Dbt Group Agreements

All patients begin pre-treatment. Then, the individual therapist discusses the DBT agreements and assesses the motivation for the engagement. People involved in DBT must be voluntary. The DBT expressly prohibits any involuntary processing. Thus, if the treatment is not voluntary, the patient should have the opportunity to choose another non-DBT treatment. Thus, in DBT, there are patient agreements and therapist agreements. These can be oral, but are written and returned optimally if they are needed in the future. Also, make a smooth transition to another engagement strategy that evaluates the pros and cons of entering DBT. It is important to sincerely emphasize the differences between DBT and other therapeutic modes, which includes the disadvantages of entering the treatment. DBT takes longer than CBT, taking into account individual therapy, group formation, and intersessional contact components that occur weekly. Instead of focusing on the crisis of the week, the therapist also engages in managing and responding to problems according to dbT`s target hierarchies. Therefore, instead of participating in heart cardio or ventilation sessions, a therapist may repeatedly redirect a patient to the previous week`s discussion of life-threatening behaviors.

This can be aversive for some patients and so it is important to point it out as a potential drawback of treatment. Until the patient and therapist agree on how the treatment will proceed, methods and goals, the patient is not involved in DBT, but is in pre-treatment. As a rule, pre-treatment should not last more than three sessions, during which a typical assessment is no different from any other form of psychotherapy. The agreements are reviewed and the therapist begins to implement the engagement strategies in order to strengthen the patient`s engagement in the treatment. The therapist undertakes to make, beyond the usual ethical and confidentiality requirements of the profession, all so-called reasonable efforts to ensure the therapy in the most competent way possible and to participate in peer consultation team meetings. The individual therapist is also committed to offering appropriate intersessional contact in the form of telephone coaching. And they are committed to treating the patient with respect and working on their own treatment behaviors that might arise. The patient accepts a one-year gentleman`s agreement.

It is therefore a one-year obligation for DBT as a whole. This is a renewable agreement, allowing patients and therapists to go back after the end of the year, review progress and determine whether to enter into a new contract. It is a gentleman`s agreement, because it is not legally binding and there is not necessarily a financial commitment that accompanies it, but it is a bit like a handshake that one can agree today and change one`s mind tomorrow, but that would not happen ideally. The patient also agrees to attend weekly sessions and weekly skills trainings….


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