It Takes a Village: A Mixed Method Analysis of Inner Setting Variables and Dialectical Behavior Therapy...

Area of Science:

• Psychology
• Psychiatry
• Healthcare Management

Background:

• Dialectical Behavior Therapy (DBT) is an evidence-based treatment for complex mental health conditions.
• Successful implementation of DBT relies on understanding organizational factors.
• The Consolidated Framework for Implementation Research provides a structure for studying implementation.

Purpose of the Study:

• To explore the relationship between inner setting variables and the implementation of Dialectical Behavior Therapy (DBT).
• To identify specific interpersonal and organizational factors influencing DBT adoption.

Main Methods:

• Mixed-methods study combining quantitative surveys and qualitative interviews.
• Online survey administered to 79 intensively trained DBT clinicians.
• Sequential qualitative interviews conducted with 20 clinicians.

Main Results:

• Four interpersonal variables—team cohesion, team communication, team climate, and supervision—were significantly correlated with the quantity of DBT elements implemented.
• Qualitative themes supported the quantitative findings regarding these interpersonal variables.
• Some variables showed associations with implementation through either quantitative or qualitative data, but not both.

Conclusions:

• Inner setting variables, particularly team dynamics and supervision, are critical for effective DBT implementation.
• A multi-faceted approach is needed to understand the complex interplay of factors influencing evidence-based practice adoption.
• Further research can explore additional variables impacting implementation fidelity.