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DBT-Linehan Board of CertificationClinician Applicant Handbook

Table of ContentsIntroduction........................................................................................................................3

Certification Fees...............................................................................................................5

Fees and Payment Schedule...........................................................................................5

Certification Costs/Rationale for Certification Fees.........................................................5

Process Overview: What does it take for you to get certified?..........................................9

Step 1: Application for Certification................................................................................11

Guide to Online Application Questions.........................................................................11

Personal Information..................................................................................................11

Employment..............................................................................................................12

Licensure...................................................................................................................12

Education...................................................................................................................13

DBT -Specific Formal Education.................................................................................14

DBT Clinical Experience............................................................................................15

DBT Team Experiences.............................................................................................16

DBT Skills Training Group Experience.......................................................................17

Mindfulness Experience.............................................................................................17

Step 2: DBT Knowledge Examination.............................................................................18

Description of the Exam...............................................................................................18

Testing Accommodations..............................................................................................18

Scheduling the Exam....................................................................................................18

Exam Results................................................................................................................18

Step 3: Work Product.......................................................................................................19

Work Product Part 1: Case Conceptualization...............................................................19

Work Product Part 2: Session Videos for Adherence Coding........................................19

Equipment for Recording...........................................................................................19

What to Focus on in the Recording............................................................................20

Content of the Recording...........................................................................................20

Video or Audio?..........................................................................................................20

Submission Process for Recordings...........................................................................20

CLINICIAN APPLICANT HANDBOOK

DBT- Linehan Board of Certification™ Clinician Applicant Handbook©

Maintenance of Certification............................................................................................23

Complaint Policies and Procedures..................................................................................25

Client Complaints..........................................................................................................25

Applicant Complaints....................................................................................................25

Privacy Policy...................................................................................................................27

Information Collection, Use, and Sharing.....................................................................27

Your Access to and Control Over Your Personal Information.........................................27

Data Security................................................................................................................27

HIPAA Compliance.........................................................................................................28

Privacy Complaints.......................................................................................................29

Updates.........................................................................................................................29

Attachment 1: ADA Examination Accommodation Request.............................................31

Attachment 2: Video Recording and Use Attestation......................................................32

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DBT-Linehan Board of Certification


Introduction

Welcome to the DBT - Linehan Board of Certification™ (DBT-LBC) Applicant Handbook for Clinician Certification. We appreciate your interest in certification and your efforts towards earning the credential that reflects yourknowledge of DBT, meeting the requirements as an independent mental health practitioner, and demonstrating the knowledge and skills to adherently deliver Dialectical Behavior Therapy (DBT) as researched and developed by Dr. Marsha Linehan and her colleagues. Our goal for this handbook is to explain the process of certification from beginning to end as well as describe the requirements for maintaining the proficiencies and status as a DBT-Linehan Board of Certification, Certified DBT Clinician™. Andwe’d like to offer a brief overview of the aim and goals of DBT-LBC.

The overarching aim of the DBT - Linehan Board of Certification™ is to:

Provide a source to the public at large and to relevant stakeholders (third party payers, consumers, families, governmental agencies, practitioners and researchers) to clearly identify providers and programs that reliably offer Dialectical Behavior Therapy (DBT) in a way that conforms to the evidence-based research for the treatment;

Recognize and identify programs representing themselves as providing DBT and as having the necessary program components and organization to do so with fidelity to the model as developed bythe treatment developer (A separate Program Certification Handbook will be available to DBT Programs seeking certification.);

Recognize and identify providers delivering DBT as having the requisite qualifications, knowledge, and demonstrated skills to deliver the treatment with adherence to the model as developed by the treatment developer,

Maintain a roster of individual providers who have been certified (aswell as certified programs),

Monitor certified providers and programs on a regular basis to ensure maintenance of necessary skill sets and programmatic organization to ensure that certified clinicians and programs continue to be able to deliver treatment with fidelity and adherence.

The DBT-LBC Board of Directors sought to develop this program with the standards of the National Commission for Certifying Agencies (NCCA) in

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mind. What this means to you is that DBT-LBC will seek national accreditation as a certifying body. Professionals throughout the world seek recognized credentials from organizations accredited by NCCA. We wanted your credential to have the highest value possible. We are also members of the Institute for Credentialing Excellence (ICE), which is affiliated with NCCA.

You, as the clinician, are (or have been) on a journey of professional development and demonstration of your skill sets that is worthy of the highest recognition that meaningful certification represents. We know your investment of time and financial resources is significant. Your colleagues in the DBT community of Subject Matter Experts have all volunteered their timeand talents to put this program together, all under the direction of Dr. Linehan herself.

This Applicant Handbook will be divided into the steps you will need to take to get and maintain your certification. We will explain the rationales for the steps and try to answer FAQ’s. If a question arises for you and you can’t find the answer here or on the website (www.DBT-LBC.org), please contact us through the website and we will get an answer for you.

Subsequent sections of the handbook will include:

1) Meeting the requirements

2) Completing an application;

3) Getting the application reviewed, submitting any requested revisions and being approved as eligible to pursue certification

4) Registering for the exam; taking the computer-based exam and getting immediate test results

5) Submitting the first step in the Work Product requirements – the Case Conceptualization.

6) Upon approval of the Case Conceptualization, submitting the second portion of the Work Product – Video Recordings of three consecutive sessions with the client for whom you wrote the case conceptualization. (There are special circumstances and requirements if your initial set of 3 videos does not pass. These will be addressed below.)

7) Once the videos are coded to adherence, your application will undergo a final review. When this is completed, you will be granted certification! In addition to a congratulations letter, you will receive a certificate in about a month suitable for framing.

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http://www.DBT-LBC.org/


Process Overview: What does it take for you to get certified?

Certification is both a professionally challenging and rewarding process that will demand time, effort, and financial investment. It will take time and effortto collect the information necessary for application. It will require taking a test measuring proficiency in DBT. It will afford you the opportunity to demonstrate your ability to deliver the treatment to a client by completing a Work Product demonstration. This involves developing a Case Conceptualization for the client (rationale and treatment targets, etc.) that is reviewed and approved followed by adherence coding of three videotaped recordings of therapy sessions with that client.

