Experiences of women with learning disabilities undergoing dialectical behaviour therapy in a secure service

Abstract

Accessible summary Dialectical behaviour therapy is a “talking” therapy developed by Marsha Linehan. It helps people who are living in the community and also living in hospitals and people who may have problems managing their emotions. In recent years, dialectical behaviour therapy has been used to help people with learning disabilities cope with feelings of anxiety, trauma‐related disorders and mood disorders, but there are not many research papers showing how it is used in forensic learning disability services. This research tells the story of seven women with learning disabilities who took part in dialectical behaviour therapy whilst living in a forensic service. Their story and experiences are important in research literature and will help other services to think about what is needed when they introduce a new type of therapy such as dialectical behaviour therapy . Abstract BackgroundThis research aimed to capture the experiences of women with learning disabilities living in secure services who undertook dialectical behaviour therapy (DBT); they were the first people to do this in the trust. It is hoped their experiences may guide and inform other services undertaking the same process. Materials and MethodsInterpretative phenomenological analysis (IPA) was used to provide a flexible framework to make sense of the way the women interpreted their experiences. Results and DiscussionThe analysis identified three main themes: How you do DBT, What we think about DBT, Using DBT. The qualitative approach adds a valuable contribution to the wider literature, highlighting the importance of capturing the women's voices. ConclusionAs most published literature regarding the effectiveness of DBT is not written from first hand service user experiences, it is hoped this research offers a unique insight into these women's experience.

What happens next? A 2‐year follow‐up study into the outcomes and experiences of an adapted Dialectical Behaviour Therapy skills training group for people with intellectual disabilities

“…Findings relating to course homework also fit well with the wider literature, with several other studies reporting that their participants found the homework hard to understand and disliked doing it (Idusohan‐Moizer et al, ; Sakdalan et al, ; Thomson & Johnson, ). Thomson and Johnson () found that their participants saw the course homework as tasks to be completed rather than ways to practise their new relaxation techniques, and some participants said that the homework reminded them of negative experiences at school.…”

“…Findings relating to course homework also fit well with the wider literature, with several other studies reporting that their participants found the homework hard to understand and disliked doing it (Idusohan‐Moizer et al, ; Sakdalan et al, ; Thomson & Johnson, ). Thomson and Johnson () found that their participants saw the course homework as tasks to be completed rather than ways to practise their new relaxation techniques, and some participants said that the homework reminded them of negative experiences at school. Idusohan‐Moizer et al, reported that 67% of their participants disliked the homework they had to complete although participants were happy to continue to use one of the creative techniques from the group (making mandalas), suggesting that they might be happier to practise creative relaxation skills between group sessions compared to more traditional homework tasks.…”

Journeys into dialectical behaviour therapy (DBT): capturing the staff and service-user experience

“…The key themes to derive from the staff teams experience were: The process of becoming a specialist multi-disciplinary DBT team, undertaking the intensive training and getting to know and living the DBT model (Johnson et al, 2013). For the women service-users the key themes were: Understanding the DBT model, using DBT skills and suggestions for the future/other services (Thomson and Johnson, 2014).…”

What Are the Experiences of People with Neurodevelopmental Disorders Receiving Outpatient Mental Health Services in Singapore?

“…Interpretative phenomenological analysis is a qualitative approach with an idiographic focus that examines the human lived experiences, including how the person make sense of a given phenomenon (Smith, Flowers, & Larkin, 2009). This approach has been used with people who have ID to understand their mental health experiences in other countries (Cookson & Dickson, 2010;Robinson, Escopri, Stenfert Kroese, & Rose, 2016), as well as their experiences receiving psychological therapy (Pearson, Austin, Rose, & Rose, 2019;Pert et al, 2013;Thomson & Johnson, 2017). Smith (2004) and Shaw and Forrester (2010) have supported small sample sizes for IPA to allow for detailed exploration of participants' experiences.…”

“…The themes identified relate to quality of interactions and working relationships with mental health professionals (Nicolaidis et al, 2015), a desire to have meaningful activity and engagement in the community (Taua, Neville, & Scott, 2015), and the quality of service and care received (O'Brien & Rose, 2010). Research involving people with ID has explored views of psychological interventions and found that the tenets of the therapeutic models, such as dialectical behavioral therapy and cognitive behavioral therapy, are understood by most service users and that one-to-one sessions with an attentive therapist are highly appreciated by people with ID (Lewis, Lewis, & Davies, 2016;MacMahon et al, 2015;Pert et al, 2013;Stenfert Kroese et al, 2016;Thomson & Johnson, 2017). Thus, including people with ND in qualitative research can inform and improve the implementation of evidence-based findings by offering a unique perspective based on their experiences (Evans, Bellon, & Matthews, 2017).…”