Samantha Mishne, M.S.W. ’99 has found again and again that dialectical behavioral therapy (DBT) is an incredible framework for therapeutic transformation, especially when the context and systemic factors are considered. This is why she is passionate about the approach, which has deeply impacted her career since her time at Smith. The combination of her clinical education and the systems-focused approach of psychodynamic theory with her DBT training has allowed her to provide effective therapeutic support to many clients who would not otherwise have access.
In fact, in large part because of her work, Bellefaire JCB, the locked residential unit where she currently serves as clinical director, is in the process of becoming the first certified DBT center in Ohio. Client restraints have dropped dramatically since she started there.
“When I first began working in this nonprofit facility, the program averaged two physical restraints per day. Currently, we average fewer than two per month,” says Mishne.
She says that the main reason for the marked drop in restraints is the program’s implementation of DBT.
“DBT allowed all staff to speak a common non-judgmental language and to buy into the belief that clients were doing the best they can, but needed to try harder and be more motivated for change.”
Five years ago when she started at the community health agency, she began the implementation process which led to the organization working on becoming the first in Ohio to be certified as a DBT center. Once certified it would be only the second program in the United States that treats adolescents.
Mishne explains that 99.9% of their clients do not come to treatment voluntarily and are referred to the program by external systems. “Despite this, most leave with increased family involvement and working knowledge of DBT skills: mindfulness, distress tolerance, interpersonal effectiveness, and emotion regulation.”
An adjunct professor at Case Western Reserve University for over 21 years, Mishne teaches Cognitive Behavioral Therapy Interventions, Practice Evaluation and Mental Health Policy. She also runs comprehensive DBT trainings “to ensure clinicians are delivering adherent, evidence-based treatment so clients can return to building their lives worth living as quickly as possible.”
She says she is especially dedicated and enthusiastic about integrating DBT with anti-racist practice, “building on foundational training I received at Smith from Beverly Daniel Tatum,” who was the 1999 Smith College commencement speaker and author of Why Are All the Black Kids Sitting Together in the Cafeteria? Tatum worked with the SSW class of 1999 on diversity after the student walkout they did in order to increase support of Smith’s anti-racism statement.
Smith SSW has been central to Mishne’s work in many ways. Her thesis on interfamilial homicide taught her how to engage critically with research, which influenced her career and helped prepare her for presenting her research and work on anti-racism and DBT, which she does across the U.S. She is still in touch with her first clinical supervisor post-graduation from SSW, Denise Balzer, M.S.W. ’91, who she meets up with yearly. Continuing the Smith tradition, Mishe also provides training and clinical supervision and says she has had the privilege of mentoring many new social workers who are figuring out their areas of specialization.
Mishne says that Smith gave her exceptional clinical training, and after graduating, she worked in community mental health for six years before moving to the for-profit sector, which allowed her to complete extensive DBT training.
“That training now enables me to provide DBT to a population that might not otherwise have access to it.”
The organization Mishne works for currently provides DBT-based skills training, phone coaching, individual therapy, and therapist consultation teams and they are able to directly support and impact close to one hundred adolescents and their families every year.
“Many DBT centers do not accept insurance due to the cost of training and program implementation, which limits access for the most vulnerable clients. In my community, the two other DBT centers are private pay, making them inaccessible to many families.”
Because it’s a non-profit organization that accepts insurance, it’s accessible to more community members, and serves a diverse population. It is the only residential treatment center in Ohio that accepts transgender youth, which helps provide access to affirming and evidence-based mental health support to teens.
“Every time a former client reaches out and says, ‘I know you probably don’t remember me, but I wanted to let you know I’m still using the skills you taught me,’ I am reminded why this work matters. I am helping young people build lives worth living.”
