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.

Effectiveness of a 10-week group program based on Dialectical Behaviour Therapy skills among patients with personality and mood disorders: findings from a pilot study

2017 ◽  
Vol 25 (5) ◽  
pp. 466-470 ◽  
Author(s):  
Agatha M Conrad ◽  
Anoop Sankaranarayanan ◽  
Terry J Lewin ◽  
Anna Dunbar
Keyword(s):  
Mental Health ◽  
Mental Health Service ◽  
Mental Health Services ◽  
Community Mental Health ◽  
Health Service ◽  
Health Services ◽  
Community Mental Health Service ◽  
Behaviour Therapy ◽  
Dialectical Behaviour Therapy ◽  
The Impact

Objectives: Community mental health services are often required to manage people experiencing repeated crises. Personality disorders are not uncommon, accounting for up to one-third of such presentations. These patients are often difficult to treat, leading to a revolving-door phenomenon. This study evaluated the effectiveness of a pilot intervention in reducing psychological symptoms and distress, and examined the impact of the intervention on mental health service utilization. Methods: A pre- versus post-treatment evaluation was conducted of the effectiveness of a 10-week group psychological intervention based on Dialectical Behaviour Therapy skills, conducted in a regional Australian community mental health service with patients diagnosed with either Cluster B personality disorder or a mood disorder. Results: Of those who completed the program ( N = 38 patients), 84% were female, with an average age of 35.13 years. Participants were active clients of the service for an average of 58.3 weeks prior to the program. They demonstrated significant improvements in quality of life and self-control, and a reduction in hopelessness, cognitive instability and dependence on mental health services. Conclusions: Limiting the Dialectical Behaviour Therapy program to a short-term skills-based group component was successful with the targeted patient group; however, more research is required to establish the generalizability of these results.

The impact of an expanding community mental health service on patterns of bed usage: evaluation of a four-year period of implementation

1982 ◽  
Vol 12 (1) ◽  
pp. 177-190 ◽  
Author(s):  
H. Häfner ◽  
J. Klug
Keyword(s):  
Mental Health ◽  
Mental Health Service ◽  
Community Mental Health ◽  
Health Service ◽  
International Standards ◽  
Community Mental Health Service ◽  
Case Register ◽  
National Differences ◽  
The Impact

SynopsisIn the city of Mannheim the introduction of an extensive community mental health service has been shown, by means of case-register data over 4½ years, to have led to a considerable increase in utilization, mainly at the out-patient level of care. The rates of admission to hospital increased very little. Due to the simultaneous decline in long-term bed occupancy, the overall need for psychiatric beds remained stable at a rate of about 1·2/1000, a rate which is very low by international standards.The sharp decline in the ‘old’ long-stay population was followed by a smaller increase in ‘new’ long-stay patients which it has not been possible to prevent. These patients are, however, admitted for a long-term stay significantly later than formerly, and their diagnostic composition has changed significantly.The increase in the bed requirements for short- and medium-term stay patients resulted from different sources: an increasing morbidity in some groups of disorders, the rising utilization in case of emergencies and severe crises, and the transfer of long-stay patients to alternative care services. The level of these needs was very similar in Mannheim, Salford, Samsø and Camberwell, whereas the rates for long-term beds still show clear national differences.

scholarly journals Achieving evidence-based prescribing practice in an adult community mental health service

2006 ◽  
Vol 30 (2) ◽  
pp. 51-55 ◽  
Author(s):  
Maria Moran ◽  
Bangaru Raju ◽  
Jean Saunders ◽  
David Meagher
Keyword(s):  
Mental Health ◽  
Mental Health Service ◽  
Community Mental Health ◽  
Health Service ◽  
Evidence Based ◽  
Community Mental Health Service ◽  
Prescribing Practice ◽  
Evidence Based Guidelines ◽  
The Impact

Aims and MethodPrescribing in everyday practice frequently deviates from evidence-based guidelines. Previous work compared practice in a community mental health service with evidence-based guidelines and identified factors related to suboptimal prescribing. This study reports the impact of a multifaceted intervention on prescribing practice. A Prescribing Practice Quality (PPQ) score was generated from six key aspects of prescribing at initial assessment and again 1 year later after an intervention to reduce suboptimal prescribing practices.ResultsA total of 264 patients were attending the service at both the initial and follow-up phase and were thus exposed to the prescribing intervention. In this population, PPQ scores were significantly lower at follow-up (0.96v.0.67,P<0.001). Improved prescribing practice was predicted by receipt of adjunctive supportive inputs, such as anxiety management (P=0.003).Similarly, mean PPQ scores substantially decreased when the total patient population was considered at each time point (0.75 in 2001 and 0.52 in 2002). These results suggest a reduction in both the initiation and continuation of suboptimal practices.Clinical ImplicationsPrescribing in real-world settings can be improved by interventions that target multiple aspects of service activity. The provision of supportive inputs is a key factor in improving practice.

