Consultation Team Agreements

Being an active member in a consultation team requires a great deal of vulnerability. In order to help everyone get the most out of team, we ask members to agree to the 6 consultation team agreements set forth by Marsha Linehan in Cognitive Behavioral Therapy for Personality Disorders, 1993:

1. Dialecitcal agreement: We agree to accept a dialectical philosophy: There is no absolute truth. When caught between two conflicting opinions, we agree to look for the truth in both positions as, “What’s being left out?”

2. Consultation-to-the-patient agreement: We agree that the primary goal of this group is to improve our own skills as DBT therapists, and not serve as a go-between for patients to each other. We agree to not treat patients or each other as fragile. We agree to treat other group members with the belief that others can speak on their own behalf.

3. Consistency agreement: Because change is a natural life occurrence, we agree to accept diversity and change as they naturally come about. This means that we do not have to agree with each others’ positions about how to respond to specific patients nor do we have to tailor our own behavior to be consistent with everyone else’s.

4. Observing limits agreement: We agree to observe our own limits. As therapists and group members, we agree to not judge or criticize other members for having different limits from our own (e.g., too broad, too narrow, “just right”).

5. Phenomenological empathy agreement: All thing being equal, we agree to search for non pejorative or phenomenologically empathic interpretations of our patients’, our own, and each other’s behavior. We agree to assume we and our patients are trying our best, and want to improve. We agree to strive to see the world through our patients’ eyes and through one another’s eyes. We agree to practice a nonjudgmental stance with our patients and with one another.

6. Fallibility agreement: We agree ahead of time that we are each fallible and make mistakes. We agree that we have probably done whatever problematic thing we’re being accused of, or some part of it, and so we can let go of assuming a defensive stance to prove our virtue or competence. Because we are fallible, it is agreed that we will inevitably violate all of the agreements, and when this is done we will rely on each other to point out the polarity and move to a synthesis.