In order to give you an overview of the sequence and timing of events, we have created a timeline with an example.

Timeline for DBT- LBC Certification Process

The DBT - LBC Certification process takes approximately one year to complete and involves the following:

Step 1. Application: You will go onto the website at www.dbt-lbc.org and begin an application.

o It will be referred to as My Account whenever you are directed to return to your application. You will be assigned a unique applicationnumber which is used in all steps of the review process so that your case conceptualization and video recordings are all coded anonymously. Any correspondence done relative to your application will refer to it only by your number.

o After the application is submitted and the non-refundable application fee is paid electronically through PayPal, the application undergoes a thorough review for completeness and accuracy. We then verify your ID and do Primary Source Verification of your license to practice, and educational degree (Masters or higher). This means we go to the primary source to verify the information you have entered. When that step is complete, the clinical aspects of the application are reviewed by Certified Clinicians trained in the review process. You will receive an email indicating any revisions that are required or, if your application is complete, approving you to select an exam window. The application review takes about 4 – 6 weeks or so.

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http://www.dbt-lbc.org/


o After your application is approved, you will be invited to sign up to take the exam during one of the upcoming exam windows. Certain application deadlines are set to correspond with the Exam window options and allow for time for approval so that you can chose the exam date of your choice. You must choose an exam window within60 days of your application approval.

Step 2. Knowledge Exam: Exam windows are during the months of March/April/May; August/September; and November/December. The examis taken at a Pearson Vue testing center of your choice and the results are provided to you immediately upon completion. This method was selected for your convenience to use nearby testing locations at a convenient time of the year. Exam dates are provided during two or three month windows several times a year and you can take the exam on any date during those months. (See more information under the Exam Dates and Locations tab on the website). Exam results will be provided immediately upon completion of the exam. All exam questions are based on Dr. Linehan’s treatment manual. (Cognitive-Behavioral Treatment of Borderline Personality Disorder, 1993) and the article Validation and Psychotherapy (1997) located on the DBT-LBC website. As subsequent exams are developed, they will include questions from the new skills training manualalso - DBT®-Skills Training Manual, Second Edition, 2014.

Step 3. Work Product:

You have achieved two major hurdles in steps one and two. Congratulations! You have demonstrated you have met the initial requirements for certification in your application and were granted permission to take the knowledge exam and passed. This next partis where you demonstrate that you can deliver the treatment in an adherent manner following the principles of DBT and using the strategies, treatment planning, skills and tools of the treatment.

o Part 1 is the clinical Case Conceptualization write-up. Within 90 days of passing the exam, complete and submit a clinical case conceptualization of the client for whom you will also be submitting video recordings.

Part 2: Video adherence coding – within 90 days of the Case Conceptualization approval, you will need to submit three consecutive sessions of therapy with the client for whom you wrote the Case Conceptualization along with a completed Session Information Form and copies of any diary cards reviewed in those sessions. These sessions will be rated by a coder, trained specifically to code DBT sessions to a standard of adherence. You will hear within 90 days whether at least 2 of your 3 submitted

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videos has passed adherence. If there is a need to submit a second set of videos of this client, you will be notified. See below for descriptions of the Case Conceptualization.

Upon passing both parts of the Work Product you will have completed the DBT certification process. DBT- LBC once again goes through the entire application and steps completed for a final review, including reverifying your license(s) to practice.

You will be notified of having earned the designation – DBT - Linehan Board of Certification, Certified DBT Clinician.

You will receive a certificate suitable for framing in the mail. Congratulations!

A sample timeline example:

1. Month one: Learn about the DBT certification process and your readiness JULY

2. Create and collect the necessary documentation and complete the online application. AUGUST

3. Sign up for exam SEPTEMBER and take exam. NOVEMBER (YAY, you passed!)

4. Submit case conceptualization JANUARY and get confirmation, MARCH

5. Upon acceptance of case conceptualization, submit video series. APRIL

6. Get confirmation of passing adherence and certification. JUNE7. Receive official mailed copy of certificate. JULY (Congratulations!)

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Certification Fees Fees and Payment Schedule

The fees for becoming certified are divided into three payments to DBT-LBC spaced out as each section of the process is completed, with an additional fee to Pearson Vue Testing Centers to take the computer-based exam at one of their locations.

Step 1: Initial application: there is a non-refundable application fee of $155 that is paid electronically through PayPal. Your application will not be reviewed until that initial fee is paid.

Step 2: Exam: The second payment due to DBT-LBC is $270 before you can register for the exam. You will be provided the needed information for contacting the Pearson Vue testing centers located throughout the US, Canada and other worldwide locations to schedule an exam at a location andtime most convenient to you. The fee to you for the use of Pearson Vue centers is $150, payable directly to them.

Step 3: Work Product Demonstration [Case Conceptualization and Video Coding]: There is a fee of $270 for this third portion of the certification process. Coding will not begin until this fee is paid.

Certification Costs/Rationale for Certification Fees

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At DBT- LBC, as a non-profit certification organization, we are very sensitive to keeping the fees to you and costs incurred for the certification process to a minimum and still provide a valuable credential. We want to be clear about our costs and expenses so individuals and programs can make informed decisions about certification.

In considering the certification fees, please keep in mind the costs of development and operations involved in certification and why we are having individual practitioners (and programs) go through a certification process.

Our primary purpose is so:

1. All the work that individuals and programs do to implement DBT may be recognized;AND

2. There is some way to distinguish between DBT and other treatments that (whether called DBT or not) do not meet or fulfill adherence guidelines for DBT.

As we continue implementing the certification process, we are working to build investment in the value of certification for relevant stakeholders.

Having a certification process will help increase the likelihood that clinicians who are engaged in the complex, comprehensive, compassionate and effective treatment we all know as DBT are recognized and can be sought by the clients we all want to serve.

We want to have a referral network that can be a reliable resource for DBT services.

In addition, we want skilled DBT professionals more readily recognized and appropriately compensated by Federal, State and other health insurance programs.

