Process evaluation of dialectical behavior therapy dissemination: Knowledge retention and recursive training effects
Dialectical behavior therapy (DBT) can be challenging to implement with fidelity to the model. Residential treatment settings are frequently overlooked as sites of implementation for DBT despite the potential benefits. This mixed-methods process evaluation examines the impact of DBT training in five...
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| Published in | Current psychology (New Brunswick, N.J.) Vol. 41; no. 9; pp. 6014 - 6023 |
|---|---|
| Main Authors | , , |
| Format | Journal Article |
| Language | English |
| Published |
New York
Springer US
01.09.2022
Springer Springer Nature B.V |
| Subjects | |
| Online Access | Get full text |
| ISSN | 1046-1310 1936-4733 |
| DOI | 10.1007/s12144-020-01095-3 |
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| Abstract | Dialectical behavior therapy (DBT) can be challenging to implement with fidelity to the model. Residential treatment settings are frequently overlooked as sites of implementation for DBT despite the potential benefits. This mixed-methods process evaluation examines the impact of DBT training in five residential programs on provider DBT-specific knowledge, staff turnover rates, and staff perceptions of training impact on their practice.
Post-training staff knowledge levels varied considerably, but on average demonstrated substantial DBT-related knowledge retention. Staff turnover rates did not change significantly in four of five programs despite showing an overall trend in reduction. Qualitative results suggest substantial recursive training effects consistent with the DBT model. Themes emerged related to the impact of the training on effectiveness of practice with clients, application of DBT skills in staff personal lives, and positive effects on program culture. Results have implications for better understanding the mechanisms of successful dissemination of DBT across treatment settings. |
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| AbstractList | Dialectical behavior therapy (DBT) can be challenging to implement with fidelity to the model. Residential treatment settings are frequently overlooked as sites of implementation for DBT despite the potential benefits. This mixed-methods process evaluation examines the impact of DBT training in five residential programs on provider DBT-specific knowledge, staff turnover rates, and staff perceptions of training impact on their practice. Dialectical behavior therapy (DBT) can be challenging to implement with fidelity to the model. Residential treatment settings are frequently overlooked as sites of implementation for DBT despite the potential benefits. This mixed-methods process evaluation examines the impact of DBT training in five residential programs on provider DBT-specific knowledge, staff turnover rates, and staff perceptions of training impact on their practice. Post-training staff knowledge levels varied considerably, but on average demonstrated substantial DBT-related knowledge retention. Staff turnover rates did not change significantly in four of five programs despite showing an overall trend in reduction. Qualitative results suggest substantial recursive training effects consistent with the DBT model. Themes emerged related to the impact of the training on effectiveness of practice with clients, application of DBT skills in staff personal lives, and positive effects on program culture. Results have implications for better understanding the mechanisms of successful dissemination of DBT across treatment settings. Dialectical behavior therapy (DBT) can be challenging to implement with fidelity to the model. Residential treatment settings are frequently overlooked as sites of implementation for DBT despite the potential benefits. This mixed-methods process evaluation examines the impact of DBT training in five residential programs on provider DBT-specific knowledge, staff turnover rates, and staff perceptions of training impact on their practice. Post-training staff knowledge levels varied considerably, but on average demonstrated substantial DBT-related knowledge retention. Staff turnover rates did not change significantly in four of five programs despite showing an overall trend in reduction. Qualitative results suggest substantial recursive training effects consistent with the DBT model. Themes emerged related to the impact of the training on effectiveness of practice with clients, application of DBT skills in staff personal lives, and positive effects on program culture. Results have implications for better understanding the mechanisms of successful dissemination of DBT across treatment settings. |
| Audience | Academic |
| Author | Hunt, Susan R. See, Mary Renata Holbrook, Amber M. |
| Author_xml | – sequence: 1 givenname: Amber M. orcidid: 0000-0002-9368-5349 surname: Holbrook fullname: Holbrook, Amber M. email: aholbrook@wcupa.edu organization: Graduate Department of Social Work, West Chester University – sequence: 2 givenname: Susan R. surname: Hunt fullname: Hunt, Susan R. organization: Resources for Human Development, Inc, 4700 Wissahickon Avenue – sequence: 3 givenname: Mary Renata surname: See fullname: See, Mary Renata organization: West Chester University |
