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Dialectical behaviour therapy for younger adults: evaluation of 22 weeks of community delivered dialectical behaviour therapy for females 18–25 years

Published online by Cambridge University Press:  16 January 2015

J. L. Lyng Open the ORCID record for J. L. Lyng [Opens in a new window] ,
M. A. Swales  and
R. P. Hastings
J. L. Lyng*
Affiliation:
Cluain Mhuire Community Mental Health Services, Blackrock, Dublin, Ireland School of Psychology, Bangor University, Bangor, Gwynedd, UK
M. A. Swales
Affiliation:
School of Psychology, Bangor University, Bangor, Gwynedd, UK
R. P. Hastings
Affiliation:
Centre for Educational Development Appraisal and Research, University of Warwick, Coventry, UK
*
*Address for correspondence: J. L. Lyng, Department of Psychology, Cluain Mhuire Family Centre, Newtownpark Avenue, Blackrock, Dublin, Ireland. (Email: jlyng@tcd.ie)
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Abstract

Background

Dialectical behaviour therapy (DBT) is a multi-modal psychological therapy with established efficacy in treating borderline personality disorder (BPD). Younger adults represent a group more likely to drop out of treatment than their older counterparts and treatments specifically targeted at this younger cohort may be advantageous.

The current study

We describe an evaluation of a DBT programme in a mental health centre for younger adults 18–25 years who met criteria for BPD (n=11).

Methodology

We used a simple pre/post-test design, measuring BPD symptoms, general mental health symptoms, and coping skills using self-report questionnaires at the beginning of DBT and again following the delivery of 22 weeks of DBT.

Findings

Statistically significant reductions were found in BPD symptoms and several mental health symptoms alongside an increase in DBT skills use. Dropout was 31% at 22 weeks of treatment. Methodological weaknesses and avenues for future research are discussed.

Keywords

Behaviour therapyborderline personality disorderBPDcommunity mental healthDBTdialecticaldropoutpsychotherapyyounger adult
Type
Original Research
Information
Irish Journal of Psychological Medicine , Volume 32 , Issue 4 , December 2015 , pp. 299 - 305
Copyright
© College of Psychiatrists of Ireland 2015 

