Dialectical Behavior Therapy (DBT) is a research-based empirically validated protocol developed by Marsha M Linehan, Ph.D. at the University of Washington, in Seattle. The treatment was devel­oped for people with Borderline Personality Disorder and has now been validated for a variety of other disorders, such as PTSD, depression, anxiety, addictions, eating disorders, mood disorders, impulse control disorders, personality disorders, and for those with other self-injurious behaviors.

DBT organizes treatment into stages and targets, with strict adherence to the order in which prob­lems are addressed. This logical progression first addresses the behaviors that could lead to death; then to behaviors that could lead to premature termination of therapy; and finally to the be­haviors that destroy the quality of life and the need for alternative skills. These stages increase skills that will replace ineffective coping behaviors to those that are more effective, to move from behavioral dyscontrol to behavioral control so that there is a normal life expectancy.

Treatment includes an initial assessment, individual sessions, and a 2.5 hour group weekly, with my Applied DBT Clinicians team. This includes availability for telephone coaching 24 hours a day, 7 days a week. Release of information is obtained for the treating psychiatrist within the initial as­sessment with consultations as needed. Because of the dose connection and extended hours of therapist availability, patients are coached to practice skills in order to prevent inpatient hospitaliza­tion.

The goal is to reduce extended costs, hospitalizations, and assist people in improving their quality of life.

In the event that a patient requires inpatient treatment, referrals are made to an appropriate mental health facility and voluntary admission is encouraged. In the event that that voluntary admission is re­fused, and the patient is assessed to require inpatient care, emergency personnel are contacted. The patient is provided continued phone contact until the emergency help has arrived. Consultation with admitting psychiatrists with appropriate releases of information are achieved with patient’s co­operation and follow-up care is provided upon discharge.

Currently, mental health hospital privileges are being sought for clinical psychological services within San Diego County.