Certification allows both private and public entities a clear way to determine which practitioners and programs are reliably implementing the treatment as developed by Dr. Linehan and colleagues.

To further our purpose of communicating the high standards DBT- LBC certification confers, we have a Legislative committee working on relationships with major insurance companies, state legislatures and federal agencies.

DBT- LBC expenses include those that result in developing a smooth certification process, a psychometrically defendable exam, meet HIPAA security and compliance requirements, and produce a responsive website to

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both you and those looking for certified DBT therapists and programs. This includes staffing (personnel) and program costs (operating expenses).

Personnel: The functions and activities of DBT - LBC are many and varied. They include a combination of both paid and volunteer positions with most ofthose being volunteers. We currently have two paid staff members and over 50 volunteers working together on certification efforts. The primary roles andtheir functions are as follows:

Board of Directors. The Board of Directors engages in numerous activities that maintain contact with and the involvement of the treatment developer, Dr. Marsha Linehan, and oversees the business operations of the certification process to make it a viable, self-sustaining business.

Executive Committee members function to plan, organize and recruit for the many tasks that need to be accomplished, and for future growth in needed areas like Program Certification and Skills Trainer Certification, etc.

Volunteer Coordinator/Executive Director. Since volunteers accomplish most of the efforts of creating and running DBT - LBC,the coordination of those volunteers becomes a vital function of our Executive Director. The need for expertise around how certification programs are established and made financially feasible necessitated the hiring of an Executive Director, who serves as a non-voting member of the Board and sits on all committees. Contracted personnel are paid to assist.

Application Review. These individuals monitor applications, do Primary Source Verifications, conduct review of the requirements in the application and approve the applicant’s qualifications to register for exam windows.

Case Conceptualization reviewers and Video Coders. Research has been conducted to develop a consistent, reliable and valid means of scoring case conceptualizations and video recordings of actual treatment sessions to assess adherent delivery of DBT by the clinician. Coders have been trained to a level of consistency both within and between coders; when there is any possibility of applicant failure in meeting the adherence coding standards, multiple coders, blind to previous coding of materials, are brought in to assure fairness. Coordinating the entire process and maintaining standards is a vital task for DBT- LBC experts.

Test Development Experts. These individuals oversee the components of the entire knowledge base assessment – exam

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development, question writing, job task analysis, pilot exams, psychometric analysis, setting cut scores, maintaining security ofexam questions, developing new exams. Periodic updating of exams is part of their duties.

Purchasing Agents. These individuals negotiate vendor contractswith the service providers who make the program function and assure protections required by HIPAA regulations and for the privacy of Protected Health Information. They also coordinate contract services with accountants, attorneys, the web developer, printing agents, and conference sites. This is currently done by the Executive Director.

Customer Service Representative(s). This individual provides customer service via the website and is in contact with members of the Board as well as those on committees to meet the commitment to timely responses, which has been a goal from theoutset.

Additional Volunteers/Committee members function to advance public awareness of DBT certification, encourage appropriate compensation for the work required of clinicians and programs, inform legislatures and federal agencies of the need for adequatetreatment and mechanisms for helping to better assure that those who indicate they are doing DBT can deliver the evidence-based treatment as developed.

Fundraising – this committee helps assure the on-going feasibilityof the operations of the organization and funds expansion of our certification efforts.

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Step 1: Application for Certification - details

What follows here is more detail about the steps mentioned above to help you pull together materials needed and plan your approach to the certification process. Once you’ve determined you meet the requirements for becoming certified and created an account on http://www.DBT-LBC.org you’re ready for Step 1, which consists of:

Completing the application online at http://www.DBT-LBC.org Paying the application fee of $155 online.

Guide to Online Application Questions

Note: Some of the information you provide will be subject to Primary Source Verification (“PSV”), meaning that we will contact, through the National Clearing House of Colleges and Universities, your educational institution to verify your degree and the date you received the degree. It also means we will contact the State that grants your license to verify that your license is active and has no restrictions. Any active or inactive license that's ever beengranted needs to be listed and will be verified. A government-issued ID will be used to verify your identity and used in the verification with all other primary sources. Any name changes will need to be explained so the primary source verification of degree and license to practice can be done appropriately.

Personal Information

The information in this section is used for Primary Source Verification, described above, so accuracy is very important.

Name

Your legal name. The name you submit must exactly match the name on your government-issued ID. After initially saving your name, you won't be able to change it, so be sure it's correct.

Date of Birth

Enter it in the indicated format (MM/DD/YYYY).

Last 4 digits of social security number

If you are an international applicant, please check the DBT- LBC website for information; send us a Contact Us request through the DBT-

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http://www.DBT-LBC.org/


LBC website for additional guidance or clarification on information needed for the certification process as it will vary from the standard USformat.

Level of Education

Check the box indicating the most advanced mental health-related degree you completed. You can check more than one box. If your specific degree doesn't appear in the list, check other and enter it in the box marked “Other”.

Address

The address where you currently reside. It will not be published on the website listing. Only your professional address will be listed if you select that option.

Phone number

A phone number we can use if we need to contact you about your application.

EmploymentAny case you submit as a “Completed DBT Case” must correspond to a specific employment entry and a specific Team Membership entry. Be sure both are included in the lists even if they are more than 10 years prior.

Institution

Provide the name of your employer at the highest level of organization (for example, if you work at the outpatient clinic of Smithville Hospital, the institution would be Smithville Hospital). If you're a private practitioner in a group or solo practice, provide the legal name of your business entity.

Your Job Title

If you have an official job title according to your employer, list it here. If not, provide an appropriate professional title based on either your highest degree attained (Social Worker, Psychiatrist) or the professional role you are licensed to perform (for example Clinical Psychologist, Mental Health Specialist).

Date Started and Ended

Your first and last day of employment with that employer. If you returned to work for the same employer or changed job titles, do another employment entry using those dates.

Address and Email Address

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An address and email that can be used to contact you.

Licensure

The information in this section is used for Primary Source Verification, described above, so accuracy is very important. Any active or inactive license that's ever been granted needs to be listed and will be verified.

Issuing Agency

The name of the agency that issued your license.

