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Dialectical Behaviour Therapy (DBT)

Dialectical Behaviour Therapy (DBT). Siobhan Keating, Rebecca Ewing , Nadene O’Loan Colette Caldwell Garvin McKnight. What is DBT. A cognitive behavioural treatment for difficult to treat mental disorders Originally for suicidal individuals with BPD. Wider evidence base.

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Dialectical Behaviour Therapy (DBT)

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  1. Dialectical Behaviour Therapy (DBT) • Siobhan Keating, • Rebecca Ewing , • Nadene O’Loan • Colette Caldwell • Garvin McKnight

  2. What is DBT • A cognitive behavioural treatment for difficult to treat mental disorders • Originally for suicidal individuals with BPD

  3. Wider evidence base • In- patient psychiatric settings (Linehan et al 2006) • Eating disorders (Telch et al 2001) • Addictions (Linehan et al 2002) • In patient adolescents ( Trupin et al 2002) • Forensic environment ( Evershed et al 2003) • Learning Disability ( Lew et al 2006, Singh et al 2008) • Rampton study – evidence from self-report and transfer to lower security ( Morrissey and Ingamells, 2011)

  4. Our Service • Sixmile Low Secure Forensic unit • Males with a learning Disability – IQ 55-70 • Complex treatment needs

  5. The Rampton Programme • Contract with programme developers • Catrin Morrissey • Bridget Ingamells • Provided training and Adapted materials

  6. Core Skills group modules • In this Moment • Managing Feelings • People Skills • Coping in Crisis

  7. DBT In Muckamore • Skills group • 1 – 1 session • DBT consultation meeting • Wider staff training

  8. Current Group • Adult males(6) – 21 – 55 years • IQ range - 58 – 70 • Other MH problems – Bi-polar, ADHD, Substance misuse • Offence History – Violence, sexual violence, manslaughter, abduction of a child • Legal status – both detained and voluntary

  9. Outcomes Psychometrics : • Mindfulness – 5 facets • Mindfulness – CAMS – R • Emotional regulation – ECQ • Emotional recognition – TASIT • Emotional control – STAXI • Coping skills – CRI • Behaviour monitoring – Nurse Observation Scale • Goal Attainment Scale – All modules Weekly Behaviour monitoring

  10. What we have learned? • Increased insight into how difficulties impact on day to day lives • Individualised targets on Diary Cards • Visual props more effective e.g. Sponge and sieve M & Ms

  11. What we have learned -2 • Further adaptation of materials / exercises for our client group • Use of metaphors - careful consideration of literal meaning eg “Hot mind” • Mindfulness – difficult concept to grasp - application to everyday lives • All skills need specific work to connect to daily lives

  12. Plans for the future • Further training and input from Rampton Team • Evaluation and use of psychometric data and incident recording • Extending programme to include female in-patient population

  13. Contact • Rebecca.Ewing@belfasttrust.hscni.net • Siobhan.Keating@belfasttrust.hscni.net

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