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date: 13 December 2019

Abstract and Keywords

Offering DBT as a solo practitioner presents a variety of challenges that require clinicians to balance altruistic values of a helping professional with the financial realities of business ownership. This chapter discusses decisions to make and pitfalls to avoid in setting up a DBT practice; dialectical solutions uniting clinical service and financial need are proposed throughout. Decisions about practice set-up should be guided by Linehan’s notion of functions of treatment and modes of delivery. Comprehensive DBT is best delivered to fidelity in a structure where clinicians as separate business entities can share a single location where all modes can be delivered in the same space. Practical guidance is given for handling payment-related matters in the context of the therapy relationship, and non-payment of fees is conceptualized as client treatment-interfering behaviour, while failure to target these difficulties is conceptualized as therapist treatment-interfering behaviour. Finally, it shows how to provide DBT with fidelity and also run a profitable business.

Keywords: Treatment-interfering behaviour, nonpayment of fees, dialectics, functions of treatment, independent private practice, business ownership, pre-treatment phase, comprehensive DBT

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