Type of License

The official title under which the agency granted you permission to practice.

License Number

Date of Initial Issue

The date you were first issued the license. Be aware that the date of initial issue is often not the date that appears on your current license.

Is this license active?

Reasons a license may not be active include allowing it to lapse (by notrenewing it) or requesting inactive status.

Has license ever been revoked, suspended, put on probation or restricted? Ifso, please explain.

Provide information about the circumstances, dates and outcome or resolution.

Address, Phone and Website of the Issuing Agency

Website is optional but appreciated.

Education

Undergraduate Education

In this section, list all undergraduate degree-granting programs you completed, including degrees unrelated to mental health.

Undergraduate Institution

Address

Attended From and To

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The approximates dates you began attending classes and stopped attending classes.

Degree(s)

The name the school used for your type of degree (for example, Bachelor's or B.A. or B.S.)

Major(s)

Year Awarded

Graduate Education and/or Other Advanced Training

In this section, list all mental health-related graduate degrees and/or other Advanced Training you completed or are working toward completing currently. Do not list DBT-specific training here.

Graduate Institution

Typically, the name of the college or university you attended or the organization that provided the training.

Program Name

The name of the graduate program or the topic of the training. For example, Social Work or hypnotherapy.

Your Full Name (if different than your current name)

The name you were using when you completed the degree or the training.

Address of the Institution

Attended From and To

The approximate dates of starting and finishing the degree or training.

Year of Completion

Degree(s)/Certificate Awarded

the type of degree (for example, M.S.W.) or the level or title of the training completed (Stage II or Certified Technician)

DBT-Specific Formal Education

People receive training in DBT through a number of experiences. There is a requirement that you have obtained a minimum of 40 didactic training hours specific to DBT. Please provide the following information about your DBT training experiences, which may include coursework, seminars, workshops, online learning*, in-service training (related to employment, practica, internship, or other training program) or other structured learning

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experiences. Do not include supervised DBT-specific clinical experience as part of a supervised practicum, internship, residency or private supervision. Training that specifically states it does not follow the teachings of Dr. Linehanmay provide confusing or inaccurate information as you prepare for the knowledge exam, which is based solely on Dr. Linehan’s treatment manual. The selection of training is completely up to you. *Online learning is limited to no more than 50% of the DBT-specific training hours required for initial application and for MOC requirements.

DBT-specific educational experience, provide the following information for each training:

Title

What the training was called.

Type of Experience

Pick the most appropriate option from those offered.

Occurred From and To

The approximate date it started and ended (leave the end date blank ifit hasn't ended).

Total Hours

The number of hours of training that you completed. If the training hasn't ended, give the number of hours you've completed so far. Come back into your application once you have completed the entire session to receive credit for the training session. No partial completionwill count.

Trainer(s)/Presenter(s) Names

The person or people who delivered the training to you.

How it applies to DBT if not apparent in the title

Sponsoring Agency / Institution

The name of the group responsible for the training. Organization that accredited or certified the CE’s

DBT Clinical ExperienceTo be eligible for certification, you must have completed three DBT cases through Stage 1. A completed case is defined as a client who was accurately assessed as having treatment needs that would be benefited by DBT; who was oriented to the treatment (structure, theory, goals/targets and commitments); who was concurrently enrolled in skills training and received regularly scheduled individual DBT therapy; who received/had available

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phone coaching by a DBT trained clinician; who had diary card and treatmenttargets that met the Stage I DBT target hierarchy; and whose skills trainer and individual therapist were part of a DBT Consultation Team that met regularly. (Note: Cases terminated by the client leaving treatment against therapist advice, "dropping out," are not considered completed).

Please provide the following information for each of the three DBT cases you have completed. Remember -- do not include any identifying information, even initials, in your submission information.

Clinic/Institution

The name of the place where you treated the client. Be sure that this clinic is also listed in the Employment section of the application and that you list the Consultation Team you were participating with in the DBT Team Experiences section for this client.

Occurred From and To:

The date the treatment of that client started and the date it ended.

Please describe the goals/targets at the beginning of the case and the outcome at completion.

A complete description will include:

o The treatment goals of the client, spelled out in their words.

o The targets of treatment, determined by the clinician, that matchthose goals; please spell them out in objective, behaviorally-specific terms.

o Report the outcomes of the targets listed that have been measured (like on the diary card), that indicate successful Stage 1 treatment completion. Measurable frequencies, intensities, durations, etc. are what is needed here.

o Write-ups do not need to be extensive, but there does need to beclear enough evidence that DBT occurred sufficiently for a client who met the requirements for that treatment. Please do not list skills used, but rather behavioral changes made (as a result of using the skills).

DBT Team ExperiencesTo be eligible for certification, you must meet two requirements. First, you will have been a member of a DBT Consultation Team for at least one year. Second, you must currently be a member who regularly and actively participates on a DBT Consultation Team. (NOTE: Please be sure any clinical

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case write-up listed above has a matching Consultation Team participation listed here for the dates of your treatment also.)

Have you been a participating member of a DBT Team for at least one year?

A participating member is one that regularly and actively participates in DBT Consultation Team meetings, even if the membership is time-limited (during an internship or contract period). You were not a participating Team member if you only observed the Team's meetings, were not providing at least one mode of DBT to at least one client, didn't request consultation from the Team around your DBT work or didn't provide consultation to any members of the Team.

Clinic / Institution

If your Team is not part of a clinic or Institution, provide the Team's name or enter “None”.

Participated From and To

Dates of your regular, active Team participation.

Frequency of Meetings

How often did/does the Team meet?

Length of Meetings

When the Team meets, how long is the meeting?

Team Leader

The Team Leader is generally the active, participating member who hasbeen practicing DBT the longest or who is certified.

DBT Skills Training Group Experience

To be eligible for certification, you must have knowledge of the DBT Skills (Core Mindfulness, Emotion Regulation, Distress Tolerance and Interpersonal Effectiveness) as taught in the Skills Training Manual for Treating Borderline Personality Disorder by Marsha Linehan (May 21, 1993). There is an updatedSkills Training Manual Second Edition from 2014, which expands on the 1993manual and is highly recommended for reference also.

