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

Abstract

Purpose – The purpose of this paper is to explore the lived experiences of staff and service-users regarding the introduction of dialectical behaviour therapy (DBT) into an NHS forensic learning disability (LD) service. Design/methodology/approach – Drawing on data from two recent qualitative research studies, the research team used a case-oriented approach to see beyond original findings to capture the shared experiences of the participants’ journeys, thus giving a deeper insight to the commonalities of the participants’ voices which is rarely reported in the literature (Sandelowski, 2011). Findings – A common set of phenomena became apparent when the cases were analysed, these included: trust, intensity and worthwhile. It is intended this paper gives some opportunity for reflection and shared empathetic responses to the similar experiences discussed. Originality/value – The case-orientated analysis adds value to the evidence base by highlighting the importance of the qualitative voice of both the staff and service user. This is important because most available literature reflects the process of setting up a team or DBT service, rather than describing the team experience. Equally, most published literature regarding the effectiveness of DBT is not written from the perspective of the people who receive the therapy.

Adapting dialectical behaviour therapy in forensic learning disability services: A grounded theory informed study of “what works”

“…One recurrent element within SL, SDT and the current model is the destabilizing impact of new learning on belief in self . This echoes the skill struggles and considerations of dropout reported by intellectual disability DBT participants in this and other studies (Baillie & Slater, ; Johnson & Thomson, ; Morrissey & Ingamells, ; Sakdalan, Shaw, & Collier, ). Difficulty with the learning, retention and assimilation of new skills is a characteristic inherent to intellectual disability (Carr, Linehan, O'Reilly, Walsh, & McEvoy, ).…”

“…This starting point may, therefore, more realistically account for how trust originates in Yalom and Leszcz's loop than their suggestion of courage. Moreover, this resonates with the proclivity for distrust and insecure attachment styles of PWID (Fletcher, Flood, & Hare, ), particularly in forensic services (Taylor & Novaco, ), and clarifies the analogous finding by Johnson and Thomson () of initial peer mistrust within a secure intellectual disability service DBT group.…”

“…Again mirroring the community‐based literature, only one published study appears to have employed a qualitative methodology. Following interviews with female intellectual disability participants in a UK MSU, Johnson and Thomson () described the importance of building trust within the DBT group and the difficulties experienced with learning and applying skills. Nonetheless, participants regarded their perseverance as worthwhile, in terms of improved self‐belief and progression towards lower security conditions.…”

Modeling and Simulation of Crowd Pre-Evacuation Decision-Making in Complex Traffic Environments

“…Aguirre et al, further applied ENT to explain the crowd response in the 1993 World Trade Center explosion, and the results pointed out that social groups and lasting social relations might increase the evacuation time [ 36 ]. Johnson and Kuligowski pointed out that the characteristics of group size and internal relationship type would significantly affect population interaction and state judgment [ 25 , 37 ]. According to the empirical study of the Station Nightclub fire, Aguirre et al, found that even in rapidly spreading emergencies, people in danger looked for close companions [ 36 ].…”