OBJECTIVE: Dialectical behavior therapy (DBT) is an evidence-based psychosocial 
treatment with efficacy in reducing self-harm behaviors in borderline 
personality disorder (BPD). This study describes and evaluates a clinical 
curriculum to teach DBT to psychiatry residents, developed at a large urban 
university hospital. The curriculum objectives are to (1) have psychiatry 
residents achieve basic understanding of DBT theory and clinical skill, (2) 
increase residents' ability and confidence in treating self-harm behaviors (both 
suicidal behavior and non-suicidal self-injury), and (3) enhance residents' 
willingness to treat individuals with BPD.
METHODS: In addition to a 6-week didactic course on DBT offered to all residents 
(n = 62), 25 elected to enroll in a year-long DBT clinical training curriculum 
over the course of a 5-year period. The DBT clinical training consisted of 15 h 
of additional didactics, ongoing conduct of individual therapy and group DBT 
skills training, videotaping of individual therapy sessions, and weekly 
supervision meetings utilizing videotape to provide feedback. Residents 
participating in the clinical training program videotaped baseline and later 
sessions, which were rated for DBT adherence. All 62 graduates of the program 
were surveyed regarding the impact of the training on their practice of 
psychiatry.
RESULTS: Upon graduation, a high percentage (87 % in the curriculum and 70 % in 
the didactic course only) reported incorporating DBT into their psychiatry 
practice, as well as willingness and confidence in treating BPD and self-harm 
behaviors. Residents participating in the clinical training demonstrated 
significant improvement in their ability to utilize DBT interventions, 
particularly in structuring sessions, problem assessment, problem solving, and 
using validation and dialectical strategies.
CONCLUSION: This DBT curriculum was effective in preparing 
psychiatrists-in-training to incorporate evidence-based practices for effective 
treatment of BPD and self-harm behaviors and can serve as a model for teaching 
DBT during psychiatry residency training. Limitations include a small sample 
size and lack of baseline survey measurement of attitudes for pre- and 
post-curriculum comparison.