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Implementing Dialectical Behaviour Therapy: organizational pre-treatment

Published online by Cambridge University Press:  28 September 2010

Michaela Anne Swales
Michaela Anne Swales*
Affiliation:
School of Psychology, Bangor University, Bangor, Wales, UK, and Betsi Cadwaladr Health Board
*
*Author for correspondence: Dr M. A. Swales, School of Psychology, University of Wales, Brigantia Building, Penrallt Road, Bangor, Wales LL57 2AS, UK. (email: [email protected])
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Abstract

Implementing change in organizational systems is challenging, and implementing a new psychotherapeutic approach is no different. A literature exists on issues in implementation across a wide range of domains (technological, healthcare, justice). However, little of it is utilized in endeavours to implement innovations in psychological treatments. This paper draws on the implementation literature and on the experiences of the British Isles DBT Training Team (BIDBT) in implementing Dialectical Behaviour Therapy (DBT) in mental healthcare systems in the UK over the last 13 years. This paper describes principles and strategies of ‘organizational pre-treatment’ as a necessary prerequisite to implementation.

Keywords

Dialectical Behaviour Therapy (DBT)implementationorganizational change
Type
Service models and forms of delivery
Information
the Cognitive Behaviour Therapist , Volume 3 , Issue 4 , December 2010 , pp. 145 - 157
Copyright
Copyright © British Association for Behavioural and Cognitive Psychotherapies 2010

