The RO DBT Certification Program

Our mission

The aim of the RO DBT certification program is to assess clinicians for adherence to the RO DBT treatment principles and protocols. Below we explain what we mean by adherence, and why we believe it is important.

The concept of adherence measures a therapist's relative compliance with a pre-specified set of methods, which are theoretically informed and grounded in a particular therapeutic model.

A consistent finding in the literature on treatment integrity is that higher levels of integrity are associated with best client outcomes (e.g., DiGennaro Reed, Reed, Baez, & Maguire, 2011). Specifically, client outcomes are best when procedures are implemented with perfect treatment integrity. Although this may not always be feasible (e.g., not being able to offer the full 30 weeks of skills classes), clinicians and researchers should strive to implement procedures with high levels of integrity as often as possible. An interesting finding is that when treatment integrity decreases, client behavior becomes less predictable (e.g., Groskreutz, Groskreutz, & Higbee, 2011).

Following initial training, adherence checks should be conducted periodically to detect any procedural inaccuracies (Brand et al., 2017) or instances of treatment drift (Hansford et al., 2010). This can be done by therapists themselves via the RO DBT Adherence Rating checklist from the textbook (p. 433; Lynch, 2018) and by accredited RO DBT supervisors as part of regular supervision.

The gold standard method involves the regular and systematic rating of recorded therapy sessions, being performed by more than one reviewer, and across a random sample of therapy sessions throughout the phases of a therapy (Hogue et al., 1996). Adherence/competence/integrity and subsequent improved outcomes increase through the integration of:

• detailed awareness of psychological treatment protocols,
• provision of corrective and specific supervisor feedback,
• deliberate and sustained practice of micro-skills.

The RO DBT certification program aims to follow the above-described guidelines. Our mission is to assess clinicians for adherence, thereby helping them achieve a gold standard level of treatment for their overcontrolled clients.

Certification Board

The board of certification will be part of the RO Institute, which falls under Radically Open Ltd, tasked with improving didactics, supporting research and dissemination of RO DBT.

The board will have access to applicants' dossiers which will include their application documents, completed exam documents and results, links to tapes, supervisors' assessment documents etc, along with an overall rating sheet for all of the above.

Details about the Certification Board and its members can be provided upon request.

Certification Process & Fees

Below we briefly describe the process. For more details on each of the steps and the associated fees, download the document with all eligibility requirements.

1. Eligibility check: Complete the application form and submit the application fee. You can find the eligibility requirements and fees in the downloadable document.
   1. You start by paying the Application fee. This fee is non-refundable.
   2. Once payment has been received, you will be sent the link to the application form.
   3. If your application is successful, you will be given access to Exam 1. There is no additional fee for this.
   4. However, if your application is not successful, the process stops here.
2. Certification Exam 1: You must pass an initial online exam consisting of 60 questions testing your basic knowledge of RO DBT.
   1. To pass the exam you must answer 80% of the questions correctly.
   2. You will have 60 minutes to complete this exam.
   3. You will get 3 attempts to pass the exam.
   4. After 3 failed attempts, you will be asked to withdraw from the program.
   5. If you pass, you will be invited to Certification Exam 2, which must be paid for and completed within 1 month of passing Exam 1.
3. Certification Exam 2: this second online exam consists of 2 essay questions.
   1. After you have paid the fee for exam 2, you will receive a link to the exam.
   2. You will have 60 minutes to complete this exam consisting of 2 essay questions.
   3. This exam must be paid for and completed within 1 month after you have submitted your application.
4. Adherent Sessions: upon successful completion of the exam, the candidate will have 2 years to submit 3 adherent videotapes.
   1. One full session tape.
   2. One shorter tape demonstrating teaching the mechanism of change.
   3. One shorter tape demonstrating conducting a chain and solution analysis.
   4. Payment can be made as each tape is submitted to spread the cost for the therapist.

Maintaining Certification

RO DBT certified clinicians are certified for a period of 10 years. To maintain the certification:

1. The therapist must have maintained an ongoing practice of offering RO DBT to clients in this period. At a minimum, clinicians have:
   1. Seen 2 individual RO DBT clients per year
   2. Instructed or co-instructed 1 RO Skills Class per year*
      *If the setting does not allow for full course of skills training i.e. not the full 30 lessons, describe how you have led skills classes in your setting
2. The therapist must provide evidence of having completed
   1. ten hours of continuing education, relevant to RO DBT, every two years after the first two years;
      OR
   2. five hours of individual supervision every two years by an RO DBT certified supervisor.