I'm Late, I'm Late! For A Very Important Date! DBT Consultation Team

One of the requirements of being a DBT therapist is having a consultation team.  And one of the expectations of being on the team is that you will be on time for the team meetings.  When you are a busy therapist who is grateful for time to eat and go to the restroom, being on time for team may seem like a really silly issue.  What's the problem with being five or  ten minutes late? Honestly, people need to get a life and be more compassionate. Compassion is part of DBT too, right?

     At the moment, a phone call or getting food or taking a restroom break seems more important than getting to team meeting on time and would appear to have no negative consequences. Therapists are busy people and taking just a few minutes seems harmless.

Unfortunately, it's not really harmless at all.  What can happen over time is that other team members see the meeting as starting ten minutes later than the scheduled time and everyone comes ten minutes later.  A second possibility is that the team meeting becomes devalued or that other team members feel their time is not respected. They too have phone calls to make. The consequence is that the team meeting becomes less of a priority for everyone, something that can be done if there is time,  and that is a serious consequence for all team members. A third consequence is that the team is cheated of the late team members' input and ideas that also makes the team less effective. Finally, therapists expect their clients to manage their time and be punctual for their appointments. If that expectation is reasonable for clients, it is reasonable for therapists as well.  Therapists teach partly by being role models. Structuring their time effectively is being a good role model and helps them understand the difficulty involved in modifying behaviors even when the goal is initially viewed as a priority.

Notice how being late for team is looked at as unavoidable because of the lack of time?  Addressing tardiness means first assessing the problem.  Remember, no solutions until the problem is understood. The first step is a chain analysis to look for the contingencies that maintain the late behavior, the lack of skill involved or the structure of the environment. Is it a motivational problem?  Is there some reason the team member wants to avoid team or is rewarded for being late?  Is there a higher reward for being late than for being on time, such as food? Or is there an environmental problem, such as a too tight schedule with the bathroom too far away or food unavailable during earlier breaks?  Perhaps the therapist's last session before the team meeting habitually goes over the ending time. Once the problem is clearly understood then problem solving can begin. By addressing the problem, the therapist either becomes more effective as a therapist (e.g., deals with stopping sessions on time) or finds it easier to attend team (e.g., food is made available at the team meeting or she creates a more reasonable schedule).  Asking the therapist to chain her late behavior consistently may encourage her to solve the identified problems.

Strong DBT therapists use the DBT principles and skills to address their own behavior.  Perhaps most importantly of all, not addressing late arrival at team meeting means a deviation from DBT principles.