Dialectical Behaviour Therapy in Routine Clinical Settings

2018 ◽  
pp. 466-496
Author(s):  
Carla Walton ◽  
Katherine Anne Comtois
Keyword(s):  
Psychiatric Symptoms ◽  
Skills Training ◽  
Routine Care ◽  
Clinical Settings ◽  
Behaviour Therapy ◽  
Dialectical Behaviour Therapy ◽  
Training And Supervision ◽  
The Us ◽  
Fidelity Monitoring

Dialectical Behaviour Therapy (DBT) has been researched in routine clinical settings in Europe, the US, and Australasia. This chapter reports on those studies, five evaluated outcomes over 12 months of intervention, and eight studies over five or six months. The majority of studies showed a significant reduction in self-injurious behaviour, but significant differences were found in secondary outcomes of depression, quality of life, psychiatric hospital admission days, and general psychiatric symptoms. Adaptations of DBT in routine care settings included briefer phone coaching time, reduced length of skills training, individual skills training, and skills training only. Two studies evaluated an intervention following completion of standard DBT. Overall, the studies reported showed a large difference in the amount of training and supervision received by clinicians and fidelity monitoring was included in only four studies. In addition to quantitative outcomes, this chapter reports on qualitative research describing the experience of DBT participants.

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.

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.

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.

Family skills training in dialectical behaviour therapy: The experience of the significant others

2016 ◽  
Vol 33 (S1) ◽  
pp. S210-S210
Author(s):  
S. Ekdahl ◽  
E. Idvall ◽  
K.I. Perseius
Keyword(s):  
Depressive Symptoms ◽  
Qualitative Content Analysis ◽  
Skills Training ◽  
Significant Others ◽  
Anxiety And Depression ◽  
Free Text ◽  
Behaviour Therapy ◽  
Dialectical Behaviour Therapy ◽  
Psychiatric Staff ◽  
Family Skills Training

IntroductionBorderline personality disorder (BPD) is a severe psychiatric health problem with reputation of being difficult to deal with and to treat. Significant others (SOs) of patients with BPD show higher levels of psychological distress compared with the general population. Strengthening the coping strategies of SOs plays an important role in the recovery of the patient. Support and education for SOs is important, both for SOs themselves and for the patients recovery.ObjectivesResearch around support and education for SOs is of great importance not only for SOs and patients, but also for psychiatric staff, in order to offer help and support, for the whole family.AimThe aim was to describe significant others’ experiences of dialectical behaviour therapy-family skills training (DBT-FST), their life situation before and after DBT-FST, and measurement of their levels of anxiety and depressive symptoms.MethodsThe study had a descriptive mixed method design. Data were collected with free text questionnaires (n = 44), group interviews (n = 53) and the HAD scale (n = 52) and analysed by qualitative content analysis and descriptive and inferential statistics.ResultsThe results show that life before DBT-FST was a struggle. DBT-FST gave hope for the future and provided strategies, helpful in daily life. For the subgroup without symptoms of anxiety and depression before DBT-FST, anxiety increased significantly. For the subgroup with symptoms of anxiety and depression the symptoms decreased significantly. This indicates, despite increased anxiety for one group, that DBT-FST is a beneficial intervention and most beneficial for those with the highest anxiety and depressive symptoms.Disclosure of interestThe authors have not supplied their declaration of competing interest.

scholarly journals SP2.1.14Remote examination of surgical skills is feasible and desirable during COVID crisis and beyond

2021 ◽  
Vol 108 (Supplement_7) ◽  
Author(s):  
Stephen Marsh ◽  
Caroline Bruce ◽  
Alexander Blackmore ◽  
Petre Ichim ◽  
Ajay Sharma ◽  
...  
Keyword(s):  
Skills Training ◽  
Surgical Skills ◽  
Internet Technology ◽  
Laparoscopic Skills ◽  
Face To Face ◽  
Remote Supervision ◽  
Laparoscopic Skills Training ◽  
Training And Supervision ◽  
Remote Training

Abstract Aims We aimed to investigate the feasibility of employing Zoom technology to undertake structured remote examination of surgical skill during the COVID-19 crisis and beyond as a mean to complement remote training and supervision of basic laparoscopic skills. Methods We have adapted a previously reported method of remote training and supervision of laparoscopic skills training successfully used with 7 trainees. Five consultant surgeons with established expertise in surgical education participated in remote mock examination of LapPass skills using Zoom technology. We assessed the feasibility of remote examination by assessing image quality on Maryland visual comfort scale and undertook a trainers’ survey using a 5 point Lembert scale. Result The remote examiners recorded excellent quality of views, identical in clarity and detail to the source images. Conclusions We demonstrated the feasibility and the benefit of using modern internet technology in delivering a flexible approach to examination of surgical skills met with strong satisfaction by established trainers and trainees alike. All trainers supported the idea of introduction of remote examination as beneficial for all stakeholders and ready to replace face-to-face examination in specific settings. The surgical community should embrace, on a larger scale, the concept of remote supervision and examination whenever possible.

The Oxford Handbook of Dialectical Behaviour Therapy

2017 ◽  
Keyword(s):  
College Counseling ◽  
Clinical Settings ◽  
Post Traumatic Stress ◽  
Behaviour Therapy ◽  
Future Directions ◽  
Dialectical Behaviour Therapy ◽  
Biosocial Theory ◽  
Post Traumatic ◽  
International Systems ◽  
College Counseling Centers

This handbook examines theoretical, structural, clinical and implementation aspects of dialectical behaviour therapy (DBT) for a variety of disorders such as borderline personality disorder (BPD), suicidal behaviour in the context of BPD, substance use disorders, cognitive disabilities, eating disorders, and post-traumatic stress disorder (PTSD). The volume considers the dialectical dilemmas of implementation with respect to DBT in both national and international systems, its adaptations in routine clinical settings, and its behavioural foundations. It also discusses evidence-based training in DBT, validation principles and practices in DBT, the biosocial theory of BPD, the structure of DBT programs, and the efficacy of DBT in college counseling centers. Finally, the book reflects on the achievements of DBT since the first treatment trial and considers challenges and future directions for DBT in terms of its theoretical underpinnings, clinical outcomes, adaptations and implementation in practice.

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