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Measure DBT competence with clarity, flexibility, and clinical precision.
The DBTCCS are observer-rated competency measures for Dialectical Behavior Therapy, designed to support training, supervision, consultation, and implementation across all modes of comprehensive DBT.
Contact us for calibration links and instructions
Built for assessing the therapist’s competency in DBT
The DBTCCS were developed to evaluate the therapist’s level of skill in delivering DBT in context. Ratings focus on how effectively the therapist applies DBT principles given the client’s presentation, treatment stage, risk level, session demands, and broader cultural and environmental context.
Competency-focused
Designed to assess whether DBT is delivered skillfully and effectively, rather than whether a fixed list of techniques appeared in a session.
Behaviorally anchored
Items are rated from 0 to 6, with 4 representing minimum competence and 6 representing excellent DBT practice.
Context-sensitive
Raters consider client difficulty, stage of treatment, treatment targets, risk, and whether therapist decisions fit the clinical situation.
Measures for every mode of DBT.
The DBTCCS suite includes parallel measures for the primary modes of comprehensive DBT, allowing programs to evaluate competence across the full treatment system.
What the individual therapy scale measures
The DBTCCS-I includes 13 items that map onto core DBT principles, including the target hierarchy, orientation and commitment, validation, dialectics, behavioral analysis, solution analysis, suicide risk decision-making, and diversity considerations.
| DBTCCS-I Item | How it maps onto DBT |
|---|---|
| Hierarchy | Uses the diary card and DBT target hierarchy to prioritize life-threatening, therapy-interfering, and quality-of-life targets. |
| Orientation / Commitment / Collaboration | Captures orienting clients, obtaining commitment, building collaboration, and linking work to client goals. |
| Validation | Measures competent use of validation across levels, including genuine, specific, dialectically balanced acceptance strategies. |
| Therapeutic Stance | Reflects DBT assumptions, radical genuineness, warmth, confidence, responsiveness, and a real relationship between equals. |
| Movement, Speed, and Flow | Evaluates pacing, structure, strategic movement, and management of in-session contingencies. |
| Dialectical Strategies | Assesses balancing acceptance and change, flexibility and stability, nurturing and challenge, and use of dialectical strategies. |
| Problem Assessment | Maps onto behavioral assessment and chain analysis, including prompting events, links, vulnerabilities, and consequences. |
| Controlling Variables | Identifies the thoughts, emotions, behaviors, meanings, and contextual variables maintaining the target behavior. |
| Solution Analysis Strategy | Evaluates whether selected strategies fit the problem assessment, controlling variables, treatment stage, and life-worth-living goals. |
| Application of DBT Strategies | Measures application of DBT strategies, generation of new behavior, commitments, and generalization. |
| Suicide Decision-Making | Assesses risk-responsive DBT decision-making, including framing suicidal behavior as problem solving and mobilizing skills and supports. |
| Wrap Up | Evaluates linking session content to next steps, obtaining commitment, troubleshooting plans, and ending effectively. |
| Diversity Considerations | Assesses dialectical attention to identity, bias, disadvantage, privilege, strengths, and cultural context when present. |
Designed for training, supervision, and implementation science.
The DBTCCS can be used to train new DBT providers, support supervision, calibrate raters, evaluate work samples, guide feedback, and help systems determine whether clinicians have achieved minimum competence to provide DBT within a program.
For supervisors
Use structured ratings to give specific feedback and identify therapist growth targets.
For programs
Support quality assurance across individual therapy, skills group, coaching, consultation team, and case conceptualization.
For researchers
Measure DBT competence in implementation studies while preserving clinical flexibility and contextual judgment.
Request DBTCCS materials
To obtain DBTCCS calibration links, instructions, and guidance for using the measures, please contact CBT California. Include your name, organization, role, and intended use of the measures.
Use the Form Below!