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References

American Psychiatric Association (2000). Diagnostic and Statistical Manual of Mental Disorders, 4th edn., text rev. American Psychiatric Association: Washington, DC.Google Scholar
Barrett, MS, Chua, W, Crits-Christoph, P, Gibbons, MB, Casiano, D, Thompson, D (2008). Early withdrawal from mental health treatment: implications for psychotherapy practice. Psychotherapy: Theory, Research, Practice, Training 45, 247–267.CrossRefGoogle ScholarPubMed
Blennerhassett, R, Bamford, L, Whelan, A, Jamieson, S, Wilson O’Raghaillaigh, J (2009). Dialectical behaviour therapy in an Irish community mental health setting. Irish Journal of Psychological Medicine 26, 59–63.CrossRefGoogle Scholar
Bohus, MK, Kleindienst, N, Limberger, MF, Stieglitz, RD, Domsalla, M, Chapman, AL, Steil, R, Philipsen, A, Wolf, M (2009). The short version of the Borderline Symptom List (BSL-23): development and initial data on psychometric properties. Psychopathology 42, 32–39.CrossRefGoogle ScholarPubMed
Burlingame, GM, Fuhriman, A, Johnson, JE (2011). Cohesion in group psychotherapy. In Psychotherapy Relationships That Work: Evidence-Based Responsiveness, 2nd edn. (ed. J. C. Norcross), pp. 110–131. Oxford University Press: New York.CrossRefGoogle Scholar
Carmel, A, Rose, ML, Fruzzetti, AE (2014). Administration and Policy in Mental Health and Mental Health Services Research 41, 608–614.CrossRefGoogle Scholar
Carter, GL, Willcox, CH, Lewin, TJ, Conrad, AM, Bendit, N (2010). Hunter DBT project: randomized controlled trial of dialectical behavior therapy in women with borderline personality disorder. Australian and New Zealand Journal of Psychiatry 44, 162–173.CrossRefGoogle ScholarPubMed
Cohen, JW (1988). Statistical Power Analysis for the Behavioural Sciences, 2nd edn. Lawrence Erlbaum Associates: Hillsdale, NJ.Google Scholar
Derogatis, LR (1994). SCL-90-R: Administration, Scoring and Procedures Manual. National Computer Systems: Minneapolis, MN.Google Scholar
Feigenbaum, JD, Fonagy, P, Pilling, S, Jones, A, Wildgoose, A, Bebblington, PE (2012). A real-world study of the effectiveness of DBT in the UK National Health Service. British Journal of Clinical Psychology 51, 121–141.CrossRefGoogle ScholarPubMed
Garfield, SL (1994). Research on client variables in psychotherapy. In Handbook of Psychotherapy and Behaviour Change, 4th edn. (ed. A. E. Bergin and S. L. Garfield), pp. 190–228. Wiley: New York, NY.Google Scholar
Horowitz, LM, Rosenberg, SE, Baer, BA, Ureno, G, Villasenor, VS (1988). Inventory of interpersonal problems: Psychometric properties and clinical applications. Journal of Consulting and Clinical Psychology 56, 885–892.CrossRefGoogle ScholarPubMed
Karlin, B, Cross, G (2014). From the laboratory to the therapy room: National dissemination and implementation of evidence-based psychotherapies in the US Department of Veteran's Affairs health care system. American Psychologist 69, 19–33.CrossRefGoogle Scholar
Koerner, K (2012). Doing Dialectical Behaviour Therapy. The Guilford Press: London.Google Scholar
Koerner, K (2013). What must you know and do to get good outcomes with DBT? Behaviour Therapy 44, 568–579.CrossRefGoogle ScholarPubMed
Koerner, K, Dimeff, LA (2007). Overview of dialectical behaviour therapy. In Dialectical Behaviour Therapy in Clinical Practice: Applications Across Disorders and Settings (ed. L. A. Dimeff and K. Koerner), pp. 1–18. The Guilford Press: London.Google Scholar
Koons, CR, Robins, CJ, Tweed, JL, Lynch, TR, Gonzalez, AM, Morse, JQ, Bishop, GK, Butterfield, MI, Bastian, LA (2001). Efficacy of dialectical behaviour therapy in women veterans with borderline personality disorder. Behaviour Therapy 32, 371–390.CrossRefGoogle Scholar
Lambert, MJ, Ogles, BM (2004). The efficacy and effectiveness of psychotherapy. In Bergin and Garfield’s Handbook of Psychotherapy and Behaviour Change, 5th edn. (ed. M. J. Lambert), pp. 139–193. Wiley: New York, NY.Google Scholar
Landes, SJ, Linehan, MM (2012). Dissemination and implementation of dialectical behaviour therapy: an intensive training model. In Dissemination and Implementation of Evidence-Based Psychological Interventions (ed. R. K. McHugh and D. H. Barlow), pp. 187–208. Oxford University Press: New York, NY.Google Scholar
Linehan, MM (1993 a). Cognitive-Behavioural Treatment of Borderline Personality Disorder. Guilford Press: London.Google Scholar
Linehan, MM (1993 b). Skills Training Manual for Treating Borderline Personality Disorder. Guilford Press: London.Google Scholar
