Dialectical behaviour therapy in an Irish community mental health setting

2009 ◽  
Vol 26 (2) ◽  
pp. 59-63 ◽  
Author(s):  
Richard Blennerhassett ◽  
Lindsay Bamford ◽  
Anthony Whelan ◽  
Sarah Jamieson ◽  
Jennifer Wilson O'Raghaillaigh
Keyword(s):  
Mental Health ◽  
Borderline Personality Disorder ◽  
Personality Disorder ◽  
Community Mental Health ◽  
Borderline Personality ◽  
Positive Symptom ◽  
Mental Health Setting ◽  
Behaviour Therapy ◽  
Post Intervention ◽  
Dialectical Behaviour Therapy

AbstractObjectives:Dialectical behaviour therapy (DBT) is a recommended treatment of patients with borderline personality disorder, yet there are few descriptions of the approach in public community mental health settings where the majority of such patients present. This study describes the development and evaluation of a DBT programme in an Irish setting.Methods:The DBT programme was run over a six month period. Participants were assessed at baseline and post intervention with the following instruments: The Structured Clinical Interview for DSM III R personality disorders (SCID II), the clinical Outcomes in Routine Evaluation (CORE) and the symptom checklist 90 Revised (SCL-90-Revised). Inpatient bed usage was determined from case note review.Results:Outcome data was available for eight subjects. Significant improvement (p < 0.005) was seen on all CORE subscales. SCL-90-R showed significant improvement (p < 0.05) on the global severity index and on the positive symptom distress index. A decrease in self harming behaviour was found. Subjects' inpatient bed days dropped from a mean of 58 in the year pre intervention to a mean of four days in the year post intervention. A novel finding was that 43% of subjects who originally fulfilled criteria for avoidant personality disorder no longer did so post intervention.Conclusions:The study found that DBT can be applied in a community mental health setting with benefits similar to more specialist settings. Significant difficulties were encountered in implementing the programme. The clinical implications are that specialist psychotherapy services need to be an integral part of psychiatric services to achieve better outcomes for patients with borderline personality disorder.

scholarly journals Lessons from an Australian community dialectical behaviour therapy programme for borderline personality disorder

2008 ◽  
Vol 5 (1) ◽  
pp. 15-16
Author(s):  
Catherine Thompson
Keyword(s):  
Mental Health ◽  
Borderline Personality Disorder ◽  
Personality Disorder ◽  
Personality Disorders ◽  
Evidence Base ◽  
Borderline Personality ◽  
Behaviour Therapy ◽  
Dialectical Behaviour Therapy ◽  
Australian Community ◽  
The Uk

In 2003, the National Institute for Mental Health in England (NIMHE) published guidelines for the development of services for people with personality disorders (NIMHE, 2003), prompting community mental health teams (CMHTs) to reassess their service provision for this patient group. The guidelines did not recommend any particular treatment approach, but CMHTs were encouraged to develop specialist programmes. For many CMHTs the focus has been on borderline personality disorder, as it is one of the most prevalent personality disorders seen in adult mental health services and has high costs for both the patient and the service (Moran, 2002). The evidence base for which treatment may be most effective within the community remains small, however, and this has left many CMHTs unclear regarding a suitable programme. Here I will outline a CMHT-based dialectical behaviour therapy (DBT) programme operating in Western Australia and reflect on why I feel it is an option that CMHTs in the UK looking to develop their service should consider.

Effects of a modified DBT Skills Group for military personnel and Veterans with OSIs and borderline personality disorder or traits

2021 ◽  
pp. e20190067
Author(s):  
Pamela L. Holens ◽  
Jeremiah N. Buhler ◽  
Stephanie Yacucha ◽  
Alyssa Romaniuk ◽  
Brent Joyal
Keyword(s):  
Mental Health ◽  
Borderline Personality Disorder ◽  
Personality Disorder ◽  
Military Personnel ◽  
Group Treatment ◽  
Stress Disorder ◽  
Borderline Personality ◽  
Behaviour Therapy ◽  
Negative Thoughts ◽  
Skills Group

LAY SUMMARY This study looked at the use of a group treatment known as dialectical behaviour therapy skills group (DBT-SG) to see if it was helpful for military personnel and veterans who had a variety of mental health disorders related to their service. The results of the study showed improvements in symptoms of borderline personality disorder, reductions in negative thoughts and feelings, and reductions in unhelpful behaviours. Results also showed improvements in all examined areas of functioning among participants, with the largest change occurring in the area of social functioning. The presence of posttraumatic stress disorder (PTSD), depression, or chronic pain did not impact results, but the presence of a substance abuse disorder did. Overall, the results provide preliminary support for DBT-SG as an intervention for borderline personality disorder symptoms among military and veterans, and perhaps particularly for persons who also have other mental health challenges, or persons considered inappropriate for other treatment.

A randomised trial of dialectical behaviour therapy and the conversational model for the treatment of borderline personality disorder with recent suicidal and/or non-suicidal self-injury: An effectiveness study in an Australian public mental health service

2020 ◽  
Vol 54 (10) ◽  
pp. 1020-1034
Author(s):  
Carla J Walton ◽  
Nick Bendit ◽  
Amanda L Baker ◽  
Gregory L Carter ◽  
Terry J Lewin
Keyword(s):  
Borderline Personality Disorder ◽  
Personality Disorder ◽  
Randomised Trial ◽  
Skills Training ◽  
Borderline Personality ◽  
Individual Therapy ◽  
Behaviour Therapy ◽  
Psychotherapeutic Treatment ◽  
Dialectical Behaviour Therapy ◽  
Self Injury

Objectives: Borderline personality disorder is a complex mental disorder that is associated with a high degree of suffering for the individual. Dialectical behaviour therapy has been studied in the largest number of controlled trials for treatment of individuals with borderline personality disorder. The conversational model is a psychodynamic treatment also developed specifically for treatment of borderline personality disorder. We report on the outcomes of a randomised trial comparing dialectical behaviour therapy and conversational model for treatment of borderline personality disorder in a routine clinical setting. Method: Participants had a diagnosis of borderline personality disorder and a minimum of three suicidal and/or non-suicidal self-injurious episodes in the previous 12 months. Consenting individuals were randomised to either dialectical behaviour therapy or conversational model and contracted for 14 months of treatment ( n = 162 commenced therapy). Dialectical behaviour therapy involved participants attending weekly individual therapy, weekly group skills training and having access to after-hours phone coaching. Conversational model involved twice weekly individual therapy. Assessments occurred at baseline, mid-treatment (7 months) and post-treatment (14 months). Assessments were conducted by a research assistant blind to treatment condition. Primary outcomes were change in suicidal and non-suicidal self-injurious episodes and severity of depression. We hypothesised that dialectical behaviour therapy would be more effective in reducing suicidal and non-suicidal self-injurious behaviour and that conversational model would be more effective in reducing depression. Results: Both treatments showed significant improvement over time across the 14 months duration of therapy in suicidal and non-suicidal self-injury and depression scores. There were no significant differences between treatment models in reduction of suicidal and non-suicidal self-injury. However, dialectical behaviour therapy was associated with significantly greater reductions in depression scores compared to conversational model. Conclusion: This research adds to the accumulating body of knowledge of psychotherapeutic treatment of borderline personality disorder and supports the use of both dialectical behaviour therapy and conversational model as effective treatments in routine clinical settings, with some additional benefits for dialectical behaviour therapy for persons with co-morbid depression.

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