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Challenges and Potential Solutions to Implementing Phone Coaching in Dialectical Behavior Therapy.

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Implementing Dialectical Behavioral Therapy (DBT) phone coaching faces challenges like lack of tools and clinician willingness. Addressing these barriers can improve borderline personality disorder (BPD) treatment delivery.

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Area of Science:

  • Mental Health Services Research
  • Healthcare Implementation Science
  • Clinical Psychology

Background:

  • Dialectical Behavioral Therapy (DBT) is a proven treatment for borderline personality disorder (BPD).
  • A key component, phone coaching, presents implementation challenges in healthcare settings.
  • Effective strategies for overcoming these barriers are needed.

Purpose of the Study:

  • To identify barriers encountered during the implementation of DBT phone coaching.
  • To document reported solutions and strategies for overcoming these barriers.
  • To provide recommendations for healthcare organizations seeking to implement DBT phone coaching.

Main Methods:

  • A sequential mixed methods national program evaluation was employed.
  • Quantitative data collected via self-report surveys from 59 Department of Veterans Affairs (VA) facilities.
  • Qualitative data gathered through semi-structured interviews with 16 DBT providers and administrators.

Main Results:

  • Four key themes emerged: lack of tools/policies, compensation issues, clinician willingness, and program/leadership support.
  • These themes highlight critical areas for intervention in DBT phone coaching implementation.
  • A case study illustrated these identified themes.

Conclusions:

  • Lack of resources, compensation, and consistent support are significant barriers to DBT phone coaching.
  • Addressing these barriers through targeted strategies can enhance the successful implementation of DBT phone coaching.
  • The study offers practical recommendations for healthcare facilities aiming to integrate phone coaching into their BPD treatment programs.