A pilot study of dialectical behaviour therapy skills training for autistic adults

2021 ◽  
pp. 1-16
Author(s):  
Lorie A. Ritschel ◽  
Lisa Guy ◽  
Brenna B. Maddox
Keyword(s):  
Mental Health ◽  
Neurodevelopmental Disorder ◽  
Skills Training ◽  
Preliminary Evidence ◽  
Autism Spectrum ◽  
Social Impairment ◽  
Behaviour Therapy ◽  
Group Setting ◽  
Dialectical Behaviour Therapy ◽  
Autistic Adults

Abstract Background: Autism spectrum disorder (ASD) is a common and lifelong neurodevelopmental disorder with the hallmark features of social impairment and restricted and repetitive patterns of behaviour. Individuals with ASD often experience co-occurring mental health difficulties, some of which may obfuscate the ASD features themselves. Although there is a high need for mental health services for autistic adults, there are surprisingly few evidence-based treatments (EBTs) available; moreover, many mental health practitioners who are well-trained in EBTs shy away from treating autistic individuals due to lack of training in ASD. Aims: The aim of the current study was to evaluate the feasibility and acceptability of dialectical behaviour therapy skills training (DBT-ST) in a sample of autistic adults without intellectual disability. Method: Sixteen adults with ASD were recruited from a treatment waiting list to enrol in this study, which included 24 weeks of DBT-ST delivered in a group setting. Feasibility and acceptability were assessed using retention and attendance data and a participant satisfaction questionnaire. Results: Retention (81.3%) and attendance data (mean 87.5%) provided support for the feasibility of this intervention. Overall satisfaction ratings were high (mean 4.5 out of 5), and participants reported that they felt that DBT-ST would probably be helpful for others with ASD (mean 4.5 out of 5). Conclusions: The study findings provide preliminary evidence of (1) the feasibility of providing DBT-ST for autistic adults in community-based clinics, and (2) the perceived benefit of DBT-ST for this under-served population. Recommended modifications to the standard DBT-ST materials are discussed.

Adolescent inpatient completers of dialectical behaviour therapy

2019 ◽  
Vol 22 (1) ◽  
pp. 29-39
Author(s):  
Ella Hancock-Johnson ◽  
Charlotte Staniforth ◽  
Lucy Pomroy ◽  
Kieran Breen
Keyword(s):  
Skills Training ◽  
Preliminary Evidence ◽  
Emotional Dysregulation ◽  
Social Impairment ◽  
Inpatient Setting ◽  
Behaviour Therapy ◽  
Dialectical Behaviour Therapy ◽  
Content Type ◽  
Training Cycle ◽  
Clinical Benefits

Purpose Dialectical behaviour therapy (DBT) aims to reduce emotional dysregulation and engagement in less adaptive behaviours for adults with mixed disorders of conduct and emotions (MDCE). However, there is limited evidence available for the effectiveness of DBT skills training for adolescents with MDCE who are resident within a secure impatient setting. The paper aims to discuss these issues. Design/methodology/approach A retrospective study investigated changes in aggressive and self-injurious behaviours in 22 adolescents within a secure inpatient mental health setting with MDCE who had completed one cycle of DBT skills training. Changes in symptomatic problems, behavioural and social impairment were also investigated in 17 of the 22 participants who completed the DBT skills training cycle. Findings There were statistically significant decreases in the frequencies of engagement in total aggressive and deliberate self-harm behaviours after the DBT skills training cycle. There was a significant improvement in symptomatic and behavioural impairment, but not in social impairment. Practical implications The findings of this study suggest that DBT skills training may be beneficial for behavioural and symptomatic outcomes in adolescent inpatients with MDCE. Originality/value This study provides preliminary evidence for the effectiveness of DBT skills training for adolescents with MDCE within a secure inpatient setting. Additional studies are required to investigate the clinical benefits of specific aspects of DBT for individual patients.

Dialectical Behaviour Therapy Skills Training Groups for Common Mental Health Disorders: A Systematic Review and Meta-Analysis

2020 ◽  
Author(s):  
Chantal P Delaquis ◽  
Kayla M. Joyce ◽  
Maureen Zalewski ◽  
Laurence Katz ◽  
Julia Sulymka ◽  
...  
Keyword(s):  
Mental Health ◽  
Emotion Regulation ◽  
Meta Analysis ◽  
Skills Training ◽  
Mental Health Disorders ◽  
Behaviour Therapy ◽  
Dialectical Behaviour Therapy ◽  
Transdiagnostic Treatment ◽  
Training Groups ◽  
Health Disorders

