Many National Health Service (NHS) Trusts in England have invested in dialectical behavioural therapy (DBT) for mental health service users. The experiences of NHS staff delivering DBT were explored using semi-structured interviews with six dialectical behaviour therapists working in secondary mental health services within the NHS. The aim was to consider the impact on staff of adding the DBT therapist role onto their existing job role. Interview data was analysed using thematic analysis. Six themes were inductively generated from the data; DBT as a useful framework; DBT as the most satisfying part of the job; 'Worzel Gummidge heads'-conflicts in roles; 'DBT buddies'-the importance of informal support; uncertainty about the future; and recursivity-using DBT skills personally. Interactions between themes, implications for the service and future research directions are discussed. Key findings suggest that the addition of the DBT therapist role, as well as the recursive nature of DBT, has a positive impact professionally and personally.However the service context within which participants were working can lead this additional role to cause increased demands and therefore stress, reducing that positive impact.
Impact evaluation and measurement are highly complex and can pose challenges for both social impact providers and funders. Measuring the impact of social interventions requires the continuous exploration and improvement of evaluation approaches and tools. This article explores the available evidence on meta-evaluation—the “evaluation of evaluations”—as an analytical tool for improving impact evaluation and analysis in practice. It presents a systematic review of 15 meta-evaluations with an impact evaluation/analysis component. These studies, taken from both the scholarly and gray literature, were analyzed thematically, yielding insights about the potential contribution of meta-evaluation in improving the methodological rigor of impact evaluation and organizational learning among practitioners. To conclude, we suggest that meta-evaluation is a viable way of examining impact evaluations used in the broader social sector, particularly market-based social interventions.
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