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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
Dialectical Behaviour Therapy (DBT)
  • Siobhan Keating,
  • Rebecca Ewing ,
  • Nadene O’Loan
  • Colette Caldwell
  • Garvin McKnight
what is dbt
What is DBT
  • A cognitive behavioural treatment for difficult to treat mental disorders
  • Originally for suicidal individuals with BPD
wider evidence base
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)
our service
Our Service
  • Sixmile Low Secure Forensic unit
  • Males with a learning Disability – IQ 55-70
  • Complex treatment needs
the rampton programme
The Rampton Programme
  • Contract with programme developers
  • Catrin Morrissey
  • Bridget Ingamells
  • Provided training and Adapted materials
core skills group modules
Core Skills group modules
  • In this Moment
  • Managing Feelings
  • People Skills
  • Coping in Crisis
dbt in muckamore
DBT In Muckamore
  • Skills group
  • 1 – 1 session
  • DBT consultation meeting
  • Wider staff training
current group
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
outcomes
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

what we have learned
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

what we have learned 2
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
plans for the future
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
contact
Contact
  • Rebecca.Ewing@belfasttrust.hscni.net
  • Siobhan.Keating@belfasttrust.hscni.net