Effects of a modified DBT Skills Group for military personnel and Veterans with OSIs and borderline personality disorder or traits

2021 ◽  
pp. e20190067
Author(s):  
Pamela L. Holens ◽  
Jeremiah N. Buhler ◽  
Stephanie Yacucha ◽  
Alyssa Romaniuk ◽  
Brent Joyal
Keyword(s):  
Mental Health ◽  
Borderline Personality Disorder ◽  
Personality Disorder ◽  
Military Personnel ◽  
Group Treatment ◽  
Stress Disorder ◽  
Borderline Personality ◽  
Behaviour Therapy ◽  
Negative Thoughts ◽  
Skills Group

LAY SUMMARY This study looked at the use of a group treatment known as dialectical behaviour therapy skills group (DBT-SG) to see if it was helpful for military personnel and veterans who had a variety of mental health disorders related to their service. The results of the study showed improvements in symptoms of borderline personality disorder, reductions in negative thoughts and feelings, and reductions in unhelpful behaviours. Results also showed improvements in all examined areas of functioning among participants, with the largest change occurring in the area of social functioning. The presence of posttraumatic stress disorder (PTSD), depression, or chronic pain did not impact results, but the presence of a substance abuse disorder did. Overall, the results provide preliminary support for DBT-SG as an intervention for borderline personality disorder symptoms among military and veterans, and perhaps particularly for persons who also have other mental health challenges, or persons considered inappropriate for other treatment.

scholarly journals Lessons from an Australian community dialectical behaviour therapy programme for borderline personality disorder

2008 ◽  
Vol 5 (1) ◽  
pp. 15-16
Author(s):  
Catherine Thompson
Keyword(s):  
Mental Health ◽  
Borderline Personality Disorder ◽  
Personality Disorder ◽  
Personality Disorders ◽  
Evidence Base ◽  
Borderline Personality ◽  
Behaviour Therapy ◽  
Dialectical Behaviour Therapy ◽  
Australian Community ◽  
The Uk

In 2003, the National Institute for Mental Health in England (NIMHE) published guidelines for the development of services for people with personality disorders (NIMHE, 2003), prompting community mental health teams (CMHTs) to reassess their service provision for this patient group. The guidelines did not recommend any particular treatment approach, but CMHTs were encouraged to develop specialist programmes. For many CMHTs the focus has been on borderline personality disorder, as it is one of the most prevalent personality disorders seen in adult mental health services and has high costs for both the patient and the service (Moran, 2002). The evidence base for which treatment may be most effective within the community remains small, however, and this has left many CMHTs unclear regarding a suitable programme. Here I will outline a CMHT-based dialectical behaviour therapy (DBT) programme operating in Western Australia and reflect on why I feel it is an option that CMHTs in the UK looking to develop their service should consider.

Borderline Personality Programme in a Rural Area: The Value of a Therapy

2017 ◽  
Vol 41 (S1) ◽  
pp. S714-S714
Author(s):  
M. Marin Olalla ◽  
B. Perez Ramirez ◽  
A.M. Vidal Lopez ◽  
B. Martinez Martinez ◽  
R. Maldonado Lozano
Keyword(s):  
Quality Of Life ◽  
Mental Health ◽  
Borderline Personality Disorder ◽  
Personality Disorder ◽  
Functional Organization ◽  
Borderline Personality ◽  
Therapeutic Interventions ◽  
Therapeutic Group ◽  
Behaviour Therapy

IntroductionAn increased incidence of personality disorders (TP) in general, and borderline personality (BP) is currently a significant health problem because of the complexity of the clinic, the difficulty for early diagnosis, often unsatisfactory response to available treatments and the lack of clear proposals on multidisciplinary therapeutic interventions. In more serious cases, people with TP generate a high level of self and family suffering, as well as a high care burden that does not have a proportional impact on the quality of life of those affected and their families.AimEstablish a stable functional organization of professional and organizational resources of the Mental Health Unit of the North of Almeria that ensuring comprehensive care for people with borderline personality disorder and their families.MethodsThe program was structured:– elemental: BP census, individual sessions with optional nurse reference;– advanced individual: BP census, individual sessions, Nurse reference;– advanced individual and group: BP census, Individual sessions, Nurse reference and Therapeutic Group Hospital Mental Health Day weekly applying dialectical behaviour therapy.ResultsThe census of patients with borderline personality disorder was established in 30 people, 20 of them participating in two editions of therapeutic group. Fifty weekly sessions were carried out continuously, except holiday periods. A multidisciplinary team (nurse and two psychiatrists) were involved. The results indicate that there was an improvement in the quality of life of patients. It had been reduced hospitalisations, emergency assistance, and more than 60% of them got a job after that.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Dialectical behaviour therapy in an Irish community mental health setting

2009 ◽  
Vol 26 (2) ◽  
pp. 59-63 ◽  
Author(s):  
Richard Blennerhassett ◽  
Lindsay Bamford ◽  
Anthony Whelan ◽  
Sarah Jamieson ◽  
Jennifer Wilson O'Raghaillaigh
Keyword(s):  
Mental Health ◽  
Borderline Personality Disorder ◽  
Personality Disorder ◽  
Community Mental Health ◽  
Borderline Personality ◽  
Positive Symptom ◽  
Mental Health Setting ◽  
Behaviour Therapy ◽  
Post Intervention ◽  
Dialectical Behaviour Therapy

