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Symposia

Dissemination & Implementation Science

Adherence in Dialectical Behavior Therapy: Current Efforts and Critical Need

1 - (SYM 17) Measuring Competency in Dialectical Behavior Therapy: The DBT California Competency Scales (DBTCCS)

Friday, November 21, 2025
5:06 PM - 5:27 PM CST
Location: Celestin A, Level 3
Keywords: Adherence, DBT (Dialectical Behavior Therapy), Competence
Recommended Readings: Rizvi, S. L., Bitran, A. M., Oshin, L. A., Yin, Q., & Ruork, A. K. (2024). The state of the science: Dialectical behavior therapy. Behavior Therapy. 55(6), 1233-1248. https://doi.org/10.1016/j.beth.2024.02.006,   Harned, M. S., Schmidt, S. C., Korslund, K. E., & Gaglia, A. (2023). Therapist adherence to Dialectical Behavior Therapy in routine practice: Common challenges and recommendations for improvement. Journal of Contemporary Psychotherapy. https://doi.org/10.1007/s10879-023-09601-x,   Koerner, K. (2013). What must you know and do to get good outcomes with DBT?. Behavior Therapy, 44(4), 568-579.,   Harned, M. S., Schmidt, S. C., Korslund, K. E., & Gallop, R. J. (2023). Development and evaluation of a pragmatic measure of adherence to Dialectical Behavior Therapy: The DBT Adherence Checklist for Individual Therapy. Administration and Policy in Mental Health and Mental Health Services Research, 50, 734-749.,  
Abstract Body

Dialectical Behavior Therapy (DBT) is an evidence-based treatment designed for individuals with emotion regulation difficulties, including those with borderline personality disorder and high-risk behaviors. Ensuring therapist competency in DBT is essential for effective treatment outcomes, yet standardized methods for assessing clinician proficiency remain an ongoing challenge. This presentation explores data-driven approaches to measuring DBT competency, including the use of structured rating scales developed for the LA County Roll Out of DBT (LACRODBT). We will discuss findings evaluating therapist skill acquisition, competency in DBT, and the utility of measuring competency to assist health care systems in identifying qualified providers. Additionally, we will address implications for training programs and supervision models to enhance fidelity and improve treatment effectiveness. By integrating empirical methods to assess DBT competency, we can optimize therapist training and contribute to more effective mental health interventions.