Context: Emotion regulation deficits are increasingly recognized as an underlying mechanism of many disorders. Dialectical behaviour therapy (DBT) holds potential as a transdiagnostic treatment for disorders with underlying emotion regulation deficits.Objective: Systematically review the evidence for DBT skills training groups as a transdiagnostic treatment for common mental health disorders via meta-analysis. Study Selection: Randomized control trials (RCTs) of DBT skills training groups for adults with common mental health disorders, and no comorbid personality disorder, were included. Data Synthesis: Twelve RCTs met inclusion criteria (N = 425 participants). DBT had a moderate-to-large effect on symptom reduction (g = 0.79, 95% CI [0.52, 1.06], p < .0001). Improvements in emotion regulation yielded a small-to-moderate effect (g = 0.48, 95% CI [0.22, 0.74], p < .01). Results showed significant effects of DBT on depression (g = 0.50, 95% CI [0.25, 0.75], p = .002), eating disorders (g = 0.83, 95% CI [0.49, 1.17], p = .001) and anxiety (g = 0.45, 95% CI [0.08, 0.83], p = .03).Conclusions: Findings suggest DBT is an effective treatment for common mental health disorders and may be considered as a promising transdiagnostic therapy.

Mental health correlates and potential childhood predictors for the wish to be of the opposite sex in young autistic adults

Autism ◽  
2021 ◽  
pp. 136236132110240
Author(s):  
Jung-Chi Chang ◽  
Meng-Chuan Lai ◽  
Yueh-Ming Tai ◽  
Susan Shur-Fen Gau
Keyword(s):  
Mental Health ◽  
Autism Spectrum Disorder ◽  
Autism Spectrum ◽  
Spectrum Disorder ◽  
Typically Developing ◽  
Item Endorsement ◽  
Opposite Sex ◽  
Autistic Adults

Cross-sectional research has demonstrated the overrepresentation of gender dysphoria in children and adults with autism spectrum disorder. However, the predictors and underlying mechanisms of this co-occurrence remain unclear. This follow-up study aimed to explore baseline (childhood/adolescence) predictors for the follow-up (adulthood) self-reported wish to be of the opposite sex and to investigate its mental health correlates in a sample of 88 autistic individuals as compared with 42 typically developing controls. An item on the Adult Self-Report Inventory-4, “I wish I was the opposite sex,” was used. We compared mental health symptoms between adults with and without this item endorsement. We used prediction models to explore family and autism-related predictors in childhood/adolescence to endorse this item in adulthood. There were more adults endorsing the item in the autism spectrum disorder group compared with the typically developing group. Autistic adults who endorsed the item experienced more mental health challenges, more bullying victimization, more suicidal ideations, and worse quality of life. Lower parent-reported family support and more stereotyped/repetitive behaviors during childhood/adolescence predicted the self-reported wish to be of the opposite sex in adulthood in autistic individuals. It is necessary to raise more attention to gender development and related mental health impact in autistic individuals. Lay abstract Autistic people/people with autism spectrum disorder are more likely to experience gender dysphoria. However, the possible longitudinal predictors and underlying mechanisms of this co-occurrence are unclear. To fill this knowledge gap, we assessed 88 people with autism spectrum disorder and 42 typically developing individuals at their average ages of 13.0 (baseline, childhood/adolescence) and 20.2 years old (follow-up, adulthood). At follow-up, their endorsement on the item “I wish I was the opposite sex” was used to evaluate gender dysphoric symptoms. We compared mental health symptoms between adults with and without this item endorsement at the follow-up assessment. We explored parent-reported family and autism characteristics-related predictors in childhood/adolescence to this item endorsement in adulthood. We found that more autistic adults reported the wish to be of the opposite sex than did typically developing individuals. Autistic adults who endorsed this item experienced more mental health challenges, more school bullying and cyberbullying, more suicidal ideation, and worse quality of life. Moreover, parent-reported lower family support and more stereotyped/repetitive behaviors during childhood/adolescence predicted the self-reported wish to be of the opposite sex in adulthood in autistic individuals. More attention and support should be provided to autistic people regarding gender development and related mental health and quality of life impact, especially during the transition period to young adulthood.