You will be asked: Have you read the Linehan DBT Skills Training Manual (1993)?

Yes No

Have you completed all the homework in the module?

Yes No

Have you taught (formally or informally) or participated as a student in all modules of skills training?

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Yes No

If not, have you taught all DBT skills within individual therapy and coached clients in DBT skill application?

Mindfulness Experience

Mindfulness is a core and vital feature of DBT and DBT practitioners understand the necessity of cultivating an on-going mindfulness routine that is grounded in an initial and/or repeated training course or retreat(s).

Qualifications for Certified DBT therapists include:

1. Receive training in mindfulness through at least one of the following:

a. Attendance at a mindfulness retreat for 4 days or more; or

b. Regular practice in a formal practice community (ConsultationTeam or Skills Group practices do not meet this requirement);or

c. Formal acceptance as a student of a recognized mindfulness/Zen/contemplative teacher. (Letter from the teacher is required.) or

d. At least one formal training in mindfulness. Any training that specifically spends a significant amount of time teaching the principles and practice of mindfulness will meet this requirement. This can be done by attending a mindfulness retreat, instruction in consultation team specifically focused on this as a training opportunity, supervision, seminars, DBT -specific trainings identified as mindfulness trainings, yoga practice or another accepted mindfulness training. Provide dates and descriptions for consideration.

2. Continue to engage in a routine personal or public mindfulness practice on at least a weekly basis in settings other than consultation team, client sessions or skills group sessions. This is tobe personal and for the benefit of the clinician. You will be asked to describe the practice itself, its frequency, and duration.

Step 2: DBT- LBC Knowledge Examination - detailsDescription of the Exam

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The DBT Certification Written Exam consists of 110 questions and 10 pilot questions based on the treatment manuals of Dr. Linehan (text and skills manual), as well as the Validation and Psychotherapy article/book chapter, available on the DBT-LBC website. Each question is multiple choice, and was written to be straightforward. A Job Task Analysis was done with the leadership of the Psychometrician we utilized (Lynn Webb, EdD) to determinethe composition of the test, and an analysis of the first 100 exams enabled us to analyze the results obtained to determine passing scores.

Testing Accommodations

Candidates with documented disabilities or impairments who wish to be tested under non-standard conditions should specify their condition in writingwhen submitting their application to give the Board ample time to evaluate and make any special arrangements that may be required for the test administration. The ADA Examination Accommodation Request can be found here [link to accommodations request doc., attached to this document ].

Scheduling the Exam

As soon as you’re approved to sit for the exam, you may immediately go tothe DBT-LBC portal and choose the next available exam window. Currentexam windows are 1) March, April & May, 2) August and September, 3)November and December. Exam windows are open on the first day of thepreceding exam window. So, the March through May window opens onNovember 1st, August through September window opens on March 1st and theNovember through December window opens on August 1st. Once theapplicant chooses an exam window, it takes about a week for their name anddesignated window to be transferred to Pearson Vue. At that time, they canschedule the day and location of their exam through Pearson Vue TestingCenters.

Exam Results

The computer-based exam at the Pearson Vue Testing Centers gives instantexam results on the computer screen at the conclusion of the exam.

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Step 3: Work Product - details

After successfully completing the Exam with a passing score, the next step on the path to Individual Clinician certification is to submit a two-part Work Product.

Work Product Part 1: Case ConceptualizationProvide a written DBT Case Conceptualization on the client for whom you willlater be submitting videos of therapy sessions. Be sure in all uploaded submissions throughout the entire certification process that there is NO IDENTIFYING CLIENT INFORMATION on any forms or write-ups, including this one.

The purpose of a written Case Conceptualization is to: assess your ability to interview a client; obtain relevant information on treatment issues from their

perspective; view the client’s goals from the theoretical model of DBT – the

transactional nature of the client’s behaviors and the environment; show how the client’s behavior is etiologically related to the

biosocial theory; translate the client’s concerns into problems to be addressed in

treatment that are clearly spelled out in objective and behavioral terms;

describe the client’s stage of treatment currently and provide a narrative rationale for the stage you have identified

List all primary targets since the onset of treatment for the client in order. If the client is now in Stage 2 or stage 3 but started treatment with you in Stage 1, include the primary targets from stage 1.

Work Product Part 2: Session Videos for Adherence Coding

Certification applicants will receive notification once their case conceptualization has been reviewed and approved. We recommend that yourecord sessions prior to submission of the Case Conceptualization to make meeting the deadlines for the Video coding submissions easier and to avoid unplanned technical issues or unforeseen client unavailability. Remember, you will need to submit three consecutive sessions within 90 days of approval of the Case Conceptualization.

Equipment for Recording

Most webcams will work. Be sure the audio can be heard! Some people use cameras that are installed on their computers; others use $20 webcams that

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they hang in an effective position in their office. DBT -LBC will do their best to use whatever video format you send.

If you use a smart phone or tablet, be aware that if you receive a phone call on your smart phone while recording a session, it may stop the recording. Also, be aware that most will not record more than 35 to 50 minutes at a time. You may have to record the session in two segments. In that case, be sure to upload BOTH parts of the same session if it is a two-part video and accurately label each one when submitting them.

Since there are so many different computers, cameras and phone devices with individual specifications and Internet connection speeds, it will be difficult for us to troubleshoot Applicants' technical issues. Please seek technical help on your own.

What to Focus on in the Recording

When the video is focused on both the therapist and the client, there is morecomplete information for the coder, even though both are likely to be in profile. However, clients have the right to refuse to be on camera. If that occurs, focus the camera on the therapist. Seeing the therapist is most important.

Content of the Recording

Submit three consecutive video sessions of the same client profiled in the Case Conceptualization. As long as DBT is being done, it does not matter what stage of treatment the client is in. The recordings may be in the early, middle or end of treatment. Recordings should be of complete sessions, usually around 45 - 60 minutes.

Video or Audio?

Video is preferable to audio recording, but audio would be accepted. Audio puts the applicant and the coder at a disadvantage because it is more difficult to determine adherence to DBT. Video allows the coder to see the non-verbal responses to the client, which often give clues about strategies being used.