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| Cites_doi | 10.1111/j.1365-2206.2006.00451.x 10.1111/j.1365-2850.2007.01146.x 10.1300/J007v20n03_04 10.3109/09638237.2012.689435 10.1037/0022-006X.69.6.1061 10.1186/s40479-019-0102-7 10.1176/appi.ps.53.2.171 10.1186/1471-2288-13-117 10.1016/j.jad.2012.05.054 10.1016/j.brat.2009.07.011 10.1016/S0022-3956(98)00030-2 10.1176/appi.psychotherapy.2015.69.2.97 10.1002/j.1556-6678.2011.tb00071.x 10.1016/j.apnu.2016.04.001 10.1177/1077558708317802 10.1080/0312407X.2015.1026913 10.1080/15433714.2012.760944 10.1002/jclp.22774 10.1037/h0095107 10.1016/j.childyouth.2013.01.007 10.1002/j.1556-6676.2014.00127.x 10.1016/S0306-4603(02)00293-9 10.1080/09638230601182094 10.1017/S1754470X10000115 10.1016/j.brat.2010.05.017 10.1080/15504263.2018.1437496 10.1007/s10597-013-9679-2 10.1016/j.brat.2009.01.013 10.1177/1049731513503047 |
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| Copyright | Springer Science+Business Media, LLC, part of Springer Nature 2020 COPYRIGHT 2022 Springer Springer Science+Business Media, LLC, part of Springer Nature 2020. |
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An evaluation of a state department of mental health training programJournal of Psychiatric Research199832637938410.1016/S0022-3956(98)00030-2 NeacsiuADRizviSLLinehanMMDialectical behavior therapy skills as a mediator and outcome of treatment for borderline personality disorderBehavior Research and Therapy20104883283910.1016/j.brat.2010.05.017 LinehanMMCognitive-behavioral treatment of borderline personality disorder1993New YorkGuildford Press FeigenbaumJDialectical behavior therapy: An increasing evidence baseJournal of Mental Health200716516810.1080/09638230601182094 Dimeff, L.A., Koerner, K., Woodcock, E.A., Beadnell, B., Brown M.Z., Skutch, J. M. … Harned, M. S. (2009). Which training method works best? A randomized control trial comparing three methods of training clinicians in dialectical behavior therapy skills. Behaviour Research and Therapy, 47(11), 921–930. 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| References_xml | – reference: Yanosy, S., Harrison, L.C., & Bloom, S.L. (2015). Sanctuary model community implementation guide [PDF]. The sanctuary Institute at Andrus and Community Works Philadelphia. Retrieved from: http://www.thesanctuaryinstitute.org. – reference: PanosPTJacksonJWHasanOPanosAMeta-analysis and systematic review assessing the efficacy of dialectical behavior therapy (DBT)Research on Social Work Practice20142421322310.1177/1049731513503047 – reference: Abt Associates. (2008). Characteristics of residential treatment: For children and youth with serious emotional disorders [PDF]. Retrieved from: http://www.nacbh.org/PubDocs/Characteristics%20of%20Residential%20Treatment.pdf. – reference: ManciniMMinerCLearning and change in a community mental health settingJournal of Evidence-Based Social Work20131049450410.1080/15433714.2012.760944 – reference: MellinEHuntBNicholsLCounselor professional identity: Findings and implications for counseling and interprofessional collaborationJournal of Counseling and Development20118914014710.1002/j.1556-6678.2011.tb00071.x – reference: LandesSJLinehanMMBarlowDHMcHughRKDissemination and implementation of dialectical behavior therapy: An intensive training modelDissemination and implementation of evidence-based psychological interventions2012New YorkOxford University Press187208 – reference: LenzASTaylorRFlemingMSermanNEffectiveness of dialectical behavior therapy for treating eating disordersJournal of Counseling and Development201492263510.1002/j.1556-6676.2014.00127.x – reference: HawkinsKSinhaRCan line clinicians master the conceptual complexities of dialectical behavior therapy? An evaluation of a state department of mental health training programJournal of Psychiatric Research199832637938410.1016/S0022-3956(98)00030-2 – reference: SwalesMTaylorBHibbsRImplementing dialectical behavior therapy: Program survival in routine healthcare settingsJournal of Mental Health20122154855510.3109/09638237.2012.689435 – reference: HarrisonGHealyKForging an identity as a newly qualified worker in the non-government community services sectorAustralian Social Work201669809110.1080/0312407X.2015.1026913 – reference: Dimeff, L.A., Koerner, K., Woodcock, E.A., Beadnell, B., Brown M.Z., Skutch, J. M. … Harned, M. S. (2009). Which training method works best? A randomized control trial comparing three methods of training clinicians in dialectical behavior therapy skills. Behaviour Research and Therapy, 47(11), 921–930. – reference: LouieEGiannopoulosVBaillieAUribeGByrneSDeadyMTeessonMBakerAHaberPSMorleyKCTranslating evidence-based practice for managing comorbid substance use and mental illness using a multimodal training packageJournal of Dual Diagnosis20181411111910.1080/15504263.2018.1437496 – reference: McCay, E., Carter, C., Aiello, A., Quesnel, S., Howes, C., & Johansson, B. (2016). Toward treatment integrity: Developing an approach to measure the treatment integrity of a dialectical behavior therapy intervention with homeless youth in the community. 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| Title | Process evaluation of dialectical behavior therapy dissemination: Knowledge retention and recursive training effects |
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