Overview

Students will further develop skills in conceptualising clinical cases within a DBT framework. This will encompass the identification of a treatment hierarchy in behavioural terms, the capacity to conduct behavioural and solution analyses of target behaviours on both clients and themselves and to identify opportunities to increase the effectiveness of solutions.

Assessment Strategy

-threshold -Pass 50-59%The case presentation as a whole demonstrates an understanding of DBT principles as they apply to clients’ problems. There is evidence of understanding the relevance of the biosocial theory to clients’ problems. The target hierarchy is well specified although minor errors in behavioural specificity may be evident. The chain and solution analysis demonstrates moderately comprehensive coverage of problematic links and solutions. There is some indication of efforts to evaluate outcomes and of the involvement of the wider consultation team. The chain and solution analysis demonstrates moderately comprehensive coverage of problematic links and solutions. There is some indication of efforts to evaluate outcomes of the solution analysis.The chain and solution analysis demonstrates moderately comprehensive coverage of problematic links and solutions. There may be an occasional minor error in conceptualization or solution selection. There is some evidence of implementation and reflective evaluation of the application of the therapy to the therapist.The implementation log shows participation in multiple modalities of the treatment (minimum 2). Activities and learning points are reasonably clearly described. Reflections indicate that the candidate has some grasp of the important issues in their learning and on areas for future development. -good -Good 60-69%The case presentation is a competent demonstration of the application of a DBT conceptualisation to clients’ problems. Comprehension of the biosocial theory is evident and organisation of presenting problems in a target hierarchy is clear and mostly accurate. The chain and solution analysis is comprehensive demonstrating a range of different solutions for problematic links in the chain. The evaluation of the treatment assesses the differential impact of solutions employed. There is evidence of consultation with the wider consultation team.The chain and solution analysis is comprehensive demonstrating a range of different solutions for problematic links in the chain. The conceptualization is clear and mostly accurate and solutions are accurately matched to links. The evaluation demonstrates an understanding of the application of the principles of the treatment to the therapist.The implementation log indicates participation in multiple modalities of the treatment (3 or more). The activities and learning points are well described. The reflection indicates that the candidate is thoughtful and accurate in their application of the principles of the treatment and where they may need to work on developing their skills. Candidates participating in only two modalities (e.g. Consultation Team and Skills Group would need to demonstrate very high level skills in their description of learning points and reflection to achieve this grade) -excellent -Excellent 70%+Case presentations at this level show excellence in their DBT conceptualisation of target problems and in the case as a whole. Answers demonstrate a detailed understanding of the application of the biosocial theory to clients’ difficulties and specify accurately clients’ presenting problems in the format of a behaviourally specified DBT target hierarchy. The chain and solution analysis is detailed and comprehensive using all four change procedures as appropriate and demonstrates a balance of acceptance and change procedures. The evaluation of the treatment assesses the differential impact of solutions used and presents numerical outcome data in addition to a narrative. Clear evidence of the input of the wider Consultation team is evident.A (70%+)The chain and solution analysis is detailed and comprehensive using all four change procedures as appropriate and demonstrates a balance of acceptance and change procedures. The detail and accuracy of specification of links and selection of solutions demonstrates an excellent grasp of the problem-solving aspects of the treatment. The therapist demonstrates a thorough grasp of how to apply the treatment to him or herself.The implementation log demonstrates active participation in multiple modalities of the treatment (3 or more). The activities are clearly described and learning points extracted. A wide range of activities is described. There is evidence that the candidate has extensive engagement in the delivery and learning of the therapy. The reflection on the learning points indicates a thorough understanding of the application of the principles of the treatment both in clinical practice and to the therapist and of areas for development.

Learning Outcomes

• 1. Demonstrate use of the key principles in the implementation of a DBT programme.

• 2. Conceptualise a clinical case according to DBT principles of behavioural targeting and comprehensive behavioural and solution analyses. i. Apply the principles of behavioural targeting to clinical cases. ii. Analyse targeted behaviours to identify problematic links in the chain contributing to the onset and maintenance of clinical problems. iii. Develop comprehensive solution analyses, including skills, cognitive modification, exposure and contingency management, for targeted problems. iv. Demonstrate a capacity to identify where alternative solutions could be utilised in the treatment of a clinical case.

• 3. Analyse and modify their own behaviour using the principles of the treatment