Wake Kendall's Dialectical Behavior Therapy Program

Dialectical Behavior Therapy (DBT) was developed by Marsha Linehan, Ph.D., as a treatment for individuals with Borderline Personality Disorder. DBT is an empirically-based, structured therapy that emphasizes both acceptance and change-oriented skills. The central idea in DBT is that individuals are doing the best they can and, at the same time, need to change. Clients are helped to move away from rigid, polarized thinking and to accept seemingly opposite truths to assist them in leading more effective, meaningful lives. Over the years, DBT has been extended to work with individuals who struggle with emotion regulation and tend to engage in self-destructive behaviors. For more information about DBT, visit behavioraltech.org.

Wake Kendall offers DBT for adolescents and adults according to the treatment protocol developed by Dr. Linehan. We typically ask for a one-year commitment. Four key program components must be in place and include:

Adult DBT Program

1. Weekly skills training:Clients attend one weekly instructional group with roughly ten participants and two professional leaders. The group lasts one hour and forty-five minutes. The topics covered are:

a. Mindfulness: Strategies to increase the capacity to pay attention, non-judgmentally, to the present moment

b. Interpersonal Effectiveness: Strategies to attain personal goals in interpersonal situations while enhancing self-respect and overall quality of relationships

c. Emotion Regulation: Strategies to understand and manage emotions in effective, non-harmful ways

d. Distress Tolerance: Strategies to tolerate high levels of painful emotions and accept reality as it is

2. Weekly individual therapy: Clients attend weekly individual therapy sessions, lasting from 45 to 60 minutes. Individual therapists help clients identify meaningful goals and target specific behaviors to change. Clients keep a "diary card," a checklist for tracking thoughts, feelings, behaviors, and skills on a daily basis. During sessions, the therapist's role is to facilitate application of skills to daily life. Clients are also expected to maintain or steadily move toward at least 20 hours of structured activity per week (paid work, volunteer work, or classes).

3. Telephone coaching: Clients are encouraged to call their individual therapist for brief (five minute) skills-oriented coaching when they are experiencing difficulty applying skills.

4. Treatment team: Individual therapists and group skills leaders meet on a weekly basis and work as a consultation team. Individual therapists also collaborate closely with psycho-pharmacologists and other outside professionals involved in clients' care.

Adolescent DBT program
The adolescent program teaches the same concepts and skills as the adult program, although the curriculum is modified to meet the needs of adolescents and their parents more effectively. Similar to the adult program, adolescents are in weekly individual therapy and can call their therapist for telephone coaching during the week. Adolescents and their parents attend the weekly group skills training. During the first hour, the adolescents meet with one therapist, and the parents meet with a second therapist. During the second part of the evening, both groups come together for skills training.

Support for parents and significant others
Partners, parents, relatives, and close friends of clients in our DBT program often benefit from extra support and guidance. A range of options may be considered, including one of our groups.

Scheduling
We currently offer three adult groups: Tuesdays (9:30-11:15); Wednesdays (10:30-12:15); and Thursdays (5:30-7:15). The adolescent group meets Mondays from 5:30-7:15. Individual therapy appointments are on weekdays only. Some of our therapists offer early morning and early evening appointments.

Fees & Insurance
Please call our intake coordinator, Lenni Snyder, for a review of fees and financial policies (202-686-7699, ext. 66). Upon request, she can also email you a brief summary of this information. The Wake Kendall Group is not a participant in any insurance plans but will provide bills suitable for insurance reimbursement.

Intake Procedure
We often have waiting lists for our DBT programs. The wait time is highly variable and unpredictable (ranging from one month to one year). The average wait time is 2-5 months.

In the interest of facilitating a smooth intake procedure, we ask that you proceed with the following steps:

1. Complete the attached application (scroll down to links at the bottom of this page). This brief screening form is a preliminary tool for us to begin determining whether our DBT program is an appropriate treatment for you. It is not a substitute for a more thorough, in-person intake process.
2. Send your application to the following address: Attn: DBT Program, The Wake Kendall Group, 5247 Wisconsin Avenue NW, Washington DC 20015. You can also send it by fax (202-362-9633).
3. Once we receive your application, our intake coordinator, Lenni Snyder (202-686-7699, ext. 66), will follow up with a brief phone call to review your form and address any questions that you may have.
4. Unless it is clear from this brief telephone screening that our DBT program is not appropriate, your name will be put on the waiting list. Please make sure you get the treatment you need while you are waiting to get into our program.
5. We ask that you call our intake coordinator every three weeks to express your continued interest. She will return your calls and, with time, be able to offer closer estimates regarding possible start dates. If a few months pass without updates from you, your name will be dropped from the waiting list.
6. Once it becomes clear that we will have an opening in a group, we will assign you to an individual therapist. We ask that you call this therapist within 1-2 days to schedule an initial intake appointment.
7. You will then begin a 3-6 week phase of "Pre-DBT individual therapy." This is a time for building a therapeutic relationship; history-taking; identifying goals for treatment; honing in on target behaviors; developing a diary card; getting oriented to core DBT theories, concepts, and strategies; solidifying commitment; etc… Assuming both parties continue to view DBT as a good treatment fit, group skills training would commence (after the 3-6 week phase of Pre-DBT individual therapy).
   

Download Application for Adult DBT Program here.

Download Application for Adolescent DBT Program here.

We strive to give you as much advance notice as possible so you can plan accordingly and, at the same time, appreciate your patience with our intake procedure.