfulness, middle path skills, distress tolerance, emotion regulation, interpersonal effectiveness).

4. Phone Coaching: Providing skills coaching between sessions to help clients generalise and apply skills in real-life situations.

5. Measurement and Evaluation: Regularly assessing progress using outcome measures and adjusting treatment strategies as needed.

6. Adherence to Protocols: Adhering to DBT protocols and guidelines as established by treatment manuals and ongoing research.

Learning, Development and Improvement:

1. Supervision and Consultation: Participating in 12 months of supervision/consultation to enhance skills and ensure fidelity to the DBT model.

2. Professional Development: 12 months of continuing education in DBT and related therapeutic modalities to stay current with best practices.

3. Feedback and Adaptation: Supporting feedback from clients and colleagues to continuously improve delivery of DBT services.

By combining this knowledge base with practical skills and a structured approach, clinicians can expect to be effectively delivering the recommended outpatient DBT model, supporting clients in developing skills for managing emotions, relationships, and challenging life situations.