Submission Process for Recordings

On the application form, there is information about how to use Box - a cloud-based provider - and an Enterprise Account that meets the obligations required by HIPAA, HITECH and the HIPAA Omnibus Rule. Do not use your own personal Box account if you have one.

Here are the steps for the Work Product Video Submission:

Log into your My Account on the DBT-LBC Website. You will see an Attestation Statement and Electronic Submission

Form [attached at the end of this document] for you to complete. Until these are filled in you may not upload any recordings to DBT-LBC.

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Your checking the box attesting to consent by your client is the equivalent of your signature. You will need to attest that you:

o have all legal rights/informed consent to submit the materials from your client to DBT-LBC for certification purposes;

o agree to upload your work sample materials directly to your DBT-LBC applicant folder through the Box website upload portal;

o understand that files uploaded or stored in any other manner or on any other Box account may not be encrypted or otherwise compliant with HIPAA regulations.

You will need to prepare three things for each video session. The videoof the session itself, a Session Information form, and an electronic copyof the Diary Card reviewed during that session.

Please follow the naming conventions for each of the video files you are saving for upload. (Naming of the other files to be uploaded follows below).

o Video Files: Name files with your certification applicant numberfollowed by the session date of the recording (MM/DD/YYYY) and the word “recording”.

o For example, #999 08-18-2015 Recordingo NOTE: if you had to restart your recording of a session because

your recording device timed out, please copy both parts of the session to a file with the naming conventions just listed but continue the label with “Recording part 1” or “Recording part 2”. That way we will know these are both parts of the same session date and will look for both parts immediately.

o For example, #999 08-18-2015 Recording part 1; #999 08-18-2015 Recording part 2.

You will need to complete a Session Information Form for each of the three sessions you are submitting. It is recommended that you complete the forms electronically as these need to be uploaded also with the videos.

o Naming conventions for saving these – complete the form for each session and save it as a separate WORD or PDF file using your applicant number, date of the session (MM/DD/YYYY) and the word “Form”.

o For example: #999 08-18-2015 Form. Please remember, the examples here include #999 as a placeholder for your personal applicant number. Note also that the dates are consistent with the video submission dates for which this form was created.

You will also need to create an electronic copy of each of the diary cards reviewed in your sessions. Be sure there is no client identifying information included.

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o Naming conventions for saving these – Save a copy of the Diary Card reviewed in each session as a separate WORD or PDF file using your applicant number, date of the session (MM/DD/YYYY) and the words “Diary Card”.

o For example: #999 08-18-2015 Diary Card Prepare files for upload: prepare the Video files, Diary Card files

and Session Information Forms for each session submitted. Please follow the steps for naming the files carefully so that each Video session can be easily paired with the matching Session Information Form and Diary Card for that session.

Accept the invitation to a shared folder on Box. The DBT-LBC Work Sample Coordinator will send you an email invitation to collaborate in your Applicant Folder we create in Box. You will be directed to create a free Box account (or to sign into your own Box account if you already have one.) Your Box account is solely for the purpose of allowing you to access the upload portal into DBT-LBC’s account so that you can upload your video and related work sample materials directly to DBT-LBC. DO NOT UPLOAD VIDEOS INTO YOUR OWN PERSONAL ACCOUNT. IT WILL NOT HAVE THE HIPAA-COMPLIANT PROTECTIONS IF YOU DO SO. Your files are instantly encrypted when they are sent from your computer to DBT-LBC’s account, but not if you send them to your own personal Box account.

Go back and review and check off all the steps listed to be sure you have done everything BEFORE uploading any required materials.

Upload your files from your computer directly through the file upload portal to your Applicant Folder on DBT-LBC’s Box Enterprise Account. Again, to ensure that your files are encrypted during data transfer DO NOT upload files to any other Box account, including your own. Please allow sufficient time and opportunity for them to be uploaded. Approximate time for upload is 25 minutes per GB (depending on connection speed).

Please see Video Recording Hints on the dbt-lbc.org website under Clinician Work Product Video Submission for information on compressing files for faster uploading as well as limiting the size of the file upload. Box limits file sizes to 5 GB.

While the process may sound complex, please be reassured that applicants have been successfully proceeding through this process for years now. You can too. If necessary, you can use the Contact Us link on the website to ask any clarifying questions.

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Maintenance of Certification

Congratulations! You successfully completed the certification process. That is important for your clients, you, your clinic, the public, and those who reimburse for DBT treatment.

Being certified as a DBT provider is not something that happens “once and for all.” Maintaining your skill level for certification will be an ongoing processbecause the field will change and new research and treatment developmentswill unfold that will require you to update your knowledge and skills to stay current with providing adherent DBT. To that end, Maintenance of Certification (MOC) is a vital part of Clinician Certification. Its purpose is to encourage and monitor lifelong learning specific to DBT and assure ongoing competency in the knowledge and skills necessary to provide adherent DBT.

Throughout the ten-year term of certification, you will be required to:

Maintain an active unrestricted professional license.

Immediately report to DBT-LBC any disciplinary action taken againstyour license.

Each year during the ten-year certification term, you will be required to:

Update your profile. This will also keep your listing active in the Listof Certified Clinicians.

Attest that you have a minimum of one active DBT case (does not have to be the same client).

Attest that you meet all the original eligibility requirements. Your professional license(s) will be primary source verified annually.

Pay the $95 Maintenance of Certification fee.

Anyone certified before July 1st will be required to pay the full $95 MOC fee by Dec. 31st of the same year being certified and the current MOC fee every year thereafter; anyone certified after June 30th will be required to pay a $50 MOC fee by Dec. 31st of the same year being certified and the current MOC fee every year thereafter.

Every two years you will be required to:

Obtain 15 Continuing Education (CE) Credits specific to DBT. This is important as it will affect your listing on the website if any aspect of MOC is not completed.

