scholarly journals Implementation of brief dialectical behavior therapy skills training among borderline personality disorder patients in Malaysia: feasibility, acceptability, and preliminary outcomes

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Shian-Ling Keng ◽  
Hajar Binti Mohd Salleh Sahimi ◽  
Lai Fong Chan ◽  
Luke Woon ◽  
Choon Leng Eu ◽  
...  
Keyword(s):  
Clinical Outcomes ◽  
Dialectical Behavior Therapy ◽  
Skills Training ◽  
Well Being ◽  
Borderline Personality ◽  
Post Intervention ◽  
Self Compassion ◽  
Skills Group ◽  
Self Harm ◽  
Muslim Majority

Abstract Aim/background Even though dialectical behavior therapy (DBT) has received substantial empirical support in treating patients with borderline personality disorder (BPD), fewer studies have evaluated whether a brief DBT skills group may be effective in improving clinical outcomes in this population. Further, less is known regarding the feasibility and outcomes of DBT beyond Euro-American contexts. This paper describes outcomes from a pilot study examining the feasibility, acceptability, and clinical outcomes following completion of a shortened, 14-week DBT skills group in a sample of Muslim-majority BPD patients in Malaysia. Methods Twenty patients were recruited from a public hospital and attended DBT skills groups in an outpatient clinic. Participants completed measures assessing psychological symptoms, self-harm behaviors, suicidal ideation, emotion regulation difficulties, self-compassion, and well-being pre- and post-intervention. Results There were significant reductions in depressive symptoms, stress, and emotion regulation difficulties, as well as increases in self-compassion and well-being from pre- to post-intervention. A trend was found for decreases in frequency and types of non-suicidal self-harm behaviors, suicidal ideation, and anxiety symptoms. Qualitative content analyses of participants’ feedback indicated that the vast majority of participants perceived a positive impact from the skills group, with mindfulness and distress tolerance being rated frequently as skills that were beneficial. Conclusion These preliminary findings suggest that DBT skills training is feasible and acceptable in a Muslim-majority, low resource clinical setting, and holds promise in improving clinical outcomes among BPD patients in Malaysia.

Predictors of Dropout From a 20-Week Dialectical Behavior Therapy Skills Group for Suicidal Behaviors and Borderline Personality Disorder

2020 ◽  
Vol 34 (2) ◽  
pp. 216-230 ◽  
Author(s):  
Natalie Stratton ◽  
Mariana Mendoza Alvarez ◽  
Cathy Labrish ◽  
Ryan Barnhart ◽  
Shelley McMain
Keyword(s):  
Borderline Personality Disorder ◽  
Personality Disorder ◽  
Behavior Therapy ◽  
Dialectical Behavior Therapy ◽  
Training Group ◽  
Skills Training ◽  
Borderline Personality ◽  
Post Intervention ◽  
Skills Training Group ◽  
Post Hoc

Treatment dropout among individuals with borderline personality disorder (BPD) is associated with negative psychosocial outcomes. Identifying predictors of dropout among this population is critical to understanding how to improve treatment retention. The present study extends the current literature by examining both static and dynamic predictors of dropout. Chronically suicidal outpatients diagnosed with BPD (N = 42) were randomly assigned to a 20-week dialectical behavior therapy (DBT) skills training group. Static and dynamic predictors were assessed at baseline, 5, 10, 15, 20 weeks, and 3 months post-intervention. A post-hoc two-stage logistic regression analysis was conducted to predict dropout propensity. Receiving disability benefits at baseline and decreases in mindfulness were associated with significantly increased probability of dropout. Clinicians working with chronically self-harming outpatients diagnosed with BPD would benefit from prioritizing clinical interventions that enhance mindfulness in order to decrease dropout propensity.

scholarly journals WHO Parents Skills Training (PST) programme for children with developmental disorders and delays delivered by Family Volunteers in rural Pakistan: study protocol for effectiveness implementation hybrid cluster randomized controlled trial

2017 ◽  
Vol 4 ◽  
Author(s):  
S. U. Hamdani ◽  
P. Akhtar ◽  
Zill-e-Huma ◽  
H. Nazir ◽  
F. A. Minhas ◽  
...  
Keyword(s):  
Mental Health ◽  
Developmental Disorders ◽  
Controlled Trial ◽  
Public Mental Health ◽  
Skills Training ◽  
Well Being ◽  
Evidence Based ◽  
Post Intervention ◽  
Hybrid Cluster ◽  
Rural Pakistan

