ABSTRACT
This chapter describes the application of dialectical behavior therapy (DBT) for adolescents in a partial hospital program setting. M. Linehan describes the dialectic of nurturance vs. benevolent demandingness as an essential characteristic of the DBT therapist, and we find it to be a component of an effectively operating DBT milieu. The polarity of unwavering centeredness vs. compassionate flexibility is a second dialectical dimension used in DBT milieu management. Educational staff members use DBT strategies and coach skills in addressing behaviors that manifest in the learning environment. The Entering phase is the pretreatment stage and includes orientation to DBT treatment assumptions, use of a daily diary card, and the role of chain analysis in problem-solving. The primary goal of the supervision/consultation group is to enhance clinician competence and motivation to deliver DBT in a manner consistent with standard treatment principles and accepted adaptations applicable to adolescents.
