Improving Accessibility to Dialectical Behaviour Therapy for Individuals with Cognitive Challenges

2017 ◽  
pp. 768-796
Author(s):  
Julie F. Brown
Keyword(s):  
Emotion Regulation ◽  
Dual Diagnosis ◽  
Mental Health Problems ◽  
Behaviour Therapy ◽  
Dually Diagnosed ◽  
Dialectical Behaviour Therapy ◽  
Factors Associated ◽  
Personal Challenges ◽  
Challenging Behaviours ◽  
Improve Access

Many individuals with developmental and intellectual disabilities (ID) who are dually-diagnosed with mental health problems experience emotional, cognitive, and behavioural regulation difficulties. The comprehensive, multi-modal approach offered by Dialectical Behaviour Therapy (DBT) addresses the complex intra- and inter-personal challenges that create and maintain patterns of dysregulation and challenging behaviours. This chapter presents information to help DBT therapists understand factors relevant to applying DBT with individuals with dual-diagnosis and emotion regulation skills deficits. Although standard aspects of DBT are critical, adjustments to improve access for individuals with ID are necessary. Therapists treating this population must be competent in standard DBT and in managing factors associated with cognitive load to modify interventions in ways that remain fundamentally DBT. This chapter addresses accommodations that alter delivery mechanisms, not changing core processes, and introduces the Skills System, an adapted curriculum with which the DBT therapist can help individuals with ID improve intrinsic emotion regulation capacities.

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.

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.

Dialectical Behaviour Therapy for Emotion Regulation Difficulties: A Systematic Review

2019 ◽  
Vol 36 (3) ◽  
pp. 143-164
Author(s):  
Lauren J. Harvey ◽  
Caroline Hunt ◽  
Fiona A. White
Keyword(s):  
Emotion Regulation ◽  
Current Evidence ◽  
Behaviour Therapy ◽  
Qualitative Synthesis ◽  
Dialectical Behaviour Therapy ◽  
Participant Engagement ◽  
Treatment Conditions ◽  
Difficulties In Emotion Regulation ◽  
Increasing Risk

AbstractWhile dialectical behaviour therapy (DBT) appears efficacious in reducing suicidal and self-harming behaviour, it is unclear whether DBT reduces emotion regulation (ER) difficulties, a purported mechanism of change of treatment. This review aims to investigate and evaluate the current evidence to understand the effectiveness of DBT in improving ER difficulties. A qualitative synthesis of studies investigating the effectiveness of DBT on self-reported ER difficulties as measured by the Difficulties in Emotion Regulation Scale (DERS) was performed, identifying eligible studies using PsycINFO, PubMed, MEDLINE and EMBASE databases. Fourteen studies were identified. Current evidence indicates that DBT does not show consistent benefits relative to existing psychological treatments in improving ER difficulties. The literature is compromised by significant methodological limitations increasing risk of bias across study outcomes. Furthermore, high variability across DBT programs and a lack of investigation regarding adherence and participant engagement within interventions was observed. Further research is needed in order to conclude regarding the effectiveness of DBT in improving ER difficulties. Consistent use of active treatment conditions, greater standardisation of DBT-based interventions, in addition to further examination of participant engagement level in DBT-based interventions in the long term may assist understanding as to whether DBT improves ER difficulties.

scholarly journals Dialectical Behaviour Therapy for the Treatment of Emotion Dysregulation and Trauma Symptoms in Self-Injurious and Suicidal Adolescent Females: A Pilot Programme within a Community-Based Child and Adolescent Mental Health Service

2013 ◽  
Vol 2013 ◽  
pp. 1-10 ◽  
Author(s):  
Keren Geddes ◽  
Suzanne Dziurawiec ◽  
Christopher William Lee
Keyword(s):  
Mental Health ◽  
Emotion Regulation ◽  
Mental Health Service ◽  
Health Service ◽  
Community Mental Health Service ◽  
Trauma Symptoms ◽  
Behaviour Therapy ◽  
Dialectical Behaviour Therapy ◽  
Pilot Programme ◽  
The Impact

Background. The literature suggests a link between childhood trauma and maladaptive emotion regulation strategies, including nonsuicidal self-injury (NSSI) and suicidality. We assessed the impact of a pilot dialectical behaviour therapy (DBT) programme on reducing trauma-related symptoms and improving emotional regulation, suicidality, and NSSI in adolescents.Methods. Six adolescents attending a community mental health service received 26 weeks of DBT, together with a parent. Independent assessors collected measures on each participant at baseline, posttreatment, and three-month followup. We implemented further improvements over past research with the use of adolescent-specific outcome measures as well as independent assessment of treatment integrity, noted as problematic in previous studies, using videotapes.Results. Firstly, adolescents reported a decrease in trauma-based symptoms, suicidality, and NSSI following participation in the DBT programme that was maintained at the three-month followup. Secondly, adolescents also reported improved emotion regulation immediately following treatment, and this was maintained, albeit more moderately, three months later. Given the burgeoning demand on mental health services, it is notable that five of the six adolescents were discharged from the service following the DBT intervention.Conclusions. The results of this pilot programme suggest that DBT has the potential to improve the symptoms of this at-risk population.

scholarly journals Factors Associated with Mental Health Problems among Malaysian Children: A Large Population-Based Study

Children ◽  
2021 ◽  
Vol 8 (2) ◽  
pp. 119
Author(s):  
Norhafizah Sahril ◽  
Noor Ani Ahmad ◽  
Idayu Badilla Idris ◽  
Rajini Sooryanarayana ◽  
Mohamad Aznuddin Abd Razak
Keyword(s):  
Mental Health ◽  
Formal Education ◽  
Mental Health Problems ◽  
Large Population ◽  
Multiple Logistic Regression Analysis ◽  
Population Based ◽  
Health Problems ◽  
Public Health Issue ◽  
Factors Associated ◽  
Lower Socioeconomic

Mental health problems are a major public health issue, particularly among children. They impair children’s development, academic achievement, and ability to live a productive life. The present study aimed to determine the prevalence and factors associated with mental health problems among children aged 5 to 15 years old in Malaysia. Data from the National Health and Morbidity Survey (NHMS) 2015 were analyzed. A validated Strengths and Difficulties Questionnaire (SDQ) was used. The overall prevalence of mental health problems among children in Malaysia was 11.1%. Multiple logistic regression analysis revealed that for every year increment in age, mental health problems decreased by 5%. Further analysis found that children who had fathers with a non-formal education and worked in the private sector, had parents who were widowed or divorced, and had either parent with mental health problems were more likely to have mental health problems themselves. Children from the lower socioeconomic group and who had either parent with mental health problems had higher odds of having mental health problems in Malaysia.

scholarly journals Understanding Black and Minority Ethnic service user's experience of racism as part of the assessment, formulation and treatment of mental health problems in cognitive behaviour therapy

2019 ◽  
Vol 12 ◽  
Author(s):  
Andrew Beck
Keyword(s):  
Mental Health ◽  
Cognitive Behaviour Therapy ◽  
Mental Health Problems ◽  
Cumulative Risk ◽  
Health Problems ◽  
Service Users ◽  
Behaviour Therapy ◽  
Cognitive Behaviour ◽  
Engagement Process ◽  
Minority Ethnic

AbstractExperiences of racism can be a cumulative risk factor for developing mental health problems. Cognitive Behaviour Therapists working with Black and Minority Ethnic (BME) service users should be confident in their ability to establish the necessary rapport to ask about these experiences and be able to incorporate this information into longitudinal formulations and as part of maintenance cycles. This paper sets out guidelines as to how to do this as part of a wider engagement process.

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