DBT with an inpatient forensic population: The CMHIP forensic model

Implementation of Dialectical Behavior Therapy (DBT) in a forensic or crimi nal justice setting differs dramatically from standard outpatient DBT Foren sic patients are multiproblem patients with violent histories and multiple diagnoses including borderline personality disorder (BPD), antisocial perso nality disorder (ASPD), and concomitant Axis I psychotic or mood disorders. DBT was selected for this population because of its emphasis on treating l ife-threatening behaviors of patients and therapy-interfering behaviors of both patients and staff. The forensic inpatient DBT model described here in cludes modification of agreements, targets, skills training groups, and dia lectical dilemmas. An additional skills module, the Crime Review, was devel oped to supplement standard DBT Conclusions and recommendations for applyin g DBT in a forensic setting are presented.