To what extent do DBT Consultation Teams align with intervision?

An intervision concept as an integral component of a psychotherapeutic intervention approach

Among psychotherapists, peer group supervision – in Germany and other European countries often referred to as »intervision« – is commonly practiced. However, in contrast, detailed concepts, experience reports and scientific research addressing this specific area of application are scarce.

Dialectical Behavioural Therapy (DBT) is currently the most extensively evaluated and implemented psychotherapeutic approach for the treatment of Borderline Personality Disorder (BPD). The concept of DBT is based on assumptions of cognitive behavioural therapy but predominantly focuses on emotions. In addition to clinical supervision being an obligatory component of treatment, psychotherapists present current case situations within a Consultation Team and consult with each other in a structured manner.

Psychotherapists who engage within a Consultation Team aim to ensure and enhance the quality of their treatment. Mutual support and reflection promote their motivation and expertise, so that they work closely aligned with the DBT concept. The meetings of a Consultation Team follow a predefined agenda, with a pre-defined structure and guidelines for the various roles. The assigned roles alternate and reverse, including the session manager.

In a co-authored article published in a special issue on »Supervision, Intervision, Coaching« of the journal PTT – Personality disorders: Theory and Therapy, Dr. Andreas Schindler, psychological psychotherapist and therapeutic director of the special outpatient clinic for personality and stress disorders at the University Medical Centre Hamburg-Eppendorf (UKE), and Dr. Kim-Oliver Tietze examine the extent to which the concept and principles of these Consultation Teams correspond to the nature of intervision.

Abstract of the article

»How much do DBT consultation teams engage in intervision? Intervision is a leaderless form of peer group supervision in the field of psychotherapy and psychiatry. Participants mutually provide consultation for issues arising in their client treatment, forgoing the need for an external supervisor. The process is characterized by four core characteristics: focus on case consultation, group setting, structured course of consultation, and fully reversible roles within in the group. Though intervision is widely practiced, we still lack empirical studies on the quantity and the quality of intervision processes. Dialectical-Behavior Therapy (DBT) for Borderline Personality Disorder (BPD) includes a Consultation Team (CT) as a core component of the treatment program. A closer look at this CT reveals that it largely meets the four criteria of intervision. However, CT integrates aspects of intervision as well as case discussions. The CT appears to partly operate with an objectivistic epistemology and partly with a subjectivistic grasp of the cases discussed. Moreover, decisions by a leaderless CT may be in conflict with the responsibility for treatment within the institutional hierarchies of health care providers.«

Tietze, Kim-Oliver & Schindler, Andreas (2022). Wie viel Intervision steckt in DBT Consultation Teams? PTT – Persönlichkeitsstörungen: Theorie und Therapie, 26(2), 188–207. doi:10.21706/ptt-26-2-188

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