Background.Development disorders and delays are recognised as a public health priority and included in the WHO mental health gap action programme (mhGAP). Parents Skills Training (PST) is recommended as a key intervention for such conditions under the WHO mhGAP intervention guide. However, sustainable and scalable delivery of such evidence based interventions remains a challenge. This study aims to evaluate the effectiveness and scaled-up implementation of locally adapted WHO PST programme delivered by family volunteers in rural Pakistan.Methods.The study is a two arm single-blind effectiveness implementation-hybrid cluster randomised controlled trial. WHO PST programme will be delivered by ‘family volunteers’ to the caregivers of children with developmental disorders and delays in community-based settings. The intervention consists of the WHO PST along with the WHO mhGAP intervention for developmental disorders adapted for delivery using the android application on a tablet device. A total of 540 parent-child dyads will be recruited from 30 clusters. The primary outcome is child's functioning, measured by WHO Disability Assessment Schedule – child version (WHODAS-Child) at 6 months post intervention. Secondary outcomes include children's social communication and joint engagement with their caregiver, social emotional well-being, parental health related quality of life, family empowerment and stigmatizing experiences. Mixed method will be used to collect data on implementation outcomes. Trial has been retrospectively registered at ClinicalTrials.gov (NCT02792894).Discussion.This study addresses implementation challenges in the real world by incorporating evidence-based intervention strategies with social, technological and business innovations. If proven effective, the study will contribute to scaled-up implementation of evidence-based packages for public mental health in low resource settings.Trial registration.Registered with ClinicalTrials.gov as Family Networks (FaNs) for Children with Developmental Disorders and Delays. Identifier: NCT02792894 Registered on 6 July 2016.

Differential Change of Borderline Personality Disorder Traits During Dialectical Behavior Therapy for Adolescents

2019 ◽  
Vol 33 (1) ◽  
pp. 119-134 ◽  
Author(s):  
Arne Buerger ◽  
Gloria Fischer-Waldschmidt ◽  
Florian Hammerle ◽  
Kristin von Auer ◽  
Peter Parzer ◽  
...  
Keyword(s):  
Borderline Personality Disorder ◽  
Personality Disorder ◽  
Behavior Therapy ◽  
Dialectical Behavior Therapy ◽  
Suicide Attempts ◽  
Treatment Options ◽  
Skills Training ◽  
Borderline Personality ◽  
Secondary Outcomes ◽  
The Impact

Despite the expansion of treatment options for adults with borderline personality disorder (BPD), research on treatment options for adolescent BPD is scarce. The aim of this study was to investigate the impact of dialectical behavior therapy for adolescents (DBT-A) on the individual trait level as primary outcome; and the frequency of suicide attempts and nonsuicidal self-injury, self-reported BPD core pathology, and general psychopathology as secondary outcomes. Seventy-two adolescents (aged 12–17 years) with full- or subsyndromal BPD were treated with DBT-A (25 single sessions, 20 sessions of skills training), and 13 patients (18.1%) withdrew during treatment. From baseline to post-treatment, the number of BPD traits decreased significantly (p ≤ .001). All secondary outcomes decreased significantly as well (p ≤ .001). Results of this uncontrolled study suggest that beside self-harm, DBT-A may also have a beneficial impact on other features of BPD.

Part 2: Borderline Personality Disorder and Its Clinical Management

2017 ◽  
Author(s):  
Robert Biskin ◽  
Joel Paris
Keyword(s):  
Borderline Personality Disorder ◽  
Personality Disorder ◽  
Behavior Therapy ◽  
Dialectical Behavior Therapy ◽  
Service Use ◽  
Age Groups ◽  
Borderline Personality ◽  
Stepped Care ◽  
Care Models ◽  
Self Harm

The treatment of patients with borderline personality disorder (BPD) has changed significantly over the past 25 years. The previous therapeutic pessimism about BPD treatment outcomes has become more optimistic with the development of a variety of specialized psychotherapies that have been shown to reduce self-harm, suicidality, and health service use as well as improve overall psychopathology. Dialectical behavior therapy was the first evidence-supported treatment, but it has been joined by mentalization-based psychotherapy and a variety of other treatments. Several common factors, including structured treatment approach, are likely important in the effectiveness of these treatments compared with unstructured comparators. Pharmacotherapy serves a more limited role in the treatment of BPD due to many methodological issues in the research and a lack of replication of studies. Judicious and rational use of pharmacotherapy is discussed, as well as suggestions for improving accessibility to specialized psychotherapies through the development of stepped care models. Improving access to care for patients with BPD, throughout all age groups, remains an important next step. This review contains 2 figures, 1 table, and 47 references. Key words: borderline personality disorder, dialectical behavior therapy, mentalization-based treatment, personality disorder, pharmacotherapy, psychotherapy, self-harm

Exploring Undergraduate Nursing Students’ Experiences of Engaging With a Dialectical Behavior Therapy-Skills Group Intervention: Findings of a Thematic Analysis

2020 ◽  
pp. 084456211989648 ◽  
Author(s):  
Heather Beanlands ◽  
Elizabeth McCay ◽  
Angel Wang ◽  
Andria Aiello ◽  
Jasna Schwind ◽  
...  
Keyword(s):  
Nursing Students ◽  
Behavior Therapy ◽  
Dialectical Behavior Therapy ◽  
Thematic Analysis ◽  
Self Care ◽  
Well Being ◽  
Negative Consequences ◽  
Undergraduate Nursing Students ◽  
Undergraduate Nursing ◽  
Skills Group

