Intersession Contact in DBT: Orienting and Introducing the Patient

Orienting the patient to intersession contact. As DBT is the only psychotherapy model which formally incorporates the use of intersession contact, patients are often not familiar with the corresponding protocols and expectations. They’ve not had access to be able to call their therapist before and especially not when they were not in a crisis. So it is important to orient the patient to the use of intersession contact as soon as possible in order to reduce the risk for confusion and to minimize therapy-interfering behavior. Failure to orient a client properly is a common error even for seasoned DBT therapists.

There are a few guidelines for orienting and introducing the patient to intersession contact. You want to first and foremost keep orientation lighthearted and casual. We don’t want it coming across as though the patient is automatically going to abuse intersession contact, that they’re going to be calling you in the middle of the night and waking you up and overcalling you and being demanding and so forth. We want to start off assuming the best as much as possible. And so our attitude is less legalistic and more conversational. I like to ask clients how they feel about the fact that intersession contact or calling me or texting me, contact between session is not only permitted but it’s encouraged. And oftentimes, the patients will express feeling cautious and that can obviously lead to a very fruitful discussion about what their concerns and fears are. Some express feeling relieved and the exploration of that can be very helpful.