Dialectical Behaviour Therapy (DBT)
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Transcript of Dialectical Behaviour Therapy (DBT)
Dialectical Behaviour Therapy (DBT)Dialectical Behaviour Therapy (DBT)
Siobhan Keating, Rebecca Ewing , Nadene O’Loan Colette Caldwell Garvin McKnight
What is DBTWhat is DBT
A cognitive behavioural treatment for difficult to treat mental disorders
Originally for suicidal individuals with BPD
Wider evidence baseWider 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 ProgrammeThe Rampton Programme
Contract with programme developers Catrin Morrissey Bridget Ingamells Provided training and Adapted materials
Core Skills group modulesCore Skills group modules
In this Moment In this Moment
Managing FeelingsManaging Feelings
People SkillsPeople Skills
Coping in Crisis Coping in Crisis
DBT In MuckamoreDBT In Muckamore
Skills group
1 – 1 session
DBT consultation meeting
Wider staff training
Current GroupCurrent 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
OutcomesOutcomesPsychometrics :
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 futurePlans 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