Dialectical Behavior Therapy in College Counseling Centers: Current Trends and Barriers to Implementation

Chugani, Carla D.; Landes, Sara J.

doi:10.1080/87568225.2016.1177429

Cited by 20 publications

(18 citation statements)

References 19 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…While effective, DBT requires specialized, time-consuming and expensive training that is difficult or costly to implement with a large number of students (Chugani & Landes, 2016). Therefore, it would be very helpful to CCCs to be equipped with a less resource-intensive treatment, shorter in duration, and easier to disseminate as a first line treatment for SR.…”

Section: Dialectical Behavior Therapy (Dbt Linehan 1993 2015a)mentioning

confidence: 99%

Developing Adaptive Treatment Strategies to Address Suicidal Risk in College Students: A Pilot Sequential, Multiple Assignment, Randomized Trial (SMART)

Pistorello¹,

Jobes

Compton

et al. 2018

Archives of Suicide Research

View full text Add to dashboard Cite

This pilot study investigated the potential to utilize adaptive treatment strategies for treating moderate to severe suicidal risk among college students. This article will describe the unique study design and report on feasibility and acceptability findings. A 2-stage Sequential Multiple Assignment Randomized Trial (SMART) was conducted: In Stage 1, 62 suicidal college students were randomized to either a suicide-focused or a treatment-as-usual condition (4-8 weeks). Those deemed insufficient responders were re-randomized to one of two Stage 2 interventions-both suicide-focused but one comprehensive and multimodal and the other flexible and theoretically agnostic (4-16 additional weeks). Recruitment rates were high, treatment dropout levels were lower than expected for the setting, study dropouts were rare, and counselors were able to deliver suicide-focused approaches with fidelity. Treatment satisfaction was high among clients and moderately high among counselors. Findings from this pilot show that a SMART is highly feasible and acceptable to suicidal college students, counselors, and campuses.

show abstract

Section: Dialectical Behavior Therapy (Dbt Linehan 1993 2015a)mentioning

confidence: 99%

Developing Adaptive Treatment Strategies to Address Suicidal Risk in College Students: A Pilot Sequential, Multiple Assignment, Randomized Trial (SMART)

Pistorello¹,

Jobes

Compton

et al. 2018

Archives of Suicide Research

View full text Add to dashboard Cite

show abstract

“…One study was conducted with college counseling center staff who either were interested in or had implemented DBT. The authors found lack of individual therapists, productivity demands, limited time for team consultation, and lack of willingness to offer phone coaching to be the most highly endorsed barriers [27].…”

mentioning

confidence: 99%

Barriers, facilitators, and benefits of implementation of dialectical behavior therapy in routine care: results from a national program evaluation survey in the Veterans Health Administration

Landes

Rodriguez

Smith

et al. 2017

Behav. Med. Pract. Policy Res.

Self Cite

View full text Add to dashboard Cite

National implementation of evidence-based psychotherapies (EBPs) in the Veterans Health Administration (VHA) provides important lessons on the barriers and facilitators to implementation in a large healthcare system. Little is known about barriers and facilitators to the implementation of a complex EBP for emotional and behavioral dysregulation-dialectical behavioral therapy (DBT). The purpose of this study was to understand VHA clinicians' experiences with barriers, facilitators, and benefits from implementing DBT into routine care. This national program evaluation survey measured site characteristics of VHA sites (N = 59) that had implemented DBT. DBT was most often implemented in general mental health outpatient clinics. While 42% of sites offered all four modes of DBT, skills group was the most frequently implemented mode. Fifty-nine percent of sites offered phone coaching in any form, yet only 11% of those offered it all the time. Providers were often provided little to no time to support implementation of DBT. Barriers that were difficult to overcome were related to phone coaching outside of business hours. Facilitators to implementation included staff interest and expertise. Perceived benefits included increased hope and functioning for clients, greater self-efficacy and compassion for providers, and ability to treat unique symptoms for clinics. There was considerable variability in the capacity to address implementation barriers among sites implementing DBT in VHA routine care. Mental health policy makers should note the barriers and facilitators reported here, with specific attention to phone coaching barriers.

show abstract

“…A number of studies have investigated barriers and facilitators associated with the implementation of DBT in a variety of service contexts (Ben‐Porath, Peterson, & Smee, ; Carmel, Rose, & Fruzzetti, ; Chugani & Landes, ; Ditty, Landes, Doyle, & Beidas, ; Herschell, Kogan, Celedonia, Gavin & Stein, ; King, Hibbs, Saville, & Swales, ; Landes et al, ; Swales, Taylor, & Hibbs, ). Most employed qualitative research methods to explore clinicians' and/or administrators' opinions about DBT.…”

Section: Introductionmentioning

confidence: 99%

“…Most employed qualitative research methods to explore clinicians' and/or administrators' opinions about DBT. Several organisational barriers to the implementation of DBT were identified and were associated with limited resources within programmes including a lack of funding for training (Carmel et al, ; Herschell et al, ), low managerial support (Swales et al, ), high rates of staff turnover (Ben‐Porath, Peterson, & Smee, ; Carmel et al, ; Chugani & Landes, ), concerns related to the programme's fit with existing practices (Carmel et al, ) and insufficient referrals (Herschell et al, ). Other common barriers identified were related to the consultation teams (Ditty et al, ), the time commitment associated with the programme (Ben‐Porath et al, ; Carmel et al, ) and themes related to individual clinicians—including staff selection for training (Ben‐Porath et al, ).…”

Section: Introductionmentioning

confidence: 99%

Barriers and facilitators affecting the sustainability of dialectical behaviour therapy programmes: A qualitative study of clinician perspectives

Popowich

Mushquash

Pearson

et al. 2019

Couns and Psychother Res

View full text Add to dashboard Cite

| 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.

show abstract

Dialectical Behavior Therapy in College Counseling Centers: Current Trends and Barriers to Implementation

Cited by 20 publications

References 19 publications

Developing Adaptive Treatment Strategies to Address Suicidal Risk in College Students: A Pilot Sequential, Multiple Assignment, Randomized Trial (SMART)

Developing Adaptive Treatment Strategies to Address Suicidal Risk in College Students: A Pilot Sequential, Multiple Assignment, Randomized Trial (SMART)

Barriers, facilitators, and benefits of implementation of dialectical behavior therapy in routine care: results from a national program evaluation survey in the Veterans Health Administration

Barriers and facilitators affecting the sustainability of dialectical behaviour therapy programmes: A qualitative study of clinician perspectives

Contact Info

Product

Resources

About