AbstractObjectives:Dialectical behaviour therapy (DBT) is a recommended treatment of patients with borderline personality disorder, yet there are few descriptions of the approach in public community mental health settings where the majority of such patients present. This study describes the development and evaluation of a DBT programme in an Irish setting.Methods:The DBT programme was run over a six month period. Participants were assessed at baseline and post intervention with the following instruments: The Structured Clinical Interview for DSM III R personality disorders (SCID II), the clinical Outcomes in Routine Evaluation (CORE) and the symptom checklist 90 Revised (SCL-90-Revised). Inpatient bed usage was determined from case note review.Results:Outcome data was available for eight subjects. Significant improvement (p < 0.005) was seen on all CORE subscales. SCL-90-R showed significant improvement (p < 0.05) on the global severity index and on the positive symptom distress index. A decrease in self harming behaviour was found. Subjects' inpatient bed days dropped from a mean of 58 in the year pre intervention to a mean of four days in the year post intervention. A novel finding was that 43% of subjects who originally fulfilled criteria for avoidant personality disorder no longer did so post intervention.Conclusions:The study found that DBT can be applied in a community mental health setting with benefits similar to more specialist settings. Significant difficulties were encountered in implementing the programme. The clinical implications are that specialist psychotherapy services need to be an integral part of psychiatric services to achieve better outcomes for patients with borderline personality disorder.

scholarly journals Assessing the efficacy of a stepped-care group treatment programme for borderline personality disorder: study protocol for a pragmatic trial

Trials ◽  
2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Judy A. Pickard ◽  
Adam Finch ◽  
Elizabeth Huxley ◽  
Michelle L. Townsend ◽  
Stephanie Deuchar ◽  
...  
Keyword(s):  
Mental Health ◽  
Borderline Personality Disorder ◽  
Personality Disorder ◽  
Community Mental Health ◽  
Health Services ◽  
Group Treatment ◽  
Pragmatic Trial ◽  
Borderline Personality ◽  
Stepped Care ◽  
Care Group

Abstract Background Borderline personality disorder (BPD) is a high prevalence and serious mental health disorder that has historically challenged the finite resources of health services. Despite empirical evidence supporting structured psychological therapy as the first line of treatment, there remains significant barriers in providing timely access to evidence-based treatment for this population. The primary aim of this study is to evaluate the effectiveness of providing a stepped-care structured psychological group treatment to individuals with BPD within local mental health services. The secondary aims of the study are to identify the variables that predict the need to step up or down in care and the effectiveness of treatment on psychosocial functioning. Methods Participants seeking treatment at two community mental health services will be invited to participate. Randomised controlled trial assignment will be to either (i) group skills treatment or (ii) treatment as usual. Group treatment will be offered via a stepped-care pathway with participants initially attending a 12-week group with the option of a subsequent 16-week group. The criteria for inclusion in continuing treatment includes meeting > 4 BPD diagnostic criteria or severity on GAF (< 65) at the completion of the 12-week group. Data will be collected at baseline and at five follow-up time points over a 12-month period. Discussion This pragmatic trial will provide valuable information regarding the effectiveness of a progressive stepped-care group treatment for individuals with BPD in the real-world setting of a community mental health service. It will further the current understanding of variables that predict treatment dose and duration. Trial registration Australian New Zealand Clinical Trials Registry ACTRN12618000477224. Registered on 3 April 2018

Primary care and suicidality among psychiatric outpatients: The patient-doctor relationship matters

2020 ◽  
pp. 009121742097799
Author(s):  
Krista Schultz ◽  
Sharan Sandhu ◽  
David Kealy
Keyword(s):  
Mental Health ◽  
Primary Care ◽  
Borderline Personality Disorder ◽  
Personality Disorder ◽  
Primary Care Physician ◽  
Population Based ◽  
Borderline Personality ◽  
Care Physician ◽  
Cross Sectional

Objective The purpose of the current study is to examine the relationship between the quality of the Patient-Doctor Relationship and suicidality among patients seeking mental health care; specifically, whether patients who perceive having a more positive relationship with primary care physician will have lower levels of suicidality. Method Cross-sectional population-based study in Greater Vancouver, Canada. One-hundred ninety-seven participants were recruited from three Mental Health Clinics who reported having a primary care physician. Participants completed a survey containing questions regarding items assessing quality of Patient-Doctor Relationship, general psychiatric distress (K10), borderline personality disorder, and suicidality (Suicidal Behaviours Questionnaire-Revised-SBQ-R). Zero-order correlations were computed to evaluate relationships between study variables. Hierarchical regression analysis was used to control for confounding variables. Results The quality of the patient doctor relationship was significantly negatively associated with suicidality. The association between the quality of the patient-doctor relationship and suicidality remained significant even after controlling for the effects of psychiatric symptom distress and borderline personality disorder features. Conclusions The degree to which patients’ perceive their primary care physician as understanding, reliable, and dedicated, is associated with a reduction in suicidal behaviors. Further research is needed to better explicate the mechanisms of this relationship over time.

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