ABSTRACT
Consultation to the client represents the change end of the dialectical approach to case management within DBT. In itself, a de®ned approach to case management is a distinctive characteristic of the treatment. Most CBT approaches, indeed most psychotherapies, do not provide principles to assist the therapist to manage interactions among the various therapeutic interventions clients receive or among the treatment providers delivering these different interventions. The absence of case-management guidance may occur simply because most psychotherapies were developed for uncomplicated Axis I disorders, which require fewer interactions and involve less con¯ict between treatment providers. For clients who have a diagnosis of BPD combined with multiple other diagnoses or social problems, receiving multiple interventions from multiple treatment providers occurs frequently. Also, given the frequent tendency for these clients both to request and to require help from their therapist in negotiating these myriad interventions and treatment providers, a treatment for this population requires some principles to guide therapists in managing their cases.
