Evaluating the national multisite implementation of dialectical behaviour therapy in a community setting: a mixed...

Area of Science:

• Mental Health Services Research
• Implementation Science
• Clinical Psychology

Background:

• Borderline Personality Disorder (BPD) treatment in community settings is vital due to high service utilization by affected individuals.
• Previous research identified facilitators and barriers to Dialectical Behavior Therapy (DBT) implementation, but further evaluation is needed.
• This study addresses the need for a national-level evaluation of a coordinated DBT implementation in community settings.

Purpose of the Study:

• To evaluate a coordinated national-level implementation of DBT in community mental health services.
• To identify facilitators and barriers to DBT implementation from the perspective of service providers.
• To inform future strategies for implementing evidence-based treatments in public health services.

Main Methods:

• A mixed-methods approach was employed, combining qualitative interviews with team leaders (n=8) and quantitative surveys with therapists (n=74).
• Qualitative data were analyzed using content analysis to explore implementation experiences.
• Quantitative data were analyzed using frequencies to examine various aspects of the implementation process.

Main Results:

• Five key themes emerged: team formation, implementation preparation, client selection, service-level challenges, and team leader role.
• Key barriers included lack of system support for phone coaching and insufficient allocated time for DBT.
• Facilitators identified were dedicated team members and management support.

Conclusions:

• Findings align with previous research on DBT implementation barriers and facilitators, highlighting the importance of the 'characteristics of individuals' domain in implementation.
• A mandated service plan is crucial for coordinated implementation of evidence-based treatments in public health.
• The study underscores the need for systemic support and dedicated resources for successful DBT implementation.