Update your website profile (My Account) to reflect the CE Credits you have earned. (We have made it easy for you to submit any CE’searned at the time they are obtained for ease of tracking. You will

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be asked to upload a copy of the goals/objectives of the training as well as a copy of the CE certificate issued to you. Let us help you keep a record of CE’s for you.

Credit Substitutions: A DBT-Certified Therapist who provides adherent DBT training, workshops, research articles, book publications, supervision or teaching can substitute these activities for up to 8 of the 15 CEs.

Details on any restrictions and number of substitute CE credits that apply to adherent DBT training, workshops, research publications, book publications, supervision or teaching will be listed on the website, if any.

Details on exceptions (researchers, writers, trainers, administrators, illness, maternity, sabbatical, etc.) to this requirement will be handled on an individual basis and may be requested through Contact Us on the website.

In the tenth year of certification, you will be required to:

Update your application;

Pass the current DBT-LBC Certification Exam;

Submit a new Work Product of a Case Conceptualization and three consecutive recorded DBT sessions, of which two must pass adherence coding; and

Pay the current application, exam, Pearson Vue testing center and Work Product fees.

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Complaint Policies and Procedures

Discussed below are ways the Board will handle client complaints about certified DBT therapists as well as applicant complaints about the certification process.

Concerns or complaints about the Board's HIPAA compliance and privacy practices are addressed in other sections of this handbook.

Client Complaints

Before we discuss the Board’s recommended steps for resolving client complaints, we will make two points clear. The first is that the DBT-Linehan Board of Certification is not a regulatory body. Because it is not such a body, it cannot enforce any restrictions, limitations, or sanctions on any practicing therapist. The second point is that, while the Board welcomes consumer communications regarding their concerns about certified DBT therapists, it is the responsibility of the certified therapist to inform the Board annually of any disciplinary actions taken against their licenses.

When a client has a question, concern, or complaint regarding their treatment by a DBT-LBC provider, the Board encourages them to take the following steps, in order. First, the client should bring up their concern directly with the therapist. This first step is crucial because it is the belief of the Board that many complaints can be effectively dealt with through a direct conversation with the therapist. This first step is also consistent with the DBT strategy of addressing therapy interfering behavior, both on the partof the consumer and the therapist, as promptly and directly as possible. If the consumer cannot resolve the issue directly with the therapist or in situations where talking directly with the therapist might be impossible or inappropriate, the consumer should then approach the therapist’s DBT Consultation Team Leader for his or her assistance in solving the problem. If the consumer’s therapist happens to be the Team Leader, the consumer should approach another team member for help in resolving the issue within the team. If the consumer cannot resolve the concern within the team after these efforts, the consumer should then contact the leadership of whatever agency the DBT program is a part. At this point, the consumer most likely willfollow the agency procedure for handling complaints. If the consumer is receiving treatment in a standalone DBT program, where there is no overarching agency to turn to, or if the client still has not been able to resolve the issue with the agency, the consumer should contact the

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therapist’s state licensing/regulatory board. At this point, the consumer will follow the complaint procedures in effect for the state licensing/regulatory board.

Applicant Complaints

When a certification applicant has a question, concern, or complaint regarding the certification process, the Board encourages the applicant to take the following steps. First, the applicant should review appropriate sections of the website and this handbook for any clarification these resources can provide. Next, the applicant is encouraged to review the DBT-LBC FAQ for further clarification. If these steps do not help to resolve the issue, the applicant should contact DBT-LBC directly through Contact Us on the website.

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Statement of Non-Discrimination and Fairness

DBT-LBC does not discriminate on the basis of race, color, religion, national origin, sex, sexual orientation, gender identity, age, genetics information, disability, or status as a protected veteran. DBT-LBC’s non-discrimination policy applies to all phases of the certification process, the employment process, and to decisions regarding certification scholarship awards. We are also committed to being fair and consistent in how we apply DBT-LBC policiesand we have developed procedures that separate all identifying information from materials that are coded or otherwise evaluated.

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Privacy Policy

This privacy policy discloses the privacy practices for the DBT -Linehan Boardof Certification™ website (DBT -LBC.org). This privacy policy applies solely to information collected by this website.

Information Collection, Use, and Sharing

We respect you voluntarily sharing and permitting us access to both professional and personal information as a part of the certification process. We commit to securely storing and protecting this information in an ongoing way. You have our assurances that:

We are the sole owners of the information collected on this site. Information we collect fromyou for certification is kept solely for that purposeand is never shared or sold. Your contact information will be used solely as a way to notify you, respond to your questions or otherwise communicate around certification issues.

Any third-party who seeks to verify your certification may access the websiteand search for your listing. If you do not want yourself listed in the Certified Clinicians register, you will have an opportunity to opt out of the listing and/or specify what information you want in the listing.

Unless you ask us not to, we may contact you via email in the future to tell you about important news affecting your certification or changes to this privacy policy.

Your Access to and Control Over Your Personal Information

You may opt out of any future contacts from us at any time. You can do the following at any time by contacting us via the email address given on our website with the understanding that some of your information is required to maintain your account and/or certification which you may delete upon request:

• Change/correct certain information we have about you. • Have us delete certain information we have about you. • Express any concern you have about our use of your data.

Data Security

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We take precautions to protect your information. When you submit sensitive information via the website, your information is protected both online and offline.

Wherever we collect sensitive information (such as credit card data or HIPAA-Protected Health Information), that data is encrypted and transmitted to us in a secure way. You can verify this by looking for a closed lock icon at the bottom of your web browser, or looking for "https" at the beginning of the address of the web page.

While we use encryption to protect sensitive information transmitted online, we also protect your information offline. Only contracted personnel and designated volunteers who have signed confidentiality agreements and who need the information to perform a specific job (for example, video coding or billing) are granted access to the data you submit. They do not upload the materials to their own computers at any time and have no access to the materials once the coding has been completed.

Additional security measures are in place to protect the Work Product relatedinformation you submit. They are detailed in the next section.