Adapted dialectical behaviour therapy skills group service evaluation

2021 ◽  
Vol 15 (1) ◽  
pp. 1-7
Author(s):  
Robert John Searle ◽  
Ianiv Borseti
Keyword(s):  
Intellectual Disability ◽  
Psychological Intervention ◽  
Training Group ◽  
Skills Training ◽  
Well Being ◽  
Service Evaluation ◽  
Behaviour Therapy ◽  
Dialectical Behaviour Therapy ◽  
Content Type ◽  
Friedman Analysis

Purpose The purpose of this paper is to determine the effectiveness of an adapted dialectical behaviour therapy (DBT) treatment programme for individuals with an intellectual disability, via completion of a service evaluation. Design/methodology/approach Outcome measurements were competed at pre-, post- and 12 months follow-up, and the effectiveness of the intervention was assessed using a Friedman analysis. Findings Findings demonstrated that the treatment group showed significant differences in their “psychological distress” scores, but no significant differences were found in their “psychological well-being”, “anxiety” or “quality of life” (WHO-QOL) scores over time. Originality/value Overall, the current study adds to the small but growing literature that supports using the skills training group part of DBT as a stand-alone psychological intervention when working with people with an intellectual disability.

Young boy with social impairment and repetitive behaviors

2021 ◽  
pp. 1-10
Author(s):  
Sirin Ozdemir ◽  
Craig L. Donnelly
Keyword(s):  
Occupational Therapy ◽  
Speech Therapy ◽  
Behavioral Therapy ◽  
Neurodevelopmental Disorder ◽  
Neuropsychological Testing ◽  
Educational Interventions ◽  
Autism Spectrum ◽  
Repetitive Behaviors ◽  
Social Impairment ◽  
Child Psychiatrist

Autism spectrum disorder (ASD) is a lifelong, highly heterogeneous neurodevelopmental disorder characterized by deficits in social communication and interaction as well as restricted, repetitive patterns of behavior, interests, or activities. The symptoms begin early in development but may not become apparent until social demands exceed abilities. The diagnostic assessment should include a medical assessment; evaluation by a clinician familiar with the signs/symptoms of ASD such as a developmental pediatrician, child psychiatrist, or child neurologist; neuropsychological testing to assess for comorbid intellectual disability; a speech and language evaluation; and an occupational therapy evaluation. There is no cure for ASD, but early diagnosis and intervention are associated with better functional outcomes. The treatment approach should be multidisciplinary and may include behavioral therapy, speech therapy, occupational therapy, and educational interventions. Pharmacologic treatment may be used to manage psychiatric comorbidities and maladaptive behaviors.

scholarly journals Wellness and resilience for college and beyond: protocol for a quasi-experimental pilot study investigating a dialectical behaviour therapy skill-infused college course

BMJ Open ◽  
2020 ◽  
Vol 10 (6) ◽  
pp. e036833
Author(s):  
Carla D. Chugani ◽  
Barbara Fuhrman ◽  
Kaleab Z. Abebe ◽  
Janine Talis ◽  
Elizabeth Miller ◽  
...  
Keyword(s):  
Mental Health ◽  
Undergraduate Students ◽  
Emotion Dysregulation ◽  
Mental Health Problems ◽  
Behaviour Therapy ◽  
Learning Collaborative ◽  
Dialectical Behaviour Therapy ◽  
University Of Pittsburgh ◽  
College Course ◽  
The University

IntroductionCollege students’ mental health problems and suicidal behaviour are serious, persistent and prevalent public health issues. With the need for mental health support greatly exceeding the availability of on-campus treatment, a recent trend on college campuses is to offer courses designed to teach students strategies for developing mental health or resilience. While these courses are exceptionally popular among students, a paucity of research investigates the health outcomes associated with participation. The purpose of this study is to investigate the acceptability, appropriateness, feasibility and preliminary effectiveness of a college course grounded in skills from dialectical behaviour therapy (DBT) titled, ‘Wellness and Resilience for College and Beyond’.Methods and analysisDuring the spring and fall 2020 semesters, the course will be offered on five campuses in Southwestern Pennsylvania and West Virginia. The course consists of 15 weekly 2.5-hour lessons, weekly homework assignments and a final examination with content drawn from DBT, acceptance and commitment therapy and positive psychology. Undergraduate students aged 18–24 will self-select into the course and control subjects receiving ‘university as usual’ will be recruited to serve as a comparison group. Students who receive the course will complete measures of course acceptability, appropriateness and feasibility. All study participants will complete measures of adaptive coping skills use, emotion dysregulation and suicidality.Ethics and disseminationAll of the study procedures were approved as an exempt protocol for evaluation of educational curricula by the University of Pittsburgh Human Research Protections Office (HRPO); the study was approved as a research study by the institutional review board (IRB) of the fifth study site. The University of Pittsburgh HRPO served as the IRB of record for all except one study site, which required standard IRB review. Data from this study will be disseminated via conference presentations, peer-reviewed publications and via our online stakeholder learning collaborative.Trial registration numberNCT04338256.

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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