DIALECTICAL BEHAVIOUR THERAPY

IN-TRAINING EVALUATION REPORT

Rotation Location______

Resident Name ______

Start Date______Stop Date______

Please indicate below the number of sessions and cases that this evaluation is based on

Number of supervised DBT or DBT-informed individual therapy sessions:

Number of individual cases:

Number of supervised DBT skills groups:

Number of DBT Consultation Team meetings:

Amount of between-session phone coaching:

For this rotation, please FOCUS the evaluation on the following CanMEDs roles (i.e. Scholar and 1-2 others):

☐ Medical Expert

☐ Collaborator

☐ Professional

The following sources of information were used for this evaluation:

[ ] clinical observations from faculty

[ ] review of medical records

[ ] audio or video recordings of clinical care

[ ] other evaluations

Ratings Descriptions of Ratings

Significant and/or multiple performance deficits, Unsafe practice.
<5% of trainees / 1 / Significant deficits in one area that are unsafe &/or markedly unprofessional Pervasive pattern of performance that is below expectations in multiple areas. (<5% of trainees are expected to be ‘Unsatisfactory’)
Inconsistent Performance
5-10% of trainees / 2 / Deficits identified in some areas. Performance of skills is inconsistent. Trainee requires close supervision for safe practice.
Consistently meets the expected performance
~60% of trainees / 3 / Consistently demonstrates the described performance throughout the rotation, seeking supervision for high-risk situations.
Exceeds expected performance with most higher complexity cases
10-20% of trainees / 4 / Performance consistently exceeds the expected behaviour in moderately complex and highly complex patients. Requires direct supervision for some high complexity issues. Above average performance should be noted by multiple supervisors or instructors.
Consistently performs far above training level with superior skill.
<5% of trainees / 5 / Performance is well above expectations in multiple domains. Consistently identified by supervisor (and others) as demonstrating knowledge and skills that are exceptional for level of training. Expected to be consistently performing far above training level with minimal indirect supervision.

Note to raters: A rating of 3 is a “pass”.

A. MEDICAL EXPERT / 1 / 2 / 3 / 4 / 5 / N/A
1.  Formulates cases according to the DBT Biosocial model (presents the Biosocial model theory to individual patients, further develops formulation in individual therapy). / ○ / ○ / ○ / ○ / ○ / ○
2.  Uses validation strategies (e.g., reflecting, validating in the context of past learning/temperament, normalising) and builds a strong alliance with patients. / ○ / ○ / ○ / ○ / ○ / ○
3.  Uses problem assessment strategies (e.g., sets behavioural goals, conducts Behavioural Analyses). / ○ / ○ / ○ / ○ / ○ / ○
4.  Balances reciprocal (mirroring) and irreverent (surprising) communication. / ○ / ○ / ○ / ○ / ○ / ○
5.  Uses DBT commitment strategies to enhance commitment to treatment and goals. / ○ / ○ / ○ / ○ / ○ / ○
6.  Uses contingency management strategies (e.g., positive reinforcement, aversive contingency when indicated). / ○ / ○ / ○ / ○ / ○ / ○
7.  Uses DBT structural strategies (e.g., structures individual session according to treatment hierarchy, manages time well when leading group, assigns and reviews homework in group and/or individual sessions). / ○ / ○ / ○ / ○ / ○ / ○
8.  Teaches DBT skills to patients, including providing in vivo skills coaching when indicated. / ○ / ○ / ○ / ○ / ○ / ○
9.  Uses dialectical strategies (e.g., models “both-and” thinking, maintains balance and flow in sessions). / ○ / ○ / ○ / ○ / ○ / ○
B. COMMUNICATOR / 1 / 2 / 3 / 4 / 5 / N/A /
10. Maintains timely and accurate written records of treatment. / ○ / ○ / ○ / ○ / ○ / ○
C. COLLABORATOR / 1 / 2 / 3 / 4 / 5 / N/A /
11. Implements the DBT Team agreements with the supervisor, group co-leader and/or teammates, including: expresses differing opinions non-judgmentally, seeks dialectical synthesis, does not speak on clients’ behalf, observes personal limits, uses phenomenologically empathic language. / ○ / ○ / ○ / ○ / ○ / ○