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References

Aarons, GA, Sawitzky, AC (2006). Organizational culture and climate and mental health provider attitudes toward evidence-based practice. Psychological Services 3, 61–72.CrossRefGoogle ScholarPubMed
Aarons, GA, Woodbridge, M, Carmazzi, A (2003). Examining leadership, organizational climate and service quality in a children's system of care. In: Proceedings of the 15th Annual Research Conference. A System of Care for Children's Mental Health: Examining the Research Base. Tampa, FL, pp. 15–18.Google Scholar
Backer, TE, Liberman, RP, Kuehnel, TG (1986). Dissemination and adoption of innovative psychosocial interventions. Journal of Consulting and Clinical Psychology 54, 111–118.CrossRefGoogle ScholarPubMed
Backer, TE, Rogers, EM (1998). Diffusion of innovations theory and workside AIDS programmes. Journal of Health Communication 3, 17–28.Google Scholar
Barwick, MA, Boydell, KM, Stasiulis, E, Ferguson, HB, Blasé, K, Fixsen, D (2005). Knowledge Transfer and Implementation of Evidence-Based Practices in Children's Mental Health. Toronto: Children's Mental Health Ontario.Google Scholar
Brazier, J, Tumur, I, Holmes, M, Ferriter, M, Parry, G, Dent-Brown, K, Paisley, S (2006). Psychological therapies including dialectical behaviour therapy for borderline personality disorder: a systematic review and preliminary economic evaluation. Health Technology Assessment 10 (35). HMSO: Norwich.Google Scholar
Chorpita, BF, Yim, LM, Donkervoet, JC, Arensdorf, A, Amundsen, MJ, McGee, C, Serrano, A, Yates, A, Burns, JA, Morelli, P (2002). Toward large-scale implementation of empirically supported treatments for children: a review and observations by the Hawaii Empirical Basis to Services Task Force. Clinical Psychology: Science and Practice 9, 165–190.Google Scholar
Clarkin, JF, Levy, KN, Lenzenweger, MF, Kernberg, OF (2007). Evaluating three treatments for borderline personality disorder: a multiwave study. American Journal of Psychiatry, 164, 922–928.CrossRefGoogle ScholarPubMed
DoH (2007). Best practice in managing risk: principles and evidence for best practice in the assessment and management of risk to self and others in mental health services. Department of Health.Google Scholar
DoH (2008). Improving Access to Psychological Therapies (IAPT) Commissioning Toolkit. Department of Health.Google Scholar
Fadden, G (1997). Implementation of family interventions in routine clinical practice following staff training programs: a major cause for concern. Journal of Mental Health 6, 599–612.CrossRefGoogle Scholar
Fixsen, DL, Naoom, SF, Blasé, KA, Friedman, RM, Wallace, F (2005). Implementation Research: A Synthesis of the Literature. Tampa, FL: University of South Florida, Louis de la Parte Florida Mental Health Institute, The National Implementation Research Network.Google Scholar
Glisson, C, Hemmelgarn, A (1998). The effects of organizational climate and interorganizational coordination on the quality and outcomes of children's service systems. Child Abuse Neglect 22, 401–421.Google Scholar
Glisson, C, James, LR (2002). The cross-level effects of culture and climate in human service teams. Journal of Organizational Behavior 23, 767–794.CrossRefGoogle Scholar
Gotham, HJ (2004). Diffusion of mental health and substance abuse treatments: Development, dissemination and implementation. Clinical Psychology: Science & Practice 11, 161–176.Google Scholar
Hemmelgarn, AL, Glisson, C, James, LR (2006). Organizational culture and climate: implications for services and interventions research. Clinical Psychology: Science and Practice 13, 73–89.Google Scholar
Henggeler, SW, Borduin, CM, Melton, GB, Mann, BJ, Smith, L, Hall, JA, Cone, L, Fucci, BR (1991). Effects of multi-systemic therapy on drug use in serious juvenile offenders: a progress report from two outcome studies. Family Dynamics of Addiction Quarterly 1, 40–51.Google Scholar
Kavanagh, DJ, Piatkowska, O, Clark, D, O'Halloran, P, Manicavasagar, V, Rosen, A, Tennant, C (1993). Application of cognitive-behavioural family intervention for sschizophrenia in multi-disciplinary teams: what can the matter be? Australian Psychology 28, 181–188.Google Scholar
Koons, CR, Robins, CJ, Tweed, JL, Lynch, TR, Gonzalez, AM, Morse, JQ, Bishop, GK, Butterfield, M, Bastian, LA (2001). Efficacy of dialectical behavior therapy in women veterans with borderline personality disorder. Behavior Therapy 32, 371–390.CrossRefGoogle Scholar
Lehman, WEK, Greener, JM, Simpson, DD (2002). Assessing organizational readiness for change. Journal of Substance Abuse Treatment 22, 197–209.Google Scholar
Lieb, K, Zanarini, M, Linehan, MM, Bohus, M (2004). Seminar section: borderline personality disorder. Lancet 164, 453–461.CrossRefGoogle Scholar
Linehan, MM, Armstrong, HE, Suarez, A, Allman, D, Heard, HL (1991). Cognitive-behavioral treatment of chronically parasuicidal borderline patients. Archives of General Psychiatry 48, 1060–1064.CrossRefGoogle ScholarPubMed
