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Implementing Dialectical Behaviour Therapy: programme survival in routine healthcare settings.

Michaela Anne Swales¹, Beverley Taylor, Richard A B Hibbs

¹School of Psychology, Bangor University, Bangor, Gwynedd, UK. m.swales@bangor.ac.uk

Journal of Mental Health (Abingdon, England)

|September 11, 2012

Summary

Dialectical Behaviour Therapy (DBT) programs in the UK face sustainability challenges, particularly in their second and fifth years. Organizational support and staff retention are crucial for effective, long-term implementation of this borderline personality disorder treatment.

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Area of Science:

Mental Health Services Research
Clinical Psychology
Psychiatry

Background:

Dialectical Behaviour Therapy (DBT) is recommended for borderline personality disorder, especially for reducing self-harm.
DBT programs were established in the UK in 1994.
Concerns exist regarding the long-term sustainability of DBT in routine clinical settings.

Purpose of the Study:

To determine the sustainability of UK-based DBT programs.
To identify factors influencing the effective implementation of DBT.

Main Methods:

Surveyed all UK DBT teams trained between 1994-2007.
Categorized teams as active or inactive and determined cessation dates.
Interviewed team leaders about implementation challenges.

Main Results:

DBT programs showed increased failure risk in years two and five post-training.
Lack of organizational support and high staff turnover were primary implementation barriers.
Common challenges included funding, training, and adherence to treatment models.

Conclusions:

Sustainable implementation of DBT requires robust organizational support.
A strategy for ongoing staff training and development is essential for program longevity.
Addressing organizational and staffing factors is key to maintaining evidence-based interventions.