The Value of Commitment (Signing a Contract!) to Therapy

Posted On February 8th, 2021

dialectical behavioral therapy (dbt)

Today’s post is from a therapist member of the RightFit community. She explains what Adherent DBT (Dialectical Behavioral Therapy) is and how it works. Thank you Shaina! Go check out her website and her profile on the RightFit directory (when we launch)!

First, you may be asking what is Adherent DBT (Dialectical Behavioral Therapy)?

Adherent DBT is a more structured and inclusive program of DBT. DBT was originally created by Marsha LInihan in the 1970s for those suffering from severe emotion dysregulation. DBT has transformed into a therapy that treats many different issues/ disorders.

Adherent DBT is a contract between the therapist and the client signifying the commitment of both parties involved.

The client will commit to:

-Weekly individual therapy

-Weekly DBT skills training

-Completion of diary card (weekly tracking tool)


The therapist will commit to:

-Providing phone coaching when needed (help client use skills in real time)

-Mutual trust

-Participating on a DBT consultation team (therapist participates in a weekly team meeting with other DBT therapists, supporting each other and holding one another accountable)


The contract helps keep both parties committed to the goal: finding a life worth living. There can definitely be some bumps in the road and the contract helps guide the client (and therapist) to stay on track. It also helps the therapist commit to boundaries and guidelines of DBT. The client agrees to stay in group for at least 24 weeks (this covers the main skills in DBT) alongside weekly individual therapy. The time the contract begins and ends is decided amongst both parties.

I am a firm believer in the effectiveness of DBT and the research it shows to help regulate emotions, eliminate suicidal ideations and find a life worth living. Adherent DBT is not a fit for everyone and I have found it to be the most effective with clients who suffer from intense emotions and suicidal thoughts/behavior. I find the commitment and financial burden to be some barriers to commitment. However, who can put a cost on finding a life worth living?! Additionally, research shows that when you commit to a DBT program, you will save money and time in the future not spending money on therapy and/or hospitalizations.

Shaina Gordon, LCSW

Owner/Clinical Director: Online Therapy of Atlanta