Another person calling looking for treatment. Again, they have called so many places, still unable to find care. So many counselors are full, often not having time in their schedules or the bandwidth in their energy to return calls for people seeking help. Ten or twelve phone messages left, without a single response is not an unusual thing I hear from people wanting counseling. If it isn’t a lack of response, it’s being put on a waitlist, receiving substandard or unhelpful care or the treatment is simply unaffordable. Additionally, I find myself in the same paradox. So many people need help and DBT is time and labor intensive to deliver. Each client might require three hours a week or more in addition to the emotional energy required from me to support people climbing out of the depths of great pain.
To quote the movie the Matrix, this problem has been like a splinter in my brain for years, it rolls around in my subconscious like so many other unsolved dilemmas. The question that keeps me up at night is, “Isn’t there a more efficient, more affordable, more consistent way to deliver DBT?” Counseling has developed in so many ways. We have new techniques, research to indicate what actually works, conferences, training, certification, all evolving the process of what is administered in the room. Now, the pressing question is how do we better deliver these improved methods? Many of us continue to sit face to face in hour long segments unchanged from the methods of the great therapy masters of the 1800’s. While some people may always prefer and require this more humanistic approach, it is the technological equivalent of riding a horse instead of driving a car.
Present technology, video chats, video recordings and interactive apps to name a few, present potential platforms for exploration. These are options that might help us deliver services more effectively to reach more people. Without question, the development of new delivery methods are already happening. Apps for DBT diary cards or therapy through texting are available now. What we don’t know is how well these technological choices serve to remedy the emotional pain that they are designed to address. Especially when that pain is of the excruciating variety that is resolved in DBT therapy.
Collaborative innovation between programmers and therapists with outcomes measured by Randomized Clinical Trials, or well-designed research is required to develop and discover what works best. I offer a call to arms for therapist, clients, and innovators alike: Can we find a shift in our thinking and push to answer the question, “Isn’t there a better way?”
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