Innovations in Practice: Dialectical behaviour therapy for adolescents: multisite implementation and evaluation of a 16‐week programme in a public community mental health setting

Flynn, Daniel; Kells, Mary; Joyce, Mary; Corcoran, Paul; Gillespie, Conall; Suarez, Catalina; Swales, Michaela; Arensman, Ella

doi:10.1111/camh.12298

Cited by 26 publications

(29 citation statements)

References 21 publications

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“…Methods detailing the implementation and evaluation of DBT-A in community settings across Ireland have been described in greater detail in a separate paper (Flynn, Kells, Joyce, Corcoran et al, 2018). The main issues relevant to this comparison study are described below.…”

Section: Methodsmentioning

confidence: 99%

“…During the initial 2 years of the project (2013)(2014)(2015), seven CAMHS teams trained in DBT and delivered the 16-week DBT-A programme as described by Miller et al (2007). The implementation and evaluation of the 16-week DBT-A programmes delivered by these seven CAMHS teams were explored by the authors and significant improvements were observed for adolescents on all outcome measures including frequency of self-harm and suicidal ideation (Flynn, Kells, Joyce, Corcoran et al, 2018). Outcomes and experiences of parents who participated in the 16-week skills group, which is part of the multifamily group component of DBT-A, were also evaluated with reductions reported in levels of burden, grief and stress (Flynn, Gillespie, & Joyce, unpublished data).…”

Section: Introductionmentioning

confidence: 99%

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Dialectical behaviour therapy for adolescents: a comparison of 16‐week and 24‐week programmes delivered in a public community setting

Gillespie

Joyce

Flynn

et al. 2019

Child Adoles Ment Health

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Background Dialectical behaviour therapy for adolescents (DBT‐A) is an intervention with a growing evidence base for treating adolescents with emotional and behavioural dysregulation. Previous studies have reported on varying lengths of treatment, however, and optimal treatment duration has not yet been identified. While the treatment developers initially proposed a 16‐week programme, they have more recently recommended an extension to 24 weeks. This study compares outcomes for adolescents and parent/guardians who participated in 16‐ and 24‐week DBT‐A programmes in a community setting. Methods Eighty‐four adolescents and 100 parent/guardians participated in 16‐week DBT‐A, while 68 adolescents and 67 parent/guardians participated in the 24‐week programme. Outcome measures for adolescents included the presence and frequency of self‐harm, suicidal ideation and depression; and for parents were burden, grief and parental stress. Outcomes were assessed at pre‐ and postintervention. Linear mixed‐effects models were used to estimate the treatment duration effect (24‐week vs. 16‐week) utilising all available data at pre‐ and postintervention. Results Data analyses showed a reduction in the presence and frequency of self‐harm at postintervention for adolescents in both programmes. Both adolescent and parent participants in the 16‐ and 24‐week programmes also showed changes indicating significant improvement on all self‐report outcome measures (p < .05). A treatment duration effect was identified with adolescents in the 24‐week programme reporting greater gains on measures of suicidal ideation and depression (p < .05). However, drop‐out rates were higher for the 24‐week programme. Conclusions The findings of the current study indicate that 24‐week DBT‐A may have additional benefits in comparison to 16‐week DBT‐A in terms of further reductions in suicidal ideation and depression. Given the nature of this study, it was not possible to explore a potential time effect, however, so these results should be interpreted with caution. Further research will assist in determining an optimal programme duration of DBT‐A.

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Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Dialectical behaviour therapy for adolescents: a comparison of 16‐week and 24‐week programmes delivered in a public community setting

Gillespie

Joyce

Flynn

et al. 2019

Child Adoles Ment Health

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“…Most children and adolescent patients (youth patients, hereafter) with mental disorder can be and should be managed as outpatients in the community, therefore to maximize the involvement of their families and other resources [10,11]. However, for some severe cases or those who are in acute crisis, psychiatric hospitalization remains a necessary and effective treatment option, although the duration has shortened significantly compared with what was in the past [12][13][14].…”

Section: Introductionmentioning

confidence: 99%

Psychiatric inpatient beds for youths in China: data from a nation-wide survey

Geng

Jiang

Rakofsky

et al. 2020

Preprint

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Background The development of child psychiatry in China is slow and very limited resources have been allocated to it. To investigate the current resources of inpatient psychiatric facilities for youth in top-tier psychiatric hospitals in China and the characteristics of youth patients hospitalized in an adult unit. Method As part of a official national survey, 29 most representative provincial tertiary psychiatric hospitals in China were selected. Data of 1975 inpatients discharged from these hospitals from March 19 to 31, 2019 were retrieved and analyzed. Results The mean number of youth psychiatric bed was 27.7±22.9 in these hospitals and 6/29 hospitals had zero youth beds. There were significantly more youth beds in developed regions than in less developed regions (P<0.05). Most of discharged youth patients were teenagers with severe mental illnesses, including schizophrenia, depressive disorder and bipolar disorder. 7.5% (149) of 1975 discharged patients were youth while youth beds only accounted for 3.2% (804/25136) of all psychiatric beds. 45.6% (68) of youth patients hospitalized in adult units. Conclusion Our findings highlight a dire situation of youth inpatient service in China, especially in less developed regions. There is an urgent need to change the policy and develop mental health services, including inpatient services for child and adolescent patients.

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“…Most child and adolescent patients (youth patients, hereafter) with mental disorder can be and should be managed as outpatients in the community, to maximize the involvement of their families and other resources [10,11]. However, for some severe cases or for those who are in acute crisis, psychiatric hospitalization remains a necessary and effective treatment option, although the duration has shortened significantly compared with what it was in the past [12][13][14].…”

Section: Introductionmentioning

confidence: 99%

Psychiatric inpatient beds for youths in China: data from a nation-wide survey

Geng

Jiang

Rakofsky

et al. 2020

Preprint

View full text Add to dashboard Cite

Background The development of child psychiatric services in China has been slow and very limited resources have been allocated to support its growth. This study set out to investigate the child and adolescent inpatient psychiatric resources currently available in top-tier psychiatric hospitals in China and the characteristics of youth patients hospitalized on an adult unit. Method As part of a official national survey, 29 most representative provincial tertiary psychiatric hospitals in China were selected. Data of 1975 inpatients discharged from these hospitals from March 19 to 31, 2019 were retrieved and analyzed. Results The mean number of youth psychiatric beds was 27.7±22.9 in these hospitals and 6/29 hospitals had zero youth beds. There were significantly more youth beds in developed regions than in less developed regions (P<0.05). Most of discharged youth patients were teenagers with severe mental illnesses, including schizophrenia, depressive disorder and bipolar disorder. 7.5% (149) of 1975 discharged patients were youth while youth beds only accounted for 3.2% (804/25136) of all psychiatric beds. 45.6% (68) of youth patients were discharged from adult psychiatric units. Conclusion Our findings highlight the lack of adequate youth psychiatric inpatient services for children and adolescents living in China, especially in less developed regions. There is an urgent need to build more child and adolescent psychiatric units in provinces where there are none, and to increase the number of beds within the units that exist presently.

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Innovations in Practice: Dialectical behaviour therapy for adolescents: multisite implementation and evaluation of a 16‐week programme in a public community mental health setting

Cited by 26 publications

References 21 publications

Dialectical behaviour therapy for adolescents: a comparison of 16‐week and 24‐week programmes delivered in a public community setting

Dialectical behaviour therapy for adolescents: a comparison of 16‐week and 24‐week programmes delivered in a public community setting

Psychiatric inpatient beds for youths in China: data from a nation-wide survey

Psychiatric inpatient beds for youths in China: data from a nation-wide survey

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