Investigating Bang for Your Training Buck: A Randomized Controlled Trial Comparing Three Methods of Training Clinicians in Two Core Strategies of Dialectical Behavior Therapy

Dimeff, Linda A.; Harned, Melanie S.; Woodcock, Eric A.; Skutch, Julie M.; Koerner, Kelly; Linehan, Marsha M.

doi:10.1016/j.beth.2015.01.001

Cited by 45 publications

(62 citation statements)

References 21 publications

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“…[3, 8–10] However, this is the first study demonstrating the ability to deliver DBT knowledge in a brief and relatively low burden format to nursing staff working within a residential psychiatric setting. In such settings, staff turnover tends to be high and resources limited, [15] making it unlikely that most staff members can access the more typical intensive or comprehensive DBT training.…”

Section: Discussionmentioning

confidence: 99%

“…Similar knowledge tests have been previously used in DBT training research, with each adapted to match the specific content of the training being tested. [8–10] The test consisted of multiple choice or matching questions pertaining to the content taught in the skills training, each of which had one correct answer out of four potential options. Scores on this test were calculated as percentage of questions answered correct; therefore, potential scores ranged from 0–100, with higher scores representing greater DBT skill knowledge.…”

Section: Methodsmentioning

confidence: 99%

“…[7] The extant literature on DBT training indicates that typical training methods, such as comprehensive workshops and internet-based training programs, are associated with increases in DBT skill knowledge and utilization among mental health professionals, and that individuals with widely varying levels of education and training can acquire competency in DBT under expert training and supervision. [3, 8–10] Research further indicates that clinicians who have received DBT-informed training report lower professional burnout, less stigma towards individuals with personality disorders, and more optimistic attitudes towards treating BPD clients. [11, 12, 14] Thus, there is evidence that training in DBT methods is effective and beneficial when delivered to mental health professionals working with severe and multi-problem clients.…”

Section: Introductionmentioning

confidence: 99%

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Effects of dialectical behavior therapy skills training on outcomes for mental health staff in a child and adolescent residential setting

Haynos

Fruzzetti

Anderson

et al. 2016

JHA

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Training in Dialectical Behavior Therapy (DBT) skills coaching is desirable for staff in psychiatric settings, due to the efficacy of DBT in treating difficult patient populations. In such settings, training resources are typically limited, and staff turnover is high, necessitating brief training. This study evaluated the effects of a brief training in DBT skills coaching for nursing staff working in a child and adolescent psychiatric residential program. Nursing staff (n = 22) completed assessments of DBT skill knowledge, burnout, and stigma towards patients with borderline personality disorder (BPD) before and after a six-week DBT skills coaching training. Repeated measure ANOVAs were conducted to examine changes on all measures from pre- to post- treatment and hierarchical linear regressions to examine relationships between pre- training DBT knowledge, burnout, and BPD stigma and these same measures post-training. The brief DBT skill coaching training significantly increased DBT knowledge (p = .007) and decreased staff personal (p = .02) and work (p = .03) burnout and stigma towards BPD patients (p = .02). Burnout indices and BPD stigma were highly correlated at both time points (p < .001); however, while pre-training BPD stigma significantly predicted post-training client burnout (p = .04), pre-training burnout did not predict post-training BPD stigma. These findings suggest that brief training of psychiatric nursing staff in DBT skills and coaching techniques can result in significant benefits, including reduced staff burnout and stigma toward patients with BPD-related problems, and that reducing BPD stigma may particularly promote lower burnout.

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Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Effects of dialectical behavior therapy skills training on outcomes for mental health staff in a child and adolescent residential setting

