High Fidelity Dialectical Behaviour Therapy Online: Learning from Experienced Practitioners

Dialectical Behaviour Therapy (DBT) is a highly effective treatment for individuals struggling with emotional dysregulation, self-destructive behaviors, and difficulty in interpersonal relationships. Traditionally, DBT has been delivered in face-to-face settings, requiring individuals to attend therapy sessions in person. However, with the advancements in technology and the growing demand for accessible mental health services, online delivery of DBT has gained popularity. A recent study conducted by Lakeman, Hurley, Campbell, Herrera, Leggett, Tranter, and King (2022) titled ‘High fidelity dialectical behaviour therapy online: Learning from experienced practitioners’ explores the effectiveness of online DBT and the lessons learned from experienced practitioners. The study aimed to examine the fidelity of DBT delivery online and identify the key factors that contribute to successful online implementation. The researchers recruited experienced DBT practitioners who had been delivering DBT online for at least two years. Through qualitative interviews and analysis, the researchers gathered insights into the challenges, benefits, and strategies employed by these practitioners. One of the key findings of the study was the importance of maintaining the core principles of DBT in the online format. Despite the physical distance between the therapist and the client, the practitioners emphasized the need to create a therapeutic environment that promotes validation, acceptance, and change. This involved establishing a strong therapeutic alliance, providing regular feedback, and adapting the therapy to suit the unique needs of each individual. The study also highlighted the advantages of online DBT, such as increased accessibility and flexibility. Online therapy eliminates geographical barriers, allowing individuals from remote areas or those with limited mobility to access DBT services. Additionally, the flexibility of online sessions enables clients to fit therapy into their busy schedules, improving engagement and treatment adherence. However, the study acknowledged the challenges associated with online DBT. Technical issues, such as poor internet connection or audio/video disruptions, were identified as barriers to effective therapy. To overcome these challenges, the practitioners emphasized the importance of contingency plans, such as having alternative communication methods or rescheduling sessions when technical difficulties arise. The findings of this study have important implications for mental health professionals and policymakers. Online DBT offers a promising avenue for expanding access to evidence-based treatments, particularly for individuals who face barriers to in-person therapy. However, it is crucial to ensure the fidelity of DBT delivery online by adhering to the core principles and addressing the unique challenges of the online format. In conclusion, Lakeman et al.’s (2022) study sheds light on the effectiveness and challenges of delivering high fidelity DBT online. The insights from experienced practitioners provide valuable guidance for mental health professionals looking to incorporate online therapy into their practice. By harnessing the benefits of technology and maintaining the therapeutic integrity of DBT, online delivery can enhance access to quality mental health care and improve outcomes for individuals in need. This study was a collaboration between Southern Cross University and the Australian DBT Institute Lakeman, R., Hurley, J., Campbell, K., Hererra, C., Leggett, A., Tranter, R. and King, P. (2022), High fidelity dialectical behaviour therapy online: Learning from experienced practitioners. Int J Mental Health Nurs. https://doi.org/10.1111/inm.13039
The Australian DBT Institute, established in 2004, provides a range of professional development opportunities for Mental Health Professionals seeking to become proficient in dialectical behaviour therapy-informed approaches. Our team is led by experienced DBT clinicians who have received training, mentoring, and development from Marsha Linehan’s team at Behavioral Tech LLC (2004-8). The Australian DBT Institute has led high-fidelity DBT programs since 2004 through the Essentia Health Clinics in Melbourne Victoria, Sydney New South Wales, the Gold Coast Queensland, and online. Our clinical programs have included comprehensive DBT and modified DBT programs for specific populations including youth, carers, Indigenous Australians, correctional settings and psychiatric emergency settings.