Don't even get me started on the issue of insurance companies getting to decide for us what kinds of therapy we need, or more importantly what they'll pay for!! I believe that the consumer should get to decide what works for them or what they are comfortable with after doing their own research. Unfortunately, more and more in the US, insurance companies are making these decisions based on "how quick can we stop having to pay for this client's treatment?"

That said, I believe that Hankster is correct in her interpretation of Linehan's approach. The DBT therapist might see the flaws in the client's thinking, as in seeing her cognitive distortions or interpretations, but the DBT therapist accepts the client where she is at that moment and time. She doesn't try to push or entice the client to change--sending a client out of the room because she is crying wouldn't be Linehan's approach. She might not stop and process what that particular client is experiencing at that moment and time, but she wouldn't banish the client from the room as if she had done something to shame herself. She simply works toward meeting the client where she is, getting her to clarify what's working and what's not working, teaches her coping skills and applaudes and encourages progress toward use of skills that bring relief of psychiatric/relationship pain. That's dialectics--the ying and the yang--it's okay to be where you are but you can move toward change that you welcome or embrace because it's what you want. And it's definitely okay to step forward and step back, as long as you continue to engage in the process. DBT doesn't see the regression as negative.

I do think many therapist SAY they are trained in DBT but they truly aren't. Many have gone to a one or two day workshop on DBT, read the manual and textbook and on the basis of that, they think that they can "do DBT". It's not like that. In fact, I've read articles by Linehan's instituate on DBT that says that going to a one or two day or a week long workshop is NOT being trained by Marsha Linehan. DBT is an art and the training is expensive and extensive. The team that goes for training pays a LOT Of money and they have to submit supervision tapes before they are certified as trained. Unfortunately, anyone can hang out a shingle and say that they do DBT, CBT, indepth psychoanalysis, Schema Therapy etc. All a person needs is the initial degree/license: PhD clinical psychologist, Licensed Clinical Social Worker LCMSW, Mental Health Counselor, Psychiatric Nurse Practioner, Psychiatrist MD.

I don't know about all of you, but when I struggle to ask a therapist what their credentials are . . . what they are certified in . .. what their education level is . . . this astounds me because I am a very educated person but when it comes to my "inner functioning" I go all wonky and whimpy. I guess I need to become a better consumer.