Linehan, MM, Comtois, KA, Murray, AM, Brown, MZ, Gallop, RJ, Heard, HH, Korslund, KE, Tutek, DA, Rynolds, SK, Lindenboim, N (2006). Two-year randomized controlled trial and follow-up of dialectical behavior therapy vs therapy by experts for suicidal behaviors and borderline personality disorder. Archives of General Psychiatry 63, 757–766.CrossRefGoogle ScholarPubMed
Linehan, MM, Dimeff, LA, Reynolds, SK, Comtois, KA, Shaw-Welch, S, Heagerty, P, Kivlahan, DR (2002). Dialectical behavior therapy versus comprehensive validation plus 12-step for the treatment of opioid dependent women meeting criteria for borderline personality disorder. Drug and Alcohol Dependence 67, 13–26.CrossRefGoogle ScholarPubMed
Linehan, MM, Schmidt, H, Dimeff, LA, Craft, JC, Kanter, J, Comtois, KA (1999). Dialectical behavior therapy for patients with borderline personality disorder and drug-dependence. American Journal on Addictions 8, 279–292.CrossRefGoogle ScholarPubMed
McCormick, LK, Streckler, A, McLeroy, KR (1995). Diffusion of innovation in schools: a study of adoption and implementation of school-based tobacco prevention curricula, American Journal of Health Promotion 9, 210–219.Google Scholar
Martin, G, Herie, M, Turner, B, Cunningham, J (1998). A social marketing model for disseminating research-based treatments to addictions treatment providers. Addiction 93, 1703–1715.CrossRefGoogle ScholarPubMed
National Confidential Inquiry into Suicide and Homicide (2006). Annual Report of the National Confidential Inquiry into Suicide and Homicide by people with a mental illness. University of Manchester.Google Scholar
NIMHE (2003). Personality Disorder: No Longer a Diagnosis of Exclusion. National Institute of Mental Health in England, London, 2003.Google Scholar
NICE (2004). Self-harm: the short-term physical and psychological management and secondary prevention of self-harm in primary and secondary care. Clinical Guideline 16, National Institute for Health and Clinical Excellence, London, 2004.Google Scholar
NICE (2009). Borderline personality disorder: treatment and management. Clinical Guideline 78, National Institute for Health and Clinical Excellence, London, 2009.Google Scholar
Panzano, PC, Roth, D (2006). The decision to adopt evidence-based and other innovative mental health practices: risky business? Psychiatric Services 57, 1153–1161.Google Scholar
Poole, J, Grant, A (2005). Stepping out of the box: broadening the dialogue around the organizational implementation of cognitive behavioural psychotherapy. Journal of Psychiatric and Mental Health Nursing 12, 456–463.Google Scholar
Rogers, EM (2003). Diffusion of Innovations, 5th edn. New York: The Free Press.Google Scholar
Rollinson, D (2008). Organizational Behaviour and Analysis, 4th edn. Essex: Pearson.Google Scholar
Sanders, MR, Turner, KMT (2005). Reflections on the challenges of effective dissemination at behavioural family intervention: our experience with the Triple P – Positive Parenting Programme. Child and Adolescent Mental Health 10, 158–169.CrossRefGoogle Scholar
Schoenwald, SK, Sheidow, AJ, Letourneau, EJ, Liao, JG (2003). Transportability of multisystemic therapy: evidence for multilevel influences. Mental Health Service Research 5, 223–239.Google Scholar
Scott, T, Mannion, R, Davies, H, Marshall, M (2003). The quantitative measurement of organizational culture in health care: a review of the available instruments. Health Services Research 38, 923–945.CrossRefGoogle Scholar
Stirman, SW, Crits-Christoph, P, DeRubels, RJ (2004). Achieving successful dissemination of empirically supported psychotherapies: a synthesis of dissemination theory. Clinical Psychology: Science and Practice 11, 343–359.Google Scholar
Swales, MA (2010). Implementing DBT: selecting, training and supervising a team. The Cognitive Behaviour Therapist 3, 77–79.CrossRefGoogle Scholar
Swales, MA, Heard, HL (2008). Dialectical Behaviour Therapy: Distinctive Features. London: Routledge.CrossRefGoogle Scholar
Torrey, WC, Drake, RE, Cohen, M, Fox, LB, Lynde, D, Gorman, P, Wyzik, P (2002). The challenge of implementing and sustaining integrated dual disorders treatment programs. Community Mental Health Journal 38, 507–521.Google Scholar
Turner, KMT, Sanders, MR (2005). Reflections on the challenges of effective dissemination of behavioral family intervention: our experience with the triple P – Positive Parenting Program. Child and Adolescent Mental Health 10, 158–169.Google Scholar
Turner, KMT, Sanders, MR (2006). Dissemination of evidence-based parenting and family support strategies: learning from the Triple P – Positive Parenting Program system approach. Aggression and Violent Behavior 11, 176–193.CrossRefGoogle Scholar
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
Webster-Stratton, C, Taylor, ET (1988). Adopting and implementing empirically supported interventions: a recipe for success. In: Parenting, Schooling, and Children's Behavior (ed. Buchanan, A. and Hudson, B. L.), pp. 126–160. Aldershot, UK: Ashgate Publishing.Google Scholar
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