Predictors of Adoption and Reach Following Dialectical Behavior Therapy Intensive Training™.

Dialectical behavior therapy (DBT) is an evidence-based treatment for borderline personality disorder. The DBT Intensive Training™ is widely used to train community clinicians to deliver DBT, but little is known about its effectiveness. This study prospectively evaluated predictors of adoption and reach of DBT among 52 community teams (212 clinicians) after DBT Intensive Training™. Pre-post training questionnaires were completed by trainees and a follow-up survey by team leaders approximately 8 months later. Overall, 75% of teams adopted all DBT modes and delivered DBT to an average of 118 clients. Lower training and program needs, fewer bachelor's-level clinicians, and greater prior DBT experience predicted adoption of more DBT modes. More prior DBT experience, smaller team size, more negative team functioning, and staff with lower job satisfaction, growth, efficacy, and influence predicted greater DBT reach. DBT Intensive Training™ appears effective in promoting DBT adoption and reach in routine clinical practice settings.

Dialectical behavior therapy with American Indian/Alaska Native adolescents diagnosed with substance use disorders: combining an evidence based treatment with cultural, traditional, and spiritual beliefs.

This pilot study examined pre to post-change of patients in a substance use residential treatment center that incorporated Dialectical Behavior Therapy with specific cultural, traditional and spiritual practices for American Indian/Alaska Native adolescents. Specifically, the incorporation of cultural, spiritual and traditional practices was done while still maintaining fidelity to the evidence based treatment (DBT). 229 adolescents participated in the study and were given the Youth Outcome Questionnaire-Self-Report version at pre-treatment and post-treatment and the total scores were compared. The results of the research study showed that 96% of adolescents were either "recovered" or "improved" using clinical significant change criteria. Additionally, differences between the group's pre-test scores and post-test scores were statistically significant using a matched standard T-test comparison. Finally, the effect size that was calculated using Cohen's criteria was found to be large. The results are discussed in terms of the implication for integrating western and traditional based methods of care in addressing substance use disorders and other mental health disorders with American Indian/Alaska Native adolescents.

A Pilot Evaluation of Dialectical Behavioural Therapy in Adolescent Long-Term Inpatient Care.

BACKGROUND: There is a paucity of research investigating psychosocial treatments for youth receiving long-term residential care. OBJECTIVE: This study describes the implementation and impact of dialectical behavioural therapy (DBT) in a long-term psychiatric hospital located in the United States of America. METHOD: Changes in overall functioning, number of psychotropic medications prescribed, non-suicidal self-injurious behaviour (NSIB), and locked seclusions were investigated in 106 consecutive unique adolescent patients who received DBT. In addition, a comparison group of historical controls was used to examine the effect of DBT in youth with the highest rates of NSIB. RESULTS: A statistically significant increase in overall functioning, as well as a decrease in number of psychotropic medications and non-suicidal self-injurious behaviour (NSIB) was observed within the DBT group. A decrease in locked seclusions was not observed. Accounting for the effects of age, gender, length of stay, and time, youth who received DBT were less likely to engage in NSIB relative to historical controls. CONCLUSIONS: These preliminary data suggest that DBT is beneficial for youth with NSIB in long term inpatient psychiatric care.