Journeys into dialectical behaviour therapy (DBT): capturing the staff and service-user experience
| Date | 13 June 2016 |
| Pages | 84-93 |
| Published date | 13 June 2016 |
| DOI | https://doi.org/10.1108/JIDOB-09-2015-0027 |
| Author | Paula Johnson,Michaela Thomson |
| Subject Matter | Health & social care,Learning & intellectual disabilities,Offending behaviour |
Journeys into dialectical behaviour
therapy (DBT): capturing the staff and
service-user experience
Paula Johnson and Michaela Thomson
Paula Johnson is a Research
and Development Manager and
Michaela Thomson is a
Research Practitioner, both at
the Department of Research
and Development,
Calderstones Partnership NHS
Foundation Trust, Whalley, UK.
Abstract
Purpose –The purpose of this paper is to explore the lived experiences of staff and
service-users regard ing the introduction of d ialectical behaviour th erapy (DBT) into an NHS fo rensic
learning disability (L D) 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 thecases 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.
Keywords Case-orientated analysis, Dialectical behaviour therapy (DBT), Forensic service,
Learning disability (LD), Staff team, Women service-users
Paper type Research paper
Introduction
This paper uses a case-orientated approach to explore the journeys undertaken by both staff
and service-users during the introduction of dialectical behaviour therapy (DBT) into an NHS
forensic learning disability (LD) service. DBT was developed from cognitive behavioural therapy
(CBT) by Marsha Linehan in the mid-1990s (Linehan, 1993) and adapted to suit the needs of
people with borderline personality disorders (BPD). DBT usually involves a combination of
individual psychotherapy and group skills training. The key dialectic in DBT is bringing together
the dual aspects of accepting and validating the person undergoing therapy, through the key
skills of mindfulness and distress tolerance, while at the same time motivating them to change,
through skills designed to improve emotion regulation and interpersonal effectiveness (Dimeff
and Linehan, 2001; McKay et al., 2007). Mindfulness skills, involving noticing and meditative
practices, are designed to bring “awareness”and a non-judgemental acceptance of the present
moment, allowing the person to become more fully aware of their sense of self. In short, DBT
balances therapeutic validation and acceptance of the person along with cognitive and
Received 2 September 2015
Revised 15 October 2015
Accepted 11 November 2015
PAGE84
j
JOURNAL OF INTELLECTUAL DISABILITIES AND OFFENDING BEHAVIOUR
j
VOL. 7 NO. 2 2016, pp.84-93, © Emerald Group Publishing Limited, ISSN 2050-8824 DOI 10.1108/JIDOB-09-2015-0027
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