scholarly journals Organisational Implementation Climate in implementing internet-based Cognitive Behaviour Therapy for depression

2020 ◽  
Author(s):  
Christiaan Vis ◽  
Annet Kleiboer ◽  
Mayke Mol ◽  
Claus Duedal Pedersen ◽  
Tracy Finch ◽  
...  
Keyword(s):  
Mental Health ◽  
Mental Health Service ◽  
Health Service ◽  
Cognitive Behaviour Therapy ◽  
Routine Care ◽  
Behaviour Therapy ◽  
Implementation Climate ◽  
System Usability Scale ◽  
Cognitive Behaviour ◽  
The Impact

Abstract Background. In the MasterMind project, Internet-based Cognitive Behaviour Therapy (iCBT) services for depression have been implemented in routine care in 14 European regions. This study aimed to advance understanding of the nature and value of organisational implementation climate in implementing iCBT services from the perspectives of implementers and service deliverers.Methods. A mixed method approach was applied. Based on principles of concept mapping, a structured workshop with implementers was conducted to qualitatively conceptualise organisational implementation climate conducive to optimizing iCBT use in routine practice. Mental health service delivers involved in the provision or referral of patients to the implemented iCBT services were invited to participate in a cross-sectional survey assessing levels of satisfaction and usability of iCBT, and organisational implementation climate. Associations between satisfaction, usability and implementation climate were explored.Results. 16 implementers representing 14 service delivery organisations participated in the workshop. The top-3 characteristics of a strong organisational implementation climate included: (1) clear roles and skills of implementers, (2) feasible implementation targets, and (3) a dedicated implementation team. The top-3 tools for creating an implementation climate included: (1) job performance feedback, (2) progress monitoring in relation to achieving implementation targets, and (3) guidelines for assessing the impact of iCBT. In total 111 respondents (73% female) completed the survey. Mental health service deliverers were generally satisfied delivering iCBT services (MCSQ = 9.11, SD = 1.96, range = 3-15, n = 108) and found their usability slightly below average (MSUS = 63.76, SD = 15.53, range = 0-100, n = 103). They regarded their organisational implementation climate as supportive in implementing iCBT services (MICS = 43.21, SD = 5.62, range = 12-60, n = 89). Organisational implementation climate was weakly associated with the system usability scale (r = 0.25, p =.03) and moderately with the satisfaction scale (r = .51, p £ .00).Conclusions. Organisational implementation climate as part of the wider organisational context in which implementation processes take place, is a relevant factor to implementers and service deliverers in implementing iCBT in routine care. The qualitative conceptual findings align with the quantitative approach applied in this study for measuring organisational implementation climate. Implementers can use various practical tools to shape organisational implementation climate to increase acceptance and subsequently improve implementation of iCBT in mental health care.

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 &lt; .0001). Improvements in emotion regulation yielded a small-to-moderate effect (g = 0.48, 95% CI [0.22, 0.74], p &lt; .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.

School Settings

2018 ◽  
Author(s):  
Melissa K. Holt ◽  
Jennifer Greif Green ◽  
Javier Guzman
Keyword(s):  
Mental Health ◽  
Mental Health Service ◽  
Mental Health Services ◽  
Health Service ◽  
Health Services ◽  
Service Provision ◽  
Community Mental Health Service ◽  
Health Service Provision ◽  
School Settings ◽  
Mental Health Service Provision

Schools are a primary setting for mental health service provision to youth and are also main sources of referral to community mental health service providers. This chapter examines the school context and its key role in the child and adolescent mental health services system. The chapter first provides information about the association of emotional and behavioral disorders with school experiences, including academic performance. Next, the chapter presents a framework for mental health service provision and assessment in schools, including describing methods for identifying students who might need mental health services and tracking their progress. Further, several evidence-based interventions are highlighted as examples of effective practices in schools. The chapter concludes with recommendations for clinical practice in school settings.

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