Date of Award


Document Type


Degree Name

Doctor of Psychology (PsyD)



First Advisor

Derek R. Hatfield, Ph.D.

Second Advisor

Don Robertson, Ph.D.

Third Advisor

Laurie Roehrich, Ph.D.


Establishing the efficacy and effectiveness of psychotherapy is necessary but not sufficient to have a comprehensive understanding of the utility of an intervention. Researchers agree the broader clinical utility of interventions should be examined. Nelson & Steele (2006) provide a framework for evaluating interventions that include outcome, consumer, provider, and economic evaluations. Dialectical behavior therapy (DBT) is one intervention which research has established the efficacy and effectiveness, but research on pragmatic issues (e.g., where and how DBT is being implemented) is lacking. Clinical directors of mental health facilities and therapists conducting DBT around the country were surveyed. The current dissertation sought to understand if DBT is being implemented in the clinical setting, by whom, and for what population. Barriers to treatment implementation and resources of sites were identified and differences among clinical settings delineated. Funding was an important barrier and DBT's fit with reimbursement was a significant resource when participants reflected on implementing DBT. Additionally, participants practicing DBT appeared to be well-trained. The current dissertation assessed if DBT possesses important treatment selection characteristics. Results are discussed in contrast to Nelson & Steele's (2008) study on treatment selection characteristics. Finally, what additional research practitioners would like to see in the DBT literature is highlighted, along with other directions for future research.