The therapist undertakes, through the usual ethical and confidentiality requirements of the profession, to make all that is called the appropriate effort to conduct as competent therapy as possible and participate in peer consultation team meetings. The individual therapist is also committed to providing appropriate intersession contact in the form of telephone coaching. And they agree to treat the patient with respect and work on their own disruptive behaviors that might occur. There are specific patient and therapist agreements that must be approved before the start of DBT, with patient consent to the elimination of life-threatening behaviours essential. Adults of DBT are generally encouraged to commit to treatment for at least one year. If non-voluntary treatment is required, patients should be allowed to choose a non-DBT alternative, as non-voluntary treatment is not permitted. Some of the strategies are the devil`s advocate technique, in which the therapist will argue for the non-visit side of the treatment. This helps to strengthen the patient`s sense of choice and autonomy. All patients begin pre-treatment. Here, the individual therapist discusses DBT agreements and assesses the motivation for engagement. Individuals participating in the DBT must be volunteers. The DBT expressly prohibits non-voluntary treatment. Thus, if the treatment is not voluntary, the patient should have the opportunity to choose another non-DBT treatment.
Thus, in DBT, there are patient agreements and therapist agreements. These may be verbal, but they are written and returned optimally if necessary in the future. Another engagement strategy is called foot in the door. And a bit like walking in the door, what`s called the door on the face. Foot in the door, if a therapist can apply for a simple first application, put his foot in the door, which then expands the possibility of complying and increases the likelihood that the patient will accept another request. The door in the facial technique would be to ask for something bigger than expected, say no to the patient and then make it more likely that they would accept a less intense request. So, for example, if we think about homework, if we use the door in facial technique, we can ask for a new skill to be practiced every day, and that could be too much commitment for a new patient who will learn the skills so that we can resign and ask three times a week.