Academic literature on the topic 'Dialectical behaviour therapy'

Purpose Dialectical behaviour therapy (DBT) aims to reduce emotional dysregulation and engagement in less adaptive behaviours for adults with mixed disorders of conduct and emotions (MDCE). However, there is limited evidence available for the effectiveness of DBT skills training for adolescents with MDCE who are resident within a secure impatient setting. The paper aims to discuss these issues. Design/methodology/approach A retrospective study investigated changes in aggressive and self-injurious behaviours in 22 adolescents within a secure inpatient mental health setting with MDCE who had completed one cycle of DBT skills training. Changes in symptomatic problems, behavioural and social impairment were also investigated in 17 of the 22 participants who completed the DBT skills training cycle. Findings There were statistically significant decreases in the frequencies of engagement in total aggressive and deliberate self-harm behaviours after the DBT skills training cycle. There was a significant improvement in symptomatic and behavioural impairment, but not in social impairment. Practical implications The findings of this study suggest that DBT skills training may be beneficial for behavioural and symptomatic outcomes in adolescent inpatients with MDCE. Originality/value This study provides preliminary evidence for the effectiveness of DBT skills training for adolescents with MDCE within a secure inpatient setting. Additional studies are required to investigate the clinical benefits of specific aspects of DBT for individual patients.

Aims and MethodDialectical behaviour therapy is an evidence-based treatment for people with borderline personality disorder. We describe implementation and outcomes of a new service.ResultsHospital use and frequency of self-harm were reduced dramatically with dialectical behaviour therapy. Moreover, the therapy can be implemented successfully in a relatively short time at modest costs.Clinical ImplicationsDialectical behaviour therapy provides a useful model of treatment for people with borderline personality disorder and/or self-harm in community mental health settings.

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.

BackgroundDialectical behaviour therapy (DBT) is widely considered to be a promising treatment for borderline personality disorder (BPD). However, the evidence for its efficacy published thus far should be regarded as preliminary.AimsTo compare the effectiveness of DBT with treatment as usual for patients with BPD and to examine the impact of baseline severity on effectiveness.MethodFifty-eight women with BPD were randomly assigned to either 12 months of DBT or usual treatment in a randomised controlled study. Participants were recruited through clinical referrals from both addiction treatment and psychiatric services. Outcome measures included treatment retention and the course of suicidal, self-mutilating and self-damaging impulsive behaviours.ResultsDialectical behaviour therapy resulted in better retention rates and greater reductions of self-mutilating and self-damaging impulsive behaviours compared with usual treatment, especially among those with a history of frequent self-mutilation.ConclusionsDialectical behaviour therapy is superior to usual treatment in reducing high-risk behaviours in patients with BPD.

AbstractImplementing change in organizational systems is challenging, and implementing a new psychotherapeutic approach is no different. A literature exists on issues in implementation across a wide range of domains (technological, healthcare, justice). However, little of it is utilized in endeavours to implement innovations in psychological treatments. This paper draws on the implementation literature and on the experiences of the British Isles DBT Training Team (BIDBT) in implementing Dialectical Behaviour Therapy (DBT) in mental healthcare systems in the UK over the last 13 years. This paper describes principles and strategies of ‘organizational pre-treatment’ as a necessary prerequisite to implementation.