Dialectical Behavior Therapy Training to Reduce Clinical Burnout in a Public Behavioral Health System

Abstract

There is a risk of experiencing clinical burnout among therapists providing treatment to clients with borderline personality disorder (BPD), a complex, costly and difficult-to-treat psychiatric disorder. Dialectical behavior therapy (DBT) is an evidence-based treatment of BPD that has been widely disseminated. There is only one published study that has examined pre and post scores of burnout among clinicians who receive training in DBT, and none that have taken place within a public behavioral health system in the United States where resources for community-based agencies are limited and demands are high. The current study examined the rates of burnout among therapists treating clients with BPD within a large, urban public behavioral health system. The study included a sample of nine clinicians and showed significantly decreased scores of burnout after participants attended a series of DBT trainings over a period of 13 months. There were several key limitations to internal validity including the lack of a control group. Similar evaluations of training outcomes are needed to address the widespread occurrence of burnout among community-based clinicians providing treatment to clients with BPD in order to enhance the quality of patient care.

Effects of dialectical behavior therapy skills training on outcomes for mental health staff in a child and adolescent residential setting

“…[19] Thus, any means of decreasing burnout among staff in a psychiatric setting is desirable. In line with other research, [12, 15] the findings of this study suggest that training in DBT techniques can assist in reducing destructive staff burnout levels. Further, the results of this study suggest that even a small amount of time dedicated to staff training in DBT skills can lead to significant declines in both personal and work burnout.…”

“…[3, 8–10] However, this is the first study demonstrating the ability to deliver DBT knowledge in a brief and relatively low burden format to nursing staff working within a residential psychiatric setting. In such settings, staff turnover tends to be high and resources limited, [15] making it unlikely that most staff members can access the more typical intensive or comprehensive DBT training. In this study, even just twelve hours of training was sufficient for producing significant DBT skill knowledge acquisition and salutary effects on staff burnout and stigma towards patients.…”

“…There are many institutional barriers to training residential line staff in DBT techniques, including extremely limited time allotted for training and high turnover for staff in these positions. [15] Moreover, while a consultation team, which aims to improve skill in implementing DBT techniques, while simultaneously decreasing provider burnout, is a regular part of any DBT program for therapists and skill training leaders, [4] nursing staff rarely enjoy the benefits of a such a meeting. However, in inpatient or residential settings in which DBT is delivered, nursing staff can play a vital role in implementation, as these staff generally have the most frequent patient contact and are thereby the most available for coaching in DBT skill generalization.…”

Integrating Self-Determination and Job Demands–Resources Theory in Predicting Mental Health Provider Burnout

“…These groups may be particularly beneficial for providers who serve high needs clients (van Daalen et al, 2009). In fact, therapeutic models such as dialectical behavior therapy (DBT), which have a group supervision component, have been shown to reduce provider burnout (Carmel, Fruzzetti, & Rose, 2014;Little, 2000). Alternatively, staff workshops that teach conflict resolution skills and offer ideas for expanding social support in the workplace may increase staff cohesion and help to reduce burnout.…”

Interpersonal barriers to recovery from borderline personality disorder: A qualitative analysis of patient perspectives

“…Reactions like these can be damaging and leave patients feeling blamed and criticized . The link between stigma associated with BPD and clinician burnout in providing treatment is a growing area of study, with DBT showing promise in the potential to reduce burnout among clinical staff as a result of using the treatment …”