Clinical considerations for the delivery of virtual dialectical behavior therapy to high-risk patients

ABSTRACT

This article discusses the clinical considerations for the delivery of virtual dialectical behavior therapy to high-risk patients. The COVID-19 pandemic has required rapid recalibration of behavioral health services, which has been challenging across all sectors of healthcare, but particularly so for high-risk patients for whom the use of telehealth has raised concerns. The telehealth model for DBT can be successfully implemented, but requires careful planning to mitigate potential risks and the use of particular strategies to facilitate relationship building and communication. Furthermore, virtual Dialectical behavior therapy (vDBT) requires a specific technological infrastructure, as well as unique policies to govern patient behavior in the presence of increased distractions found in the home environment. The dropout rates were on the lower end for comprehensive DBT programs, suggesting that the virtual modality may improve convenience for patients, thus improving retention. Although vDBT presents some unique challenges, the authors were able to overcome many of these challenges by using them as opportunities for patients to practice DBT skills, emphasizing the dialectical perspective that challenging experiences and opportunities can co-exist. vDBT provides a promising model for improving access to appropriate, high-quality care while simultaneously reducing healthcare costs. However, the understanding of vDBT is still in its infancy and work is needed to optimize clinical processes for the virtual delivery of DBT as well as evaluate clinical outcomes among patients receiving vDBT, and determine the impact of vDBT on medical expenditure associated with comorbid chronic conditions. (PsycInfo Database Record (c) 2022 APA, all rights reserved)