Someone needs to be taking care of legal matters, such as employment law, hiring/firing of employees, considering mission statements and the direction of the organization, enhancing compliance with insurance company requirements (such as claim filing and tracking), and making sure that practice is ethical and HIPAA compliant.
Like any business, someone needs to take care of marketing, referral sources, attracting clients, and providing good customer service. Due to the complexity of DBT, having a solid understanding of the treatment can take years, lots of good supervision, and a grasp of how to do not only individual psychotherapy- but group treatment and crisis coaching. It involves finding and supervising clinicians who are invested in doing the treatment, are willing to be available at all times by pager, are interested in taking on high risk clients, and who can sustain their own lifestyles in which they don’t get burned out or overwhelmed.
In addition, if the clinic or program desires to have evidence of effective treatment, the clinic may have to employ someone with a research background to work on data collection and outcome measures. Like any person with strengths and weaknesses, it makes sense that having multiple players with multiple talents is needed for very complex and “adherent” DBT treatment- and that not all clinicians (or business administrators, or researchers) are created equal.