Study Background Nursing students often have high levels of stress leading to negative consequences for academic performance and overall well-being. Novel strategies are needed to help students manage stress. Purpose To explore students’ experiences with an evidence-based intervention—Dialectical Behavior Therapy-Skills Group (DBT-SG). Methods We conducted a mixed-methods study to pilot test a DBT-SG intervention, modified for use with undergraduate nursing students. Qualitative data collected as part of this study included focus groups and written responses on a study questionnaire. Thematic analysis of these data was undertaken to explore how students experienced the intervention. The results of this analysis are reported here. Results Five themes were uncovered: experiencing stress and de-stressing, feeling accepted and validated, acquiring skills, shifting perspectives, and enhanced well-being. Conclusions Our findings suggest that by engaging with DBT-SG, nursing students felt accepted and validated, acquired a variety of skills to cope with stress, as well as developed new perspectives, such as the value of practicing self-care, which contributed to enhanced well-being. Future research could build on these results by further exploring how to best create accepting and validating learning environments where students are encouraged to develop interpersonal relationship skills and enact self-care to further support their well-being and professional development.

scholarly journals Delineating the unique contributions of mindfulness skills in predicting engagement in suicide attempts and non-suicidal self-injury among individuals with borderline personality disorder

2021 ◽  
Author(s):  
Lillian Krantz
Keyword(s):  
Borderline Personality Disorder ◽  
Personality Disorder ◽  
Dialectical Behavior Therapy ◽  
Suicide Attempts ◽  
Skills Training ◽  
Borderline Personality ◽  
Control Group ◽  
Treatment Change ◽  
Mindfulness Skills ◽  
Self Injury

The current research tested whether four dimensions of mindfulness – acceptance without judgment, observing, describing and acting with awareness – taught during 20 weeks of dialectical behavior therapy skills training (DBT-ST) predicted frequency of two forms of self-inflicted injury (SII), i.e. suicide attempts (SAs) and non-suicidal self-injury (NSSI), at baseline and mediated the relationship between pre-post treatment change in frequency of SAs/NSSI and DBT-ST. Eighty-four suicidal individuals with borderline personality disorder were enrolled in a single-blinded randomized trial comparing DBT-ST treatment to a waitlist control group. A series of regressions revealed no relationship between dimensions of mindfulness and self-inflicted injury at baseline. Although no significant effect of DBT-ST on SAs was found, a causal mediation analysis revealed acceptance without judgment significantly mediated the relation between DBT-ST and change in frequency of NSSI.

Pilot study of a well-being app to support New Zealand young people during the COVID-19 pandemic (Preprint)

2021 ◽  
Author(s):  
Anna Serlachius ◽  
Anna Boggiss ◽  
David Lim ◽  
Kiralee Schache ◽  
Kate Wallace-Boyd ◽  
...  
Keyword(s):  
New Zealand ◽  
Young People ◽  
Repeated Measures ◽  
Controlled Trial ◽  
Well Being ◽  
Post Intervention ◽  
Factors Affecting ◽  
Self Compassion ◽  
Qualitative Feedback ◽  
The Look

BACKGROUND Well-being apps represent a promising and scalable approach for improving mental health outcomes in youth, especially during a global pandemic when access to face-to-face interventions may be limited. Whitu (seven in the New Zealand Māori language Te Reo) is a newly developed well-being app with seven modules that support young people to learn and practice evidence-based coping skills, including relaxation, mindfulness, self-compassion, healthy eating, and goal-setting. OBJECTIVE During this pilot, we explored the acceptability, usability, and preliminary efficacy of Whitu before refining the app for a randomized controlled trial (RCT). METHODS We recruited 20 New Zealand young people aged 16-25 years via social media to trial the first prototype of the Whitu app over 6 weeks. Within-group differences from baseline to 2- and 6-weeks post intervention in self-reported well-being, depression, anxiety, stress, self-compassion, and optimism were evaluated using repeated-measures ANOVA. A further 21 participants aged 16-30 years were recruited to participate in 4 focus groups to give feedback on the app’s usability and cultural acceptability. Feedback was analyzed using directed content analysis. RESULTS Statistically significant improvements in anxiety (p=.024) and stress (p=.017) were observed from baseline to 2-weeks post intervention. Improvements in well-being (p=.021), depression (p=.031), anxiety (p=.005), and stress (p=.004) were also observed from baseline to 6-weeks. No statistically significant changes were seen in self-compassion, optimism, or sleep. Qualitative feedback comprised of five key themes, namely: factors affecting engagement, issues with functionality, preferences regarding aesthetics, effectiveness and adverse effects, and cultural acceptability. CONCLUSIONS Our preliminary results suggest that Whitu may be an effective app for improving multiple dimensions of young people’s well-being. Modifications to the look and feel, cultural content, and onboarding have been undertaken based on the qualitative feedback, and an RCT is currently underway.

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