Revised 2013
POST-GRADUATE TRAINING OBJECTIVES
IN DIALECTIVAL BAHVIOR THERAPY (DBT)
University of Toronto, Department of Psychiatry
Psychotherapy Stream, PHES Division
I.
PREAMBLE
Dialectical Behaviour Therapy is a CBT-based therapy programme, comprised of four modes of
treatment: one hour weekly of individual therapy, two hours weekly of skills group, between-session
phone contact, and therapist attendance at weekly consultation team meetings. There is a growing
evidence base for DBT in treating Borderline Personality Disorder as well as other forms of
emotional and behavioural dysregulation (including suicidal adolescents, binge-eating disorder, and
forensic populations).
‘Working knowledge’ objectives will be met via three mandatory requirements: the three-hour
PGY-2 Core Lecture, two 1.25-hour PGY-4 Psychotherapy seminars, and observation of two twohour DBT Skills Groups. The PGY-2 Core Lecture will focus on the structure of the DBT
Programme and will include observation of one or more recorded segments from individual therapy
sessions. The PGY-4 seminars will focus on more advanced theory and techniques, which will allow
residents to formulate cases from a DBT perspective in various settings (eg, outpatient, consultation,
ER). Residents may schedule the observation of two Skills Groups at any point in PGY-3 to PGY-5.
To qualify, the group must be run by trained facilitators in a DBT-adherent manner. The contact
person is Julie Wilson, wilsonj@mtsinai.on.ca
‘Proficiency’ in DBT requires hands-on training which may be accomplished by applying for an
elective or selective. Electives may include co-facilitating a DBT group for a half-day per week,
treating a patient (with BPD or emotional/behavioural dysregulation) in DBT-informed individual
therapy, doing assessments/consultations, or being involved in medication follow-up visits. For
group or individual therapy, the recommended elective duration is six months, with an absolute
minimum of three months.
‘Advanced’ competency in DBT could be accomplished during residency by applying for a one-year
selective which would require at least 1.5 days per week, to attend Team meetings, co-facilitate a
group, and treat at least two individual patients. Electives and selectives can also be tailored to
individual residents’ needs. The contact person for electives is Carmen Wiebe,
carmen.wiebe@camh.ca
DBT is a complex therapy that requires more than one year of immersion in order to become
competent. The BPD Clinic would be open to discussing how to offer further training for fellows or
staff.