The Acceptance and Change Protocol:
Using DBT Dialectical Dilemmas to Enhance Treatment
with Dr. Andrea Gold and Dr. Suzanne Decker
Behavioral Care Center of New Jersey and Metro NY DBT Center bring you this 2-part virtual seminar, which will provide Enhanced Treatment methods using DBT Dialectical Dilemmas.
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Date: September 19, 2025, and September 26, 2025
Time: 12:00 noon to 3:00 pm EST (virtual)
Fee: $350 per person.
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All Payments must be received by September 5, 2025, or when capacity is reached.
Click here to register online and for payment information.
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Training Description:
In this two-part clinical workshop for advanced DBT practitioners, we will present and practice the Acceptance and Change Protocol (ACP), a career-long body of work developed by the late Seth Axelrod, PhD, and colleagues. The ACP aims to clarify client behavior patterns, develop treatment goals that address secondary targets, and inform strategic interventions of “what to do when” by integrating Linehan’s original three dialectical dilemmas with her descriptions of three dialectics representing DBT therapist characteristics (i.e., nurturing vs. benevolent demanding; oriented to acceptance vs. oriented to change; and compassionate flexibility vs. unwavering centeredness). Day 1 will focus on tools for identifying the dialectical dilemmas and empathic formulation of client behavior, therapist behavior, and client-therapist transactions. We will illustrate DBT's dialectical dilemmas (Linehan, 1987, 1993) and identify further elements of each dilemma to enhance therapists' empathic formulation of clients' challenges and needs, and to facilitate participants' ability to identify polarized behavior patterns reflecting over- and under-regulation of emotion (Axelrod, Gold, & Decker, under review). Specifically, the ACP extends Linehan’s original (1987, 1993) descriptions to flesh out the challenging context, client phenomenology, secondary targets, and skills deficits associated with each dialectical dilemma. We will also identify therapist responses that may serve to reinforce secondary target behavior consistent with the transactional model. Day 2 will focus on intervening with the dialectical dilemmas, describing the ACP intervention approach of the "two-step" therapist response. We discuss and demonstrate how the ACP is rooted in behavioral principles and synthesizes DBT's acceptance and change strategies to extinguish ineffective behavior and elicit more skillful, adaptive behavior, while acknowledging the validity of the client’s needs. Participants will discuss case examples with opportunities for conceptualizing a client’s challenges and needs using the ACP and how to apply the ACP’s intervention in a therapist-client interaction in session via role-play demonstrations. Participants will engage in homework between sessions, including identifying a case formulation based on the dialectical dilemmas to inform intervention. This workshop is suited for therapists at an intermediate-to-advanced level, given that it requires an understanding of the biosocial/transactional model, dialectics, levels of validation, and behaviorism.
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For the Training Objectives and information about CEs, please click here.
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For the Schedule, Please Click Here.​
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Meet the Presenters:
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Andrea Gold, PhD, is a clinical psychologist and Clinical Assistant Professor of Psychiatry and Human Behavior at the Brown University Alpert Warren School of Medicine and the Pediatric Anxiety Research Center (PARC) at Bradley Hospital. She is the Team Lead of the DBT-X Track in PARC’s Intensive Program for OCD & Related Disorders. She is also on the Board of Directors for the National Education Alliance for Borderline Personality Disorder (NEABPD) and the DBT Bulletin.
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Suzanne Decker, PhD, is a clinical psychologist who received DBT training at InterAct of Michigan and Yale School of Medicine. She now works at VA Connecticut Healthcare System and Yale School of Medicine as a psychologist, investigator, and Associate Professor in the Department of Psychiatry. Her work focuses on implementation of DBT Skills Groups.
​Questions or concerns: If you have any questions or concerns not addressed on the website, please email emiller@behavioralcarenj.com or cdiamond@metronydbt.com or call 973-660-0700.
