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Case Conceptualization & Behavioral Targeting in Stages 1 & 2 of DBT: Treating High Target Behaviors and Trauma in the Multi-Diagnostic Client w/ Lorie Ritschel, PhD

Friday, February 3, 2017, 8:30 -4:30 at the Cardinal Innovations Healthcare -OPC Community Office,  Chapel Hill, NC || Slides || printable handouts: 3 slides per page with notes || 6 slides per page

When: Friday, February 3, 2017 from 8:30-4:30 , with  1 hour lunch and 2 fifteen minute breaks

WhereCardinal Innovations Healthcare -OPC Community Office; 201 Sage Road, Suite 300, Chapel Hill, N.C. 27514 

Continuing Education 6 hours

Fees: General Admission: $260;  SSW disount: $160 
            Early Bird discount available before December 27th: General $210; SSW discount: $110 
  • SSW Discount available for current UNC-CH School of Social Work students, faculty, field instructors, and task supervisors.
  • Additional $6 fee for psychologists who would like to receive Category A credit
Registration: Online pre-registration    You may pre-register up until the day before the program


Dialectical behavior therapy (DBT) is an evidence-based treatment for individuals with severe emotion regulation difficulties and borderline personality disorder (BPD). The treatment comprises four stages that are structured based on the client’s level of disorder (e.g., severity, complexity), and each stage includes both primary and secondary treatment targets. In Stage 1, the primary treatment target is severe behavioral dyscontrol (e.g., suicidality, self-injury), and the associated treatment goal is behavioral control. In Stage 2, which often requires treatment for trauma and PTSD, the primary treatment target is emotional avoidance and the associated goal is non-anguished emotional experiencing. Across both stages, clinicians use chain analyses to identify a client’s secondary treatment targets (e.g., emotional vulnerability, apparent competence, inhibited grieving), or the underlying dialectical dilemmas and behavioral patterns that are related to problem behaviors.

Thus, effective therapeutic work with multi-diagnostic clients relies on careful case conceptualizations and chain analyses. This workshop will help DBT clinicians improve their ability to assess primary and secondary treatment targets and create case formulations to address what is most relevant in multi-diagnostic clients – particularly those in need of treatment for PTSD. In addition, clinicians will be given an overview of the DBT-Prolonged Exposure (DBT-PE) protocol for the treatment of comorbid BPD and PTSD.

This workshop is an intermediate to advanced workshop for clinicians with knowledge of DBT.



lorie PicLorie Ritschel, Ph.D., is Clinical Assistant Professor of Psychiatry at the University of North Carolina School of Medicine and is a licensed psychologist with a private practice in Durham, NC. She is a certified DBT therapist and an expert trainer of DBT through Behavioral Tech, LLC. Dr. Ritschel specializes in the treatment of depression, anxiety, and emotion dysregulation in adolescents and adults using Cognitive Behavior Therapy, Dialectical Behavior Therapy, and Behavioral Activation.





  • 8:30-9:00 – registration and sign-in    
  • 9:00- 10:15 –DBT as a transdiagnostic treatment; treatment targets based on stage of treatment
  • 10:15 – 10:30 – break
  • 10:30 – 12:00 – Primary and secondary targets in Stage 1 treatment
  • 12:00-1:00 – lunch
  • 1:00 – 2:30 – Targets in Stage 2: the DBT-PE protocol
  • 2:30 – 2:45 – break
  • 2:45 – 4:30 – Chain analyses and case conceptualizations


Learning Objectives: 

At the completion of this program, participants will be able to

  • Classify primary treatment targets according to stage of treatment
  • Identify secondary treatment targets
  • Create a case conceptualization that includes both primary and secondary treatment targets by stage of treatment
  • Understand how to conduct nuanced chain analyses to address treatment targets
  • Describe the DBT-PE protocol for the treatment of comorbid BPD and PTSD


  • Harned, M. S., Korslund, K. E., Foa, E. B., & Linehan, M. M. (2012). Treating PTSD in suicidal and self-injuring women with borderline personality disorder: Development and preliminary evaluation of a dialectical behavior therapy prolonged exposure protocol. Behaviour research and therapy, 50(6), 381-386.
  • Koerner, K. (2011). Doing Dialectical Behavior Therapy: A Practical Guide. New York, US: The Guilford Press.
  • Koerner, K., & Linehan, M. M. (1997). Case formulation in dialectical behavior therapy for borderline personality disorder. Handbook of psychotherapy case formulation, 340-367.
  • Wagner, A. W., Rizvi, S. L., & Harned, M. S. (2007). Applications of dialectical behavior therapy to the treatment of complex trauma‐related problems: When one case formulation does not fit all. Journal of Traumatic Stress,20(4), 391-400.


Transportation/ Directions: Click here for Directions

How to access UNC wireless: Information for connecting to wireless at UNC

Information on Continuing Educational Credit:

Contact hours provided for LCSWs and LMFTs 6 hours

CEU: # Contact Hours per event

6 Contact Hours from UNC Chapel Hill School of Social Work.

6 Contact Hours NBCC (provider #6642) The UNC School of Social Work is an NBCC-Approved Continuing Education Provider (ACEPTM) and may offer NBCC-approved clock hours for events that meet NBCC requirements. The ACEP solely is responsible for all aspects of the program.  

Each clinical lecture is co-sponsored by the North Carolina Psychological Association and the UNC School of Social Work. The North Carolina Psychological Association is approved by the American Psychological Association to sponsor continuing education for psychologists. The North Carolina Psychological Association maintains responsibility for this program and its content. Each workshop is offered for 6 Hours of continuing education credit.

ADA Statement: If you require any of the auxiliary aids or services identified in the Americans with Disabilities Act in order to participate in this program, please call us at 919-962-6540 no later than ten business days before the program.

Attendance Policy: – To receive credit, you must be present for the entire session, and you must sign the sign-in and sign-out sheets (for psychologists). No partial credit will be given. No credit will be given to participants who are more than 15 minutes late at the beginning of any session. No credit will be given to participants who leave before the close of a session. 

Payment and refund policies A refund of 60% of the paid registration fee will be available when cancellation request is received  at least 48 hours prior to the program date. You may send a substitute in your place.

Additional questions? Contact Deborah Barrett, PhD, LCSW at / 919-843-5818 or Carol Ann Hincy at / 919-962-6540.

Register Here


ONYEN LOG IN is ONLY for UNC-CH SCHOOL OF SOCIAL WORK current students, staff and faculty.


CAROL ANN HINCY 919-962-6540 or