
4 Levels of TBT-S Training
See below for: a) Goals, b) Descriptions, and c) What each TBT-S Level qualifies you to do

Level 1: Introduction
TBT-S Level 1 Training: Introduction
Goal:
Introduce psychologists, social workers, MH therapists, educators, and graduate students to an eating disorder temperament-based therapy grounded in temperament-based research: Temperament Based Therapy with Support (TBT-S). This is a core TBT-S training Level1.
Level 1 Qualifies Practitioners to:
- share TBT-S neurobiological research and treatment tools with patients and students.
Description:
- Step 1 toward Certified TBT-S Practitioner.
- 6-8 hours.
- Core foundational training introducing professionals to a temperament-based treatment approach for eating disorders.
- For medical, psychologists, social workers, mental health providers, dietitians and educational professionals.
- Level 1 does not require clinical licensure.
- Offered in a 6-hour, one-day, face-to-face training, or by
- Recorded asynchronous distant learning, (online videos) accessible to view any time. 8 hours of videos must be completed to prepare for Level 2.
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- Videos can be purchased individually for TBT-S Level 1 or in a bundle format of all 14 videos. All videos must be completed for continuing education credit and completion of online Level 1.
- Quizzes follow each online video training and is required if seeking continuing education credits.
- As an enhanced method of learning, online video quizzes are scored by hand.
- One question is allowed to be missed per video.
- If more questions are missed, the professional will be instructed on which question(s) missed, what to do and how to retake the quiz. This is required if applying for CE credits.
- The fee is the same for both face-to-face and the bundle of recorded asynchronous distant learning formats.
- CE credits for psychology and social work are provided if requirements are completed.
- Both face-to-face and recorded asynchronous distant learning trainings provide handouts.
- If a professional clinician is working toward "TBT-S Certified Practitioner" status, then all Level 1 quizzes must be taken and passed successfully.
- A "Confirmation of Attendance" is provided when Level 1 requirements are met, or
- A “Certificate of Attendance/Credit” for 8 approved continuing education credits in social work..
Continuing Education Credits:
The TBT-S Training Institute, [2313], is approved as an ACE provider to offer social work continuing education by the Association of Social Work Boards (ASWB) Approved Continuing Education (ACE) program. Regulatory boards are the final authority on courses accepted for continuing education credit. ACE provider approval period: [3.14.2-25-3.14.2026]. Social workers completing this course receive 6 clinical continuing education credits.
CE credits in psychology pending.

Level 2: Application
TBT-S Level 2 Training: Application
Goal:
Apply current neurobiological eating disorder temperament-based research and TBT-S experiential clinical intervention tools into multiple treatment levels of care and cultures for eating disorders and comorbid trait-based illnesses.
Level 2 Qualifies Practitioners to:
- Provide TBT-S Intervention tools at all levels of care.
- Be listed in the TBT-S Clinical Directory as Level 2 trained.
- It does not qualify practitioners to train other clinicians in TBT-S or provide public TBT-S trainings.
Description:
- Step 2 toward Certified TBT-S Practitioner.
- 18 hours.
- An experiential 3-day face-to-face training for professionals. (Not offered virtually).
- Focused on how, when, where and why to apply temperament-based research into interactive structured interventions.
- Provides a temperament treatment foundation to augment ongoing therapies.
- Focuses on practicing TBT-S clinical tools and experiential interventions for all levels of care.
- Level 2 does not require clinical licensure but does require a person to be in a professional medical, psychological, social work, dietitian or other mental health profession or to be in a graduate practicum/internship.
- A " Confirmation of Attendance” will be provided at the end of the training, or
- A " Confirmation of 18 hours Credit/Attendance” will be provided for those who complete requirements for continuing education credits in social work or psychology.
There are two versions:
- Child/adolescent addressing adolescent development and how TBT-S builds upon family therapy.
- Adult TBT-S Training (18 yrs. and above). This includes tools for Severe-and-Enduring Anorexia Nervosa.
Prerequisites:
Successful completion of Level 1
Continuing Education Credits:
The TBT-S Training Institute, [2313], is approved as an ACE provider to offer social work continuing education by the Association of Social Work Boards (ASWB) Approved Continuing Education (ACE) program. Regulatory boards are the final authority on courses accepted for continuing education credit. ACE provider approval period: [3.14.2-25-3.14.2026]. Social workers completing this course receive 18 clinical continuing education credits.
Psychology CE credits pending approval.