Haynos

Fruzzetti

Anderson

et al. 2016

JHA

View full text Add to dashboard Cite

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“…Although increased access to training can help improve the dissemination of EBTs, ensuring that clinicians actually implement the new skills with their patients (and implement them correctly) is a posttraining challenge (Decker, Jameson, & Naugle, 2011; McHugh & Barlow, 2010). Didactic training alone does not, in itself, necessarily yield improvements in clinical skills (Dimeff et al, 2015; Herschell, et al, 2010; Kobak, Engelhardt, Williams, & Lipsitz, 2004). American Psychological Association guidelines state that clinicians should not only demonstrate knowledge of EBT theories and methods but also be able to demonstrate skill in implementing EBT intervention strategies (American Psychological Assocation, 2007).…”

mentioning

confidence: 99%

Therapist Training on Cognitive Behavior Therapy for Anxiety Disorders Using Internet-Based Technologies

et al. 2016

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This study investigated a technology-enhanced training protocol to facilitate dissemination of therapist training on cognitive behavior therapy (CBT) for anxiety disorders. Seventy community clinicians received an online tutorial followed by live remote observation of clinical skills via videoconference. Impact of training on patient outcomes was also assessed. Training resulted in a significant increase in both trainee knowledge of CBT concepts and techniques and therapist competence in applying these skills. Patients treated by trainees following training had significant reductions in anxiety and depression. Ratings of user satisfaction were high. Results provide support for the use of these technologies for therapist training in CBT.

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“…While most resident psychotherapy education studies utilize pre- and post-surveys of perceived competence and willingness to practice as the main outcome, in this study we measure DBT skill improvement by coding videotaped sessions using the DBT adherence rating scale. In addition, very few studies compare different approaches to teaching DBT [11-13] or in teaching DBT to psychiatry residents [14] . In this study, we compare the full 12-month DBT curriculum to a 6-week didactic course, including the residents who only received the required 6-week course in the basic theories and interventions of DBT as a comparison group to those who chose the additional 12-month clinical curriculum.…”

Section: Introductionmentioning

confidence: 99%

Teaching Dialectical Behavior Therapy to Psychiatry Residents: The Columbia Psychiatry Residency DBT Curriculum

et al. 2016

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Objective Dialectical Behavior Therapy (DBT) is an evidence-based psychosocial treatment with efficacy in reducing self-harm behaviors in borderline personality disorder (BPD). This study describes and evaluates a clinical curriculum to teach DBT to psychiatry residents, developed at a large urban university hospital. The curriculum objectives are to: 1) have psychiatry residents achieve basic understanding of DBT theory and clinical skill, 2) increase residents’ ability and confidence in treating self-harm behaviors (both suicidal behavior and non-suicidal self-injury) and 3) enhance residents’ willingness to treat individuals with BPD. Methods In addition to a six-week didactic course on DBT offered to all residents (n=62), 25 elected to enroll in a year-long DBT clinical training curriculum over the course of a five-year period. The DBT clinical training consisted of 15 hours of additional didactics, ongoing conduct of individual therapy and group DBT skills training, videotaping of individual therapy sessions, and weekly supervision meetings utilizing videotape to provide feedback. Residents participating in the clinical training program videotaped baseline and later sessions, which were rated for DBT adherence. All 62 graduates of the program were surveyed regarding the impact of the training on their practice of psychiatry. Results Upon graduation, a high percentage (87% in the curriculum and 70% in the didactic course only) reported incorporating DBT into their psychiatry practice, and willingness and confidence in treating BPD and self-harm behaviors. Residents participating in the clinical training demonstrated significant improvement in their ability to utilize DBT interventions, particularly in structuring sessions, problem assessment, problem solving, and using validation and dialectical strategies. Conclusion This DBT curriculum was effective in preparing psychiatrists-in-training to incorporate evidence-based practices for effective treatment of BPD and self-harm behaviors, and can serve as a model for teaching DBT during psychiatry residency training. Limitations include a small sample size and lack of baseline survey measurement of attitudes for pre and post curriculum comparison.

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Investigating Bang for Your Training Buck: A Randomized Controlled Trial Comparing Three Methods of Training Clinicians in Two Core Strategies of Dialectical Behavior Therapy

Cited by 45 publications

References 21 publications

Effects of dialectical behavior therapy skills training on outcomes for mental health staff in a child and adolescent residential setting

Effects of dialectical behavior therapy skills training on outcomes for mental health staff in a child and adolescent residential setting

Therapist Training on Cognitive Behavior Therapy for Anxiety Disorders Using Internet-Based Technologies

Teaching Dialectical Behavior Therapy to Psychiatry Residents: The Columbia Psychiatry Residency DBT Curriculum

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