Learning how to supervise: the 2024 RO DBT retreat

Well, who doesn’t want to go to the South of France for a 4-day retreat? Especially when you get to learn how to supervise fellow RO DBT clinicians firsthand from the treatment developer, Dr Thomas Lynch, himself? Twenty of our accredited senior clinicians, supervisors and trainers travelled from the UK, USA, Norway and Argentina to join Tom, Erica, Roelie and Jodi in beautiful Alet-les-Bains, France, this June for four days of new learning, lots of fun, and making new friends. The group consisted of a mix of experienced RO supervisors as well as newly graduated RO scholars, all eager to learn and further hone their RO DBT knowledge and skills.

Each year we select a theme to further develop and improve RO DBT treatment delivery and dissemination, and this year’s theme was ‘Improving Supervisory Skills’. With the new RO DBT certification pathway in mind (expected to be launched in 2025), we need enough accredited RO supervisors to support and assess certification candidates. The certification program is part of our mission to safeguard RO DBT treatment fidelity: we want to make sure that RO DBT is delivered in a way that closely matches the treatment as intended by its treatment developer, Dr Thomas Lynch.

This retreat aimed to improve existing supervisory and general RO DBT skills as well as prepare senior clinicians to become a supervisor, whether that be relatively soon or a few years from now. There was something to learn for everyone.

So, what did we cover? Well … a lot!!! Here’s an overview to give you an idea:

• What is the difference between adherence and competence, and why are they important?
• Update on the RO Certification program
• Using the Adherence Rating scale
• Common problems keeping therapists from delivering adherent RO DBT (and how to supervise them):
  • Lack of Agenda setting
  • Substandard diary card review
  • Not interrupting
  • Not using silliness and or the ‘Oh My Gosh!’ signal
  • Not spotting alliance ruptures and not repairing them effectively
  • Substandard targeting and lack of behavioural specificity
  • Lacking teasing
  • Substandard or absent chain and solution analyses

So, don’t think we were all just lounging around the swimming pool drinking cocktails! This was serious business, with some fun and games mixed in – where appropriate, of course 😉. We asked the senior clinicians what they took away from this retreat or what was new of different for them, and here are a couple of quotes:

“One of the biggest take-aways for me is to focus more on the client’s behaviours and social signalling instead of the therapist’s.”

“To supervise in the moment regardless if an earlier misstep took them down the wrong path.”

“To be sure I include specifically what to do, not just point out issues and general direction.”

“New teaching on silliness and teasing, particularly how to construct a tease.”

“Feel invigorated. Training a shot in the arm. The drilling down on targeting – 3 factors used to evaluate and making them behaviourally specific particularly helpful. Enjoyed the game.”

“Loved the ‘let’s make a deal’ idea to help clients date/socialize in more effective ways. Getting client commitment to do novel change behaviours if they really want to fulfil a valued-goal takes commitment to acting differently. I think many times therapists miss how important it is to emphasize this.”

“I realized how quickly I turned my learnings into (surprise surprise) rules!! And then I tend to rigidly apply those rules. I need to use flexible-mind!”

“The mimicking game nicely demonstrated, in a fun way, the importance of being behaviourally specific.”

Thanks to all the senior clinicians who attended, threw themselves in there and made this retreat the success that it was, and of course special thanks to Tom and Erica for preparing the training materials, and to Jodi for her patience and perseverance when the PowerPoint crashed three times!

Finally: if you are curious about how these clinicians got to be where they are today, that is, part of the senor clinician team, take a look at our Trainer and Supervisor Pathway page. And keep an eye out for the RO Certification Program announcements, expected in 2025.

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