Self-care as an ethical imperative for psychologists necessitates a continuous, proactive engagement in behaviours that promote psychological, emotional, and physical wellness. Graduate training programs have an ethical obligation to equip students with the knowledge and skills necessary to practice ethically and competently; there is, however, a considerable lack of emphasis on self-care in graduate programs as well as in the profession as a whole. This article reviews principles relating to self-care from the Canadian Code of Ethics for Psychologists, particularly the principles of Responsible Caring and Integrity in Relationships. The professional psychology training context is described as it relates to self-care, with a review of the training literature and accreditation standards. Given the lack of systematic training in self-care currently provided by professional psychology training programs, it is suggested that programs conceptualise self-care beyond impairment, view self-care as a competency to be taught and practiced, and integrate training opportunities across the spectrums of training and professional practice.
| INTRODUC TI ONDialectical behaviour therapy (DBT) is an intensive, evidence-based, outpatient treatment that applies cognitive and behavioural strategies to target problematic behaviours (Linehan, 1993). DBT was originally developed to treat individuals with chronic suicidality and high-risk behaviours, presentations that can be costly to the health system overall (e.g. costs associated with higher rates of healthcare service utilisation such as inpatient hospitalisations; Bender et al.,
AbstractDialectical behaviour therapy (DBT) is a psychological treatment developed for individuals experiencing chronic suicidality and high-risk behaviours. Despite the substantial evidence supporting the effectiveness of DBT, many programmes have problems with its sustainability. The goals of the current qualitative study were to identify factors that impact the sustainability of DBT programmes within a publicly funded mental health system and identify factors that are particularly relevant for youth DBT programmes. Interviews with trained adult and youth DBT clinicians (N = 31) were conducted to explore their experiences providing DBT. Three major themes that emerged as barriers to the sustainability of DBT programmes included the following: systemic challenges, conflicts within the consultation teams and clinician burnout. Factors influencing the success of DBT programmes included the following: systemic support, clinician commitment and "buy in", and team cohesion.Factors specific to providing DBT with youth (i.e. level of commitment, simplifying the language, and parental investment) and recommendations for sustainability for adults and youth programmes were also identified. Findings of this study provide valuable information on factors impacting DBT programmes within the unique context of a Canadian mental health service system, where community-based services are publicly funded. These findings have clear clinical utility and can be used to generate solutions to clinicians' perceived barriers and to foster perceived facilitators within similar contexts.
K E Y W O R D Sbarriers, clinicians perspectives, dialectical behaviour therapy, service deliver, sustainability | 69 POPOWICH et al.
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