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Key Takeaways: How To Assess Your Care
At THIRA Health, DBT is the foundation of our Bellevue programs – and we structure care so DBT skills can transfer into real life, not just stay on paper.
Comprehensive DBT is most often delivered through four therapy modes working together: individual therapy, DBT skills training, between-session coaching (often phone coaching), and a therapist consultation team.
In THIRA IOP and PHP, we build programming around those modes – including weekly consultation teams and between-session coaching during business hours (availability contingent on therapist schedule).
If a program says “DBT,” you deserve clarity on what is actually provided. “DBT-informed” can help, but it usually means pieces of DBT without the full structure.
THIRA Health is Joint Commission accredited (Gold Seal of Approval), reflecting standards for safety and quality in behavioral healthcare.
What We Mean by “DBT With Fidelity” at THIRA Health
People often use “DBT with fidelity” as shorthand for “this is the real thing.” We get why – the label matters when you are trying to choose safe, effective care.
At THIRA Health, fidelity is not a marketing phrase. It is the practical question of:
Is the program structured to deliver DBT the way it was designed to be delivered? (program fidelity)
Do sessions consistently reflect DBT strategies and targets instead of drifting into a loose blend of approaches? (adherence in practice)
We also believe fidelity depends on clinician support. DBT is demanding work, and therapists need a team structure to stay aligned and avoid burnout. That is why the DBT consultation team is built into the model and into our programming.
A DBT foundation that matters
DBT was developed by Dr. Marsha Linehan, and at THIRA Health, practicing DBT with fidelity means delivering structured programming, clinician consultation, skills training, and practical support that helps clients use DBT in real life across levels of care.
That background is part of why we take “fidelity” seriously as a clinical standard, not a buzzword.
How DBT Is Delivered Inside THIRA Programs
Rather than speaking in generalities, here is what DBT looks like in our actual program structure.
DBT in THIRA IOP
Our DBT programming includes:
Individual therapy (1x/week) focused on goals, problem behaviors, and building a “life worth living.”
DBT skills training groups (listed on our DBT page as 3x/week (EIOP) and 5x/week (MIOP)).
Phone coaching between sessions (during business hours) to support real-life skills use (availability contingent upon therapist schedule).
Weekly DBT consultation team meetings for our therapists.
We also offer an in-person Adult IOP designed for all genders, with an identity-affirming approach and a strong emphasis on community and small-group learning.
DBT in THIRA PHP
Our PHP includes:
Individual therapy (1x/week)
DBT skills training groups (2–3x/day)
Milieu coaching (as needed) – support from clinical staff to practice skills in real-life moments while in program
Weekly DBT consultation team meetings
DBT vs DBT-Informed: The Difference (And Why It Can Feel Confusing)
Comprehensive DBT (what most people mean by “DBT with fidelity”)
Comprehensive DBT typically involves four therapy modes working together: individual therapy, skills training, in-the-moment coaching, and a consultation team.
That structure is designed to do two things at once:
Help you build skills (emotion regulation, distress tolerance, mindfulness, interpersonal effectiveness)
Help you use skills in the moments you actually need them (not just in session)
DBT-informed (also called DBT-based or DBT-influenced)
DBT-informed care usually means a clinician or program uses DBT skills or principles, but without the full structure (for example, skills group without coaching, or individual therapy without a consultation team).
DBT-informed care can still be helpful – especially when you want skills support, you are stepping down from a higher level of care, or comprehensive DBT is not available where you live. The key is knowing what you are getting so expectations match reality.
A Simple Comparison Table (Use This When You Call Any Program)
| What to look for | More comprehensive DBT structure | DBT-informed care |
|---|---|---|
| Individual therapy | Yes | Sometimes |
| Skills training | Yes | Sometimes |
| Between-session coaching | Usually included in some structured form | Often not included |
| DBT consultation team | Yes | Often not included or informal |
| Program talks clearly about structure | Specific and concrete | Often vague (“DBT tools,” “DBT style”) |
If you call THIRA, you can ask these same questions – we expect them, and we welcome them.
Questions We Encourage You To Ask (Even If You Are Calling THIRA)
How often are DBT skills groups offered?
Do you provide between-session coaching? If yes, how does it work (hours, expectations, who responds)
Do DBT therapists meet in a weekly consultation team?
How do you prevent “DBT drift” over time? (supervision, consultation, adherence review)
What does a typical individual DBT session include? (targets, problem solving, skills generalization, “life worth living” goals)
Is the program inclusive and identity-affirming in practice – not just in language? (especially important in group settings)
Why This Matters: What Research Shows About DBT Outcomes
DBT has strong evidence in high-risk populations. In a major randomized trial, participants receiving DBT were about half as likely to make a suicide attempt compared to a rigorous comparison treatment.
That is one reason we care about structure. If you only get fragments of DBT, you may still benefit – but you may not get the coordinated support the model is designed to provide.
Finding DBT at THIRA Health
THIRA Health is a Joint Commission accredited mental health treatment center in Bellevue, Washington.
Our DBT programming includes weekly therapist consultation team meetings and between-session phone coaching during business hours (availability contingent upon therapist schedule), alongside skills groups and individual therapy built around DBT principles.
To learn more about the clinicians behind our programs, visit Our Team.
Call (425) 454-1199 to talk with admissions.