Level 3: Integration
TBT-S Level 3Training: Integration
Goal:
Group consultation on how to integrate Temperament Based Therapy with Support (TBT-S) into clinical practice modules ranging from outpatient to residential care for clients of all ages with eating disorders to fill treatment gaps in ongoing eating disorder therapies.
Qualifies Practitioners to:
- Provide TBT-S Intervention tools at all levels of care.
- Be listed in the TBT-S Clinical Directory as TBT-S Level 3 trained.
- It does not qualify a clinician to train other clinicians in other facilities on TBT-S treatment or public TBT-S Professional trainings.
Description:
- Step 3 toward become a "Certified TBT-S Practitioner."
- 8 hours.
- Four live virtual 2-hour consultation sessions in a group of 5-8 professional clinicians (totaling 8 hours).
- 8 CE credits in social work and psychology (pending) are provided if participants register for this option and requirements are met.
- Level 3 requires:
- clinical licensure in a professional medical, psychological, social work, dietitian or other mental health profession or
- to be in a graduate practicum/internship, or
- work under a professionally licensed practitioner.
- State and province board and legal requirements require having liability insurance, or one's clinical program or educational site covers liability
- A "Confirmation of Attendance" is awarded.
- A Certificate of Attendance/Credit is awarded to those completing CE credit requirements.
Prerequisites:
Successful completion of Levels 1 & 2.
Continuing Education Credits:
The TBT-S Training Institute, [2313], is approved as an ACE provider to offer social work continuing education by the Association of Social Work Boards (ASWB) Approved Continuing Education (ACE) program. Regulatory boards are the final authority on courses accepted for continuing education credit. ACE provider approval period: [3.14.2-25-3.14.2026]. Social workers completing this course receive 8 clinical continuing education credits.
CE credits in psychology pending.

Level 4: Supervision
TBT-S Level 4: Individualized Supervision:
Goal:
To receive a practicum supervised experience of individualized observation and supervision for psychologists, social workers, MH therapists, or graduate educators to confirm accuracy of TBT-S application and integration and the TBT-S philosophy, principles and intervention tools into one’s own practice.
Description:
- This is the final step of TBT-S training to become a “Certified TBT-S Practitioner.
- 5-40 hours.
- Licensure is required for practitioners who want to be certified as a TBT-S Practitioner. Submission of the following is required to the TBT-S Training Institute centralized site in the USA:
- A copy of graduate diploma.
- A copy of licensure.
- Proof of liability insurance.
- This is a “practicum experience” to assess competencies and fidelity of practitioner application and integration of Temperament Based Therapy with Support (TBT-S) intervention modules for clients of all genders and cultures proving therapy ranging from outpatient to residential or multiday treatment.
- Supervision is offered for “Adult” and/or “Adolescent” patients.
- Individualized supervision comes in two formats:
- A practitioner is to be supervised while offering their first multiday TBT-S treatment program for adolescents and/or adults (unless the practitioner provides confirmation they are not offering a multi-day treatment currently or in the future).
- Five hours of one-on-one hourly individual supervision synthesizing all components from TBT-S Levels 1-3 during outpatient or higher levels of care.
- How to receive supervision: Individuals can receive “practicum” supervision in three ways:
- Live observation.
- Recorded videos of cases.
- Roleplay cases.
- Individualized supervision can only be provided by a TBT-S Certified Trainer or a TBT-S Training Institute Partner.
- A written open-book exam is required to be passed at 90%. It is administered in English by the TBT-S Training Institute central office.
Two versions of Level 3 and 4:
- Child/adolescent (children through 17 years old) addressing adolescent development and how TBT-S builds upon family therapy.
- Adult (18 yrs. and above). This includes tools for Severe-and-Enduring Anorexia Nervosa.
Prerequisites:
- Successful completion of Levels 1, 2, 3.

Certified TBT-S Practitioner!
"Certified TBT-S Practitioner" certificate is awarded!
Goal:
Award confirmation of successful training and proven ability to apply, integrate and implement the researched based Temperament Based Therapy with Support for eating disorders into multiple levels of care.
TBT-S Certification Qualifies Practitioners to:
- Be featured in the TBT-S Clinical Directory as a “Certified TBT-S Practitioner” for adults and/or adolescents.
- Train other clinicians in TBT-S at one's own hospital, clinic or practice.
- Lead a multi-day TBT-S Treatment week.
- Provide TBT-S at one’s practice at all levels of care.
- Provide public TBT-S presentations.
- It does not qualify a practitioner to:
- provide professional TBT-S trainings
- train TBT-S clinicians facilities/practices outside of one’s own facility.
- provide public TBT-S Trainings for other clinicians.
- These areas are reserved for the "Certified TBT-S Trainers" who receive further training.
A "Certified TBT-S Practitioner" credential is awarded.
TBT-S Supplemental Trainings
TBT-S Supplemental Trainings
Additional TBT-S Trainings are being developed to enhance a temperament-based approach in ongoing eating disorder therapies and adhere to the TBT-S philosophy and principles:
- Young adult (YA) application with developmental framework: 1 day add-on to child/adolescents or adult trainings.
- Clinician learning to provide meal support addressing patient traits: ½ day training.
- How, when and why to include support persons: ½ day training
- Dietary training for RDNs from a temperament/trait basis (TBD: ranging from 1-2 days of training).
More information to come in 2025!
Full disclosure/Conflicts of Interest:
- The presenters of some of the TBT-S trainings are also the co-developers of TBT-S and authors of the book titled, Temperament based therapy with support: A novel treatment for anorexia nervosa, 2022, by Hill, L. et. al., Cambridge University Press, Cambridge, England. They receive royalties from book sales.
- There is no commercial support for TBT-S trainings hosted by the TBT-S Training Institute.
- Trainers seek to share the research findings clearly, addressing limitations and key points.
- If attendees are seeking CEs, the attendees must be present for the full training.
- AI has not been used in the development nor content of TBT-S trainings. AI is used for international language interpretation of the recorded asynchronous distant learning Level 1 videos.