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For a young woman suffering from borderline personality disorder (BPD), waiting weeks or months for treatment can be devastating. People with the disorder often harm themselves and are sometimes suicidal, so the scarcity of therapists trained in one of the gold standard treatments—dialectical behavior therapy (DBT)—leaves many vulnerable.
In an effort to meet a growing need for clinicians skilled in DBT, four years ago, McLean created a clinical training opportunity under the direction of master clinician and trainer Michael Hollander, PhD. The donor-funded, highly competitive fellowship trains young clinicians within McLean’s 3East, a nationally known program providing a continuum of DBT-centered services for adolescents and young women.
“Providing promising young clinicians with a year-long immersion into this powerful therapy creates a broad impact on treatment for adolescents and young women for many years to come,” says Dr. Hollander, director of training, 3East DBT Services.
The fellows work with patients on the 3East intensive residential unit under Hollander and supervisory staff. 3East has hired four of the five psychologists who have completed the program to address its own waiting lists.
The fellowship was established by Barbara Hughey, PhD, and Robert Beckwitt, whose daughter was treated successfully with DBT at 3East.
“From our family’s experience with our daughter and through my work at MIT, I’ve seen how adolescence is the best time to intervene and what an excellent tool DBT is for young people,” says Hughey, an instructor in mechanical engineering. “We viewed supporting this fellowship as the best way to spread knowledge about the treatment and ensure that it is more widely used.”
Current fellow Jody Kemmerer, LCSW, considers the fellowship the best training available anywhere for someone interested in DBT. “I work with an amazing team, and I feel honored every day to be part of it,” she says.
Kemmerer says the girls she and her team treat typically arrive with multiple challenges, which makes the work tough, but gratifying. “There’s often a lot of complexity to why they ended up at 3East: PTSD, eating disorders, substance use, social phobias, obsessive compulsive disorder, trauma, and more,” she explains.
Kemmerer recalls one patient who was packing her bags to leave every week. The clinical team responded with unconditional acceptance and encouragement.
Ultimately, she decided to stay and work with them. “Like her, a lot of our patients struggle with self-loathing, which can be an obstacle to their wanting to get better,” says Kemmerer, who was initially attracted to DBT because of its roots in Buddhism, which she has practiced for 13 years.
Sara Land, PhD, the program’s inaugural fellow, says the training was a singular opportunity to work with Hollander, a world-renowned expert in DBT. And while she arrived at McLean with some expertise in DBT, her experience had been limited to working with adults.
“I really wanted to round out my training and work with adolescents and families as well,” explains Land, who now is a full-time psychologist with the 3East program. “You have to be spontaneous and have a lot of humility when you work with teenagers,” she says. “But there is a lot of playfulness, too. Even when they are going through very dark times, there is still laughter and so much creativity on the unit.”
Developed in the late 1970s, DBT teaches patients skills to cope with stress, regulate emotions, and improve relationships. For adolescents, treatment typically includes once- or twice-a-week individual therapy, family meetings, and training sessions where patients learn skills such as distress tolerance, interpersonal effectiveness, emotion regulation, and mindfulness.
Land admits the work can be daunting because the stakes are so high, but that nothing feels better than when a former patient is thriving. One such 3East patient—who at one time was suicidal—regularly sends her updates and told her recently that she was “committing” to another year of life. “It was a beautiful thing to hear,” says Land. “She went off to college, works, and is developing a quality of life she never thought she could have.”
Like Land’s patient, Hughey and Beckwitt’s daughter is now thriving, and they see their gift as ensuring that other young women benefit from the same superb treatment. “We like leveraging our philanthropy by supporting things that can help a lot of people,” comments Beckwitt. “Training just one fellow can mean treatment for hundreds of young women suffering with borderline personality disorder. And if that fellow in turn trains other therapists in DBT, the ripples go even further.”