“We can feel good”: evaluation of an adapted DBT informed skills programme in medium security

Pages184-194
Date05 November 2018
Published date05 November 2018
DOIhttps://doi.org/10.1108/AMHID-06-2018-0031
AuthorSarah Ashworth,Natalie Brotherton
We can feel good: evaluation of an
adapted DBT informed skills programme
in medium security
Sarah Ashworth and Natalie Brotherton
Abstract
Purpose The purpose of this paper is to provide a routine evaluation of clinical effectiveness of an adapted
DBT informed skills programme (I Can Feel Good; Ingamells and Morrissey, 2014), run on both male and
female intellectual disability wards of a medium security psychiatric hospital.
Design/methodology/approach A prepost evaluation study of routine clinical practice was undertaken
utilising staff report scales collected as the primary source of evaluation.
Findings Findings show a positive shift regarding each module for both gender groups. Due to observed
baseline differences between gender groups, data were separated and analysed separately. Non-parametric
statistical analysis demonstrates statistically significant improvement across three modules for the male
sample (managing feelings, coping in crisis and people skills) and two modules for the female sample
(managing feelings and people skills).
Originality/value There appears to be subtle outcome differences regarding this programme for both
gender groups across modules. Potential reasons for this are discussed, along with clinical reflections
regarding gender differences and adaptations. Reflections upon future revisions including the integration of
the new DBT skills (Linehan, 2014) are made in light of these findings.
Keywords Intellectual disability, Mental health, Learning disability, Psychology, Forensic,
Adapted dialectical behaviour therapy
Paper type Research paper
Introduction
This paper aims to provide an evaluation of routine effectiveness regarding the application of a
skills-based programme designed for people with intellectual disability (ID) and difficulties
managing emotions, run on male and female wards within a medium secure environment. It aims
to address the question does a skills programme adapted from the mainstream actually have
any impact on skills and behaviour.
Dialectical behaviour therapy (DBT)
DBT was developed by Marsha Linehan in an attempt to create an effective treatment for suicidal
womenpresentingwithsuchcomplexsymptomatology (Linehan, 1993). Linehan reviewed literature
exploring the efficacy of psychosocial interventions for multiple disorders (including anxietyand mood
disorders) and concluded such evidence-based interventions were typically focused upon changing
cognitions and behaviours. She identified that these approaches engendered the feelings of criticism,
misunderstanding and invalidation which resulted in high attrition rates.
Patients diagnosed with borderline personality disorder (BPD) are particularly complicated to
treat (Linehan, 1993). Such patients display high dropout rates, show little responsiveness to
typical therapeutic attempts and make significant emotional demands of the therapist,
particularly when they display suicidal and para-suicidal behaviours.
Received 26 June 2018
Revised 21 September 2018
Accepted 1 October 2018
Sarah Ashworth is Forensic
Psychologist at the University of
Nottingham Centre for
Forensic and Family
Psychology, Nottingham, UK;
and at Partnerships in
Care Psychology Calverton
Hill Ramsdale Park Arnold,
Nottingham, UK.
Natalie Brotherton is based in
Nottingham, UK.
PAGE184
j
ADVANCESIN MENTAL HEALTH AND INTELLECTUAL DISABILITIES
j
VOL. 12 NO. 5/6 2018, pp.184-194, © Emerald Publishing Limited, ISSN 2044-1282 DOI 10.1108/AMHID-06-2018-0031

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