No abstract

BackgroundDialectical behaviour therapy (DBT) is a third wave behaviour therapy combining behaviour based components with elements of mindfulness. Although DBT effectiveness has been explored, relatively little attention has been given to its implementation. Frameworks are often the basis for gathering information about implementation and can also direct how the implementation of an intervention is conducted. Using existing implementation frameworks, this critical literature review scoped the DBT implementation literature to develop and refine a bespoke DBT implementation framework.Method and resultsThe initial framework was developed by consolidating existing implementation frameworks and published guidance on DBT implementation. The critical literature review retrieved papers from Medline, CINAHL, PsycInfo, PubMed, and the reference lists of included papers. Framework elements were used as codes which were applied to the literature and guided the synthesis. Findings from the synthesis refined the framework.The critical literature review retrieved 60 papers but only 14 of these explicitly focused on implementation. The DBT implementation framework captured all the execution barriers and facilitators described in the literature. However, the evidence synthesis led to a more parsimonious framework as some elements (e.g., research and published guidance) were seldom discussed in DBT implementation.ConclusionTo our knowledge this is the first published review exploring DBT implementation. The literature synthesis suggests some tentative recommendations which warrant further exploration. For instance, if DBT implementation is not pre-planned, having someone in the organisation who champions DBT can be advantageous. However, as the literature is limited and has methodological limitations, further prospective studies of DBT implementation are needed.Electronic supplementary materialThe online version of this article (10.1186/s40479-019-0102-7) contains supplementary material, which is available to authorized users.

No abstract

Neuropsychological assessments, especially for suspected dementia, often emphasise the comparison of current and premorbid intellectual functioning. However, when assessing bilinguals, estimation of premorbid intellectual functioning may vary depending on which language provides the medium of testing. For bilingual Welsh-English speakers, testing in English only may yield an inaccurate profile of premorbid ability and hence affect the accuracy of subsequent diagnosis. We report the development and standardisation of a Welsh-language lexical decision task, Prawf Gweld y Gair, and evaluation of its suitability for assessing premorbid intellectual functioning in clinical groups. Standardisation with 101 healthy over 50s showed that scores correlated significantly with scores on other measures of crystallised intelligence and, when age and gender were taken into account, significantly predicted scores on a measure of non-verbal fluid intelligence. In subsequent evaluation with healthy older controls (N=25), people who have Alzheimer’s, vascular or mixed dementia (N=26) and Parkinson’s disease (N=25), as predicted, there were no significant correlations with age, fluid intelligence or cognitive status in the clinical groups. Gweld y Gair shows promise as a Welsh-language test of premorbid intellectual functioning and may be useful for clinicians assessing the cognitive abilities of older Welsh speakers.Mae asesiadau niwroseicolegol, yn arbennig pan yn amau dementia, yn aml yn rhoi pwyslais ar gymhariaeth o weithrediad deallusol cyfredol a chyn-forbid. Fodd bynnag, wrth asesu pobl ddwyieithog, gall amcangyfrif o weithrediad deallusol cyn-forbid amrywio yn dibynnu ar gyfrwng iaith y profion. Ar gyfer siaradwyr dwyieithog Cymraeg-Saesneg, gall profi yn Saesneg yn unig gynhyrchu proffil anghywir o allu cyn-forbid a thrwy hynny gall effeithio ar gywirdeb unrhyw ddiagnosis dilynol. Adroddwn yma ar ddatblygiad proses safoni tasg dewis geiriau Cymraeg, Prawf Gweld y Gair, a’n gwerthusiad o’fi addasrwydd ar gyfer asesu gweithrediad deallusol cyn-forbid mewn grwpiau clinigol. Drwy safoni gyda 101 oedolyn iach dros 50 oed, dangosodd ein canlyniadau bod sgorau ar y prawf yn cydberthynnu’n arwyddocaol gyda sgorau ar fesurau eraill o wybodaeth cyn-forbid, a phan ystyriwyd oed a rhyw, roedd yn ragweld sgorau ar fesur o lifedd gwybodaeth di-eiriol. Mewn gwerthusiad dilynol gyda grŵp rheolaeth o bobl hŷn oedd yn iach (N=25), pobl sydd a chlefyd Alzheimer, demensia fasgwlaidd neu gymysg (N=26) a chlefyd Parkinson (N=25), fel y rhagwelwyd, nid oedd unrhyw cydberthyniad arwyddocaol gydag oed, llifedd deallusrwydd na statws gwybyddol yn y grwpiau clinigol. Mae Gweld y Gair yn dangos addewid fel prawf Cymraeg o weithrediadau deallusol cyn-forbid a gall fod yn ddefnyddiol i glinigwyr asesu galluoedd gwybyddol siaradwyr Cymraeg hŷn.

It is now widely acknowledged in policy and practice that the individual with dementia retains the status of a person and the essence of selfhood, has the right to be heard, and has the capacity to live well with the disabilities that dementia brings, given appropriate support. Nevertheless, negative assumptions about dementia as a ‘loss of self' and a ‘living death' remain influential. This chapter examines research evidence that can provide a foundation for a psychologically minded approach to dementia care and help to create a more constructive view of what it means to live with dementia. In this chapter findings are drawn from projects conducted by the Research in Ageing and Cognitive Health (REACH) group at Bangor University, UK on awareness, self-concept, identity and the experience of dementia for people across the dementia trajectory. The REACH group is now at the University of Exeter, UK.