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date: 13 December 2019

Abstract and Keywords

DBT is a complex principle-driven treatment, with an abundance of treatment strategies, and is applied by contextual factors. This chapter reviews studies investigating whether adherence to the DBT treatment manuals is related to outcome in the treatment and which implementation strategies may promote therapist adherence. It includes a brief introduction to the DBT-ACS, the DBT adherence rating scale that has been used for research purposes, and how training, supervision, and effective use of consultation team all show promise as approaches that enhance therapists’ adherence to and competence in the model. It explores common therapist adherence pitfalls, provides some suggestions for therapists seeking to avoid these difficulties, and promotes the likelihood of providing adherent DBT. Finally, it includes examples of common problems, which pull therapists out of adherence, that occur in consulation team, individual therapy, and group skills class, and offers potential solutions.

Keywords: Fidelity, adherence, competence, DBT ACS, training, supervision, consultation team, common obstacles, treatment strategies

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