In March 2020, like many other businesses, DBT Center of Orange County needed to close its physical doors at the beginning of the global pandemic to keep their staff and clients safe. Thankfully, the DBTOC team worked fast to transition services to a telehealth format. We were initially surprised at how smoothly it went! There were some adjustments for staff and clients, however, once the protocols were learned many staff and clients didn’t notice a difference in the effective treatment!

It has now been over a year, and the pandemic drags on. Many are asking, “When are you returning to in-person services?” This has been a complicated decision for management, as we want to continue to ensure the safety of staff and clients. Many variables related to the pandemic continue to shift and change  (variants, safe practices, CDC recommendations, etc.). Ultimately, and largely as a result of research, and client and staff feedback, we now plan to offer a hybrid model – BOTH in-person and telehealth services will be available.

There are many benefits to keeping a telehealth platform, including:

  • Ease to attend sessions (due to a global pandemic, health concerns, time constraints, etc.)
  • Fewer resources used (gas money, time away from family or work responsibilities, energy-related traffic/driving to the appointment or visiting a new place, etc.)
  • Opportunity to gain many of the same skills, learning & benefits. Zalewski et al. found that telehealth treatment across DBT modalities was either moderately effective or very effective (Zalewski et al., 2021). 
  • Telehealth sessions can provide a unique view into the client’s at-home life that a clinician wouldn’t otherwise see. The clinician can support the client in utilizing more effective skills to apply in their relationships and environment.

We also recognize the desire for in-person services, including:

  • Some clients like being away from their home to separate therapy from home/work life
  • In-person may be easier for family sessions, to better navigate multiple people talking at once.
  • Possibility of technology issues
  • Possibly experiencing a deeper connection with other group members or their clinician. Lopez et al.’s “findings indicate that while both [telehealth & in-person] groups felt equally connected to the facilitator, there were significant differences between the online and in-person groups on the group cohesion scale. Those in the online group did not feel as connected to other group members as those in the in-person group” (Lopez et. al, 2020). Despite these limitations, research indicates the convenience of telehealth services outweigh any negative effects, as attendance and participation is much improved. 

DBT Center of Orange County has started to transition back into the office. We are currently offering some individual services in-person to existing clients. We have protocols in place to reduce the risk for both clients and staff. As we obtain more information about CDC recommendations and guidelines, we will slowly transition some of our groups and Intensive Outpatient Program (IOP) to in-person. Our team is excited to remain in a hybrid-model to support everyone involved. We appreciate everyone’s continued patience and support. 

Written by Nora Josephson LPC AMFT & Jamie Marshall, BS



Lopez, A., Rothberg, B., Reaser, E., Schwenk, S., & Griffin, R. (2020). Therapeutic groups via video teleconferencing and the impact on group cohesion. mHealth, 6, 13.

Zalewski, M., Walton, C. J., Rizvi, S. L., White, A. W. Gamache-Martin, C., O’Brien, J. R. and Dimeff, L. 2021. Lessons learned conducting dialectical behavior therapy via telehealth in the age of COVID-19. Cognitive and Behavioral Practice.

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