Youth in residential care present with increasingly complex and severe mental health problems, and often with behavior that threatens the safety of themselves and others. Direct care or "front line" staff are largely responsible for the everyday care and treatment of these disturbed youth. Yet research indicates many problems are related to their preparation for this role; even though line staff have the most hours of direct contact with residential clients, they often receive the lowest pay, have the least education and preparation, and receive the least training and supervision. Not surprisingly, burnout, treatment apathy, and turnover are high for line staff, all of which impact the treatment provided to youth through residential treatment centers (RTCs).

Given the serious challenges posed by residential youth and faced by many line staff, we need to know of ways to better prepare line staff for their role. DBT is one model of treatment that effectively deals with high levels of emotional/behavioral dysregulation and chronic, unsafe behavior. The current effort utilized the DBT model to design a training and consultation group manual for line staff. The proposed manual aims to improve staffs ability in implementing an effective DBT-informed treatment, increase staffs experience of being supported, and decrease staff burnout and treatment apathy.