Clinical Grand Round 3 - DBT Clinical Grand Round: Exploring the Four Modes of Treatment Through a Live Demonstration

ISITDBT will commemorate the 30th anniversary of the original DBT text (Linehan, 1993; Cognitive-Behavioral Treatment of Borderline Personality Disorder) with an invited Clinical Grand Rounds at ABCT 2023's annual convention in Seattle, Washington, the birthplace of DBT. Through an extended clinical demonstration, attendees will have the opportunity to witness the four modes of DBT treatment—Individual Therapy, Skills Group Training, Phone Coaching, and Consultation Team—come alive on stage. Through a single case vignette, a common and challenging clinical scenario will be presented to illustrate the effectiveness of DBT. The live demonstration will open with a client attending an individual therapy session; during this session, the audience will witness the client become emotionally dysregulated in response to a comment made by the therapist. The demonstration will unfold with role-plays of each of the four treatment modes; ultimately revealing how each mode plays a crucial and distinctive role in repairing the client-therapist relationship. Whether novices or experts in DBT, participants will observe the intricate ways these distinct modes of treatment work together to support patients and improve treatment outcomes.

Outline:
I Introduction to Four Modes of Treatment in DBT; brief description of how the role play will unfold through a single extended case vignette
II. Role play of rupture between therapist and client during individual treatment session (audience will observe client becoming increasingly emotionally dysregulated in session)
III. Role play of client in group, revealing to skills group leaders they are angry with their therapist and want to quit treatment (audience will watch group leaders reinforce effectiveness skills with client)
IV. Role play of consultation team, in which therapist reveals difficulty of individual session. Therapist reveals they are anxious that next phone coaching session will lead to greater client dysregulation (audience will observe how consultation team helps therapist cope ahead with potential phone coaching call)
V. Client will call therapist to receive phone coaching (audience will observe how client using skills reinforced by skills leaders as well as how consultation team helped therapist be effective on coaching call)
VI. Summary. Narrator will describe and summarize the role plays, highlighting specifically the distinct and interconnected role of the four modes of treatment