Dialectical Behaviour Therapy
(DBT)
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Siobhan Keating,
Rebecca Ewing ,
Nadene O’Loan
Colette Caldwell
Garvin McKnight
What is DBT
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A cognitive behavioural treatment for difficult
to treat mental disorders
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Originally for suicidal individuals with BPD
Wider evidence base
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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
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Sixmile Low Secure Forensic unit
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Males with a learning Disability – IQ 55-70
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Complex treatment needs
The Rampton Programme
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Contract with programme developers
Catrin Morrissey
Bridget Ingamells
Provided training and Adapted materials
Core Skills group modules
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In this Moment
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Managing Feelings
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People Skills
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Coping in Crisis
DBT In Muckamore
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Skills group
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1 – 1 session
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DBT consultation meeting
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Wider staff training
Current Group
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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
Psychometrics :
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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?
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Increased insight into how difficulties impact on
day to day lives
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Individualised targets on Diary Cards
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Visual props more effective
e.g. Sponge and sieve
M & Ms
What we have learned -2
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Further adaptation of materials / exercises for our client
group
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Use of metaphors - careful consideration of literal meaning
eg “Hot mind”
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Mindfulness – difficult concept to grasp - application to
everyday lives
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All skills need specific work to connect to daily lives
Plans for the future
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Further training and input from Rampton
Team
Evaluation and use of psychometric data
and incident recording
Extending programme to include female inpatient population
Contact
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Rebecca.Ewing@belfasttrust.hscni.net
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Siobhan.Keating@belfasttrust.hscni.net