HIPAA Compliance

Confidentiality and security of PHI is of critical importance to DBT-LBC. We recognize that each clinician’s institution, agency, clinic and practice will have developed their own procedures for complying with HIPAA regulations. Each certification applicant is encouraged to consult with their HIPAA Privacy and Security Officer(s) to ensure that they comply with HIPAA regulations and the policies and procedures for protecting and transmitting PHI specific to their organization, including the HIPAA Privacy Rule, HIPAA Security Rule, HIPAA Breach Notification Rule and confidentiality provisions of the Patient Safety Rule.

To facilitate the submission of Video Work Samples for adherence coding, DBT-LBC has partnered with Box, a cloud-based provider. The Box product/platform we have selected (Box Enterprise Account) meets the obligations required by HIPAA, HITECH, and the HIPAA Omnibus Rule. It has been reviewed by an independent, third party auditor and issued an evaluation report that details the controls Box has in place to meet HIPAA requirements in regards to data privacy and security. Additionally, Box has signed a HIPAA Business Associate Agreement (BAA) with DBT-LBC that spellsout the methods Box uses to maintain Protected Health Information (PHI) in accordance with the above-mentioned standards.

Box offers a variety of account types; not all account types meet HIPAA

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requirements.To submit your work sample, you will need to sign up for a free, basic Box account. Your account on Box is necessary only for you to access the file upload portal in DBT-LBC’s Box Enterprise Account. Your free account meets HIPAA requirements only when used to access the upload portal. To stay HIPAA compliant do not upload or store PHI into the free account; onlyuse the account to access the file upload portal. Files that you upload through the portal are automatically encrypted from the beginning of transmission to your certification applicant folder and will remain encrypted within the DBT-LBC Box Enterprise Account.

More information about Box, HIPAA and HITECH compliance is available at: https://community.box.com/t5/Account-Information/Box-HIPAA-And-HITECH-Overview-And-FAQs/ta-p/16

Privacy Complaints

If you have concerns about our handling of your personal data or HIPAA-Protected Health Information (PHI) that you have submitted, you have the right to:

Express any concern you have about our use or handling of data and/orPHI you submit to us;

Have us permanently delete any data and/or PHI you have submitted to us;

Contact DBT-LBC via Contact Us on the website www.dbt-lbc.org. Please use Privacy Complaint in the subject line.

Additionally, if your complaint is about PHI, you have the right to complain tothe Secretary of the Department of Health and Human Services by filing a Health Information Security Complaint with the Office of Civil Rights. To do so, you may submit a written complaint in your own format via U.S. Mail to Centralized Case Management Operations, U.S. Department of Health and Human Services, 200 Independence Avenue, S.W., Room 509F HHH Building, Washington, DC 20201. Alternatively, your complaint may be submitted by email ([email protected]). Additional means for filing a complaint are available at http://www.hhs.gov/hipaa/filing-a-complaint/complaint-process/index.html.

DBT-LBC must keep a record of the complaints it receives and how they are addressed.

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https://community.box.com/t5/Account-Information/Box-HIPAA-And-HITECH-Overview-And-FAQs/ta-p/16

https://community.box.com/t5/Account-Information/Box-HIPAA-And-HITECH-Overview-And-FAQs/ta-p/16


Updates

Our Privacy Policy may change from time to time and all updates will be posted on this page.

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Attachment 1: ADA Examination Accommodation Request

The DBT-Linehan Board of Certification

ADA Examination Accommodation Request

The Americans with Disabilities Act (ADA) requires that reasonable accommodations be provided to qualified individuals with disabilities. This law defines disabilities as physical or mental impairments that substantially limit one or more of a person’s major life activities (e.g., walking, hearing, speaking, seeing, reading, or writing). The Board will provide reasonable andappropriate accommodations to qualified candidates who have documented disabilities and demonstrate a need for accommodation during the examination.

To support a request for test accommodations, please complete and mail thisform to the DBT-LBC. Also, provide current (not more than 3 years old) written supporting documentation from a qualified health professional which addresses the issues listed below.

Applicant Name and Number:______________________________________________________

Applicant:

1. Specifically identify the physical or mental disability that you believe requires this accommodation:

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

2. Specifically describe the accommodation you seek:

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

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_____________________________________________________________________________

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Qualified Health Professional:

1. Include a statement of the specific diagnosis of disability.

2. Cite the diagnostic criteria and tests given, with dates, results and interpretations. Cite how the results support the diagnosis.

3. Describe the candidate’s functional limitations due to the disability, and the impact of those limitations on physical, perceptual and cognitive abilities.

4. Recommend specific accommodation(s) and for each accommodation, provide a rationale as to how it will reduce the impact of the functional limitation(s).

5. State your professional credentials, training, work experience and any licenses you hold that support your qualifications to diagnose and/or treat this candidate’s disabilities.

6. If no prior accommodations have been made for this candidate, explain why. If they have, state what was done and provide past documentation of prior accommodations.

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Attachment 2: Video Recording and Use Attestation

Video Recording and Use Attestation

[] By checking this box, you (the therapist in the video and applicant for DBT-LBC certification attest that prior to submitting recordings of the client’s therapy sessions:

• You explained to your client (the client in the recordings) that the recordings would be submitted for adherence coding as related to your application for DBT-LBC certification as an Individual DBT clinician;

* You explained to your client the process for submitting recordings to DBT-LBC and the safeguards in place to protect their privacy;

• You discussed all foreseeable benefits and risks posed to them associated with having their sessions recorded, transmitted and used in the manner described;

• You explained to your client whether or not you will retain a copy of the session recording and whether or not that recording will become a part of thedesignated record set/health record and any limitations on their ability to request access to the recording;

• You gave your client the opportunity to ask questions about what you were asking of them, the purpose of your request and the procedures to be used and that you answered any such questions truthfully and completely;

• Your client voluntarily agreed to allow their therapy sessions to be recorded, and those recordings to be submitted to DBT-LBC, and used in the manner described;

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• You obtained a signed, written consent from the client (or their authorized representative) as required by any applicable state law and/or regulations and that you will maintain such consent as part of the client’s file.

• Additionally, you agree to upload your work sample materials directly from your computer to your DBT-LBC applicant folder through the Box website upload portal and understand that files uploaded or stored in any other manner or on any other Box account may not be encrypted or otherwise compliant with HIPAA regulation.

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