Linehan, MM, Armstrong, HE, Suarez, A, Allmon, D, Heard, HL (1991). Cognitive-behavioural treatment of chronically parasuicidal borderline patients. Archives of General Psychiatry 48, 1060–1064.CrossRefGoogle Scholar
Linehan, MM, Comtois, KA, Murray, AM, Brown, MZ, Gallop, RJ, Heard, HL, Lindenboim, N (2006). Two-year randomized controlled trial and follow-up of dialectical behaviour therapy vs. therapy by experts for suicidal behaviours and borderline personality disorder. Archives of General Psychiatry 63, 757–766.CrossRefGoogle ScholarPubMed
Linehan, MM, Schmidt, H III, Dimeff, LA, Craft, JC, Kanter, J, Comtois, KA (1999). Dialectical behaviour therapy for patients with borderline personality disorder and drug-dependence. The American Journal on Addictions 8, 279–292.CrossRefGoogle ScholarPubMed
Mehlum, L, Tormoen, AJ, Ramberg, M, Haga, E, Diep, LM, Laberg, A, Larrson, BS, Stanley, BH, Miller, AL, Sund, AM, Groholt, B (2014). Dialectical behaviour therapy for adolescents with repeated suicidal and self-harming behaviour: a randomised trial. Journal of the American Academy of Child & Adolescent Psychiatry 53, 1082–1091.CrossRefGoogle Scholar
Miller, AL, Rathus, JH, Linehan, MM (2007). Dialectical Behaviour Therapy with Suicidal Adolescents. Guilford Press: New York, NY.Google Scholar
Neacsiu, AD, Rizvi, SL, Linehan, MM (2010). Dialectical behaviour therapy skills use as a mediator of treatment for borderline personality disorder. Behaviour Research and Therapy 48, 832–839.CrossRefGoogle ScholarPubMed
Neacsiu, AD, Rizvi, SL, Vitaliano, PP, Lynch, TR, Linehan, MM (2010). Dialectical behaviour therapy ways of coping checklist: development and psychometric properties. Journal of Clinical Psychology 66, 563–582.CrossRefGoogle ScholarPubMed
Neece, CL, Berk, MS, Combs-Ronto, LA (2013). Dialectical behaviour therapy and suicidal behaviour in adolescence: linking developmental theory and practice. Professional Psychology: Research and Practice 4, 257–265.CrossRefGoogle Scholar
Pallant, J (2010). SPSS Survival Guide, 4th edn.McGraw Hill: New York, NY.Google Scholar
Pasieczny, N, Connor, J (2011). The effectiveness of dialectical behaviour therapy in routine public mental health settings: an Australian controlled trial. Behaviour Research and Therapy 49, 4–10.CrossRefGoogle ScholarPubMed
Pekarik, G, Stephenson, LA (1988). Adult and child differences in therapy dropout research. Journal of Clinical Child Psychology 17, 316–321.CrossRefGoogle Scholar
Priebe, S, Bhatti, N, Barnicot, K, Bremner, S, Gaglia, A, Katsakou, C, Molosankwe, I, McCrone, P, Zinkler, M (2012). Effectiveness and cost-effectiveness of dialectical behaviour for self-harming patients with personality disorder: a pragmatic randomised controlled trial. Psychotherapy & Psychosomatics 81, 356–365.CrossRefGoogle ScholarPubMed
Simmons, D (1992). Gender issues and borderline personality disorder: why do females dominate the diagnosis? Archives of Psychiatric Nursing 6, 219–223.CrossRefGoogle ScholarPubMed
Stanley, B, Brodsky, B, Nelson, JD, Dulit, R (2007). Brief dialectical behaviour therapy (DBT-B) for suicidal behaviour and non-suicidal self injury. Archives of Suicide Research 11, 337–341.CrossRefGoogle ScholarPubMed
Stoffers, JM, Völlm, BA, Rücker, G, Timmer, A, Huband, N, Lieb, K (2012). Psychological therapies for people with borderline personality disorder. Cochrane Database of Systematic Reviews 8, doi:10.1002/14651858.CD005652.pub2.Google Scholar
Swales, MA (2010). Implementing dialectical behaviour therapy: organisational pre-treatment. The Cognitive Behaviour Therapist 3, 145–157.CrossRefGoogle Scholar
Swales, MA, Heard, HL (2009). Dialectical Behaviour Therapy: The CBT Distinctive Features Series. Routledge: London.Google Scholar
Swift, JK, Greenberg, RP (2012). Premature discontinuation in adult psychotherapy: a meta-analysis. Journal of Consulting and Clinical Psychology 80, 547–559.CrossRefGoogle ScholarPubMed
van den Bosch, LMC, Koeter, MWJ, Stijnen, T, Verheul, R, van den Brink, W (2005). Sustained efficacy of dialectical behaviour therapy for borderline personality disorder. Behaviour Research and Therapy 43, 1231–1241.CrossRefGoogle ScholarPubMed
Verheul, R, van den Bosch, LMC, Koeter, MWJ, de Ridder, MAJ, Stijnen, T, van den Brink, W (2003). Dialectical behaviour therapy for women with borderline personality disorder: 12-month, randomised clinical trial in The Netherlands. British Journal of Psychiatry 182, 135–140.CrossRefGoogle ScholarPubMed
Wierzbicki, M, Pekarik, G (1993). A meta-analysis of psychotherapy dropout. Professional Psychology: Research and Practice 24, 190–195.CrossRefGoogle Scholar