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Switching roles: a qualitative study of staff experiences of being dialectical behaviour therapists within the National Health Service in England

Published online by Cambridge University Press:  25 August 2017

Rebecca Hutton ,
Suzanne Hodge  and
Martin Tighe
Rebecca Hutton*
Affiliation:
Lancashire Care NHS Foundation Trust
Suzanne Hodge
Affiliation:
Division of Health Research, Faculty of Health and Medicine, Lancaster University, Lancaster LA1 4YW
Martin Tighe
Affiliation:
Lancashire Care NHS Foundation Trust
*
*Author for Correspondence to Dr Rebecca Hutton, Lancashire Care NHS Foundation Trust, Preston PR5 6XT. E-mail: [email protected]
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Abstract

Many National Health Service (NHS) Trusts in England have invested in dialectical behavioural therapy (DBT) for mental health service users. The experiences of NHS staff delivering DBT were explored using semi-structured interviews with six dialectical behaviour therapists working in secondary mental health services within the NHS. The aim was to consider the impact on staff of adding the DBT therapist role onto their existing job role. Interview data were analysed using thematic analysis. Six themes were inductively generated from the data: DBT as a useful framework; DBT as the most satisfying part of the job; ‘Worzel Gummidge heads’– conflicts in roles; ‘DBT buddies’– the importance of informal support; uncertainty about the future; and recursivity – using DBT skills personally. Interactions between themes, implications for the service and future research directions are discussed. Key findings suggest that the addition of the DBT therapist role, as well as the recursive nature of DBT, has a positive impact professionally and personally. However, the service context within which participants were working can lead this additional role to cause increased demands and therefore stress, reducing that positive impact.

Keywords

self carequalitative methodspsychological therapiespersonality disordercognitive behavioural intervention
Type
Original Research
Information
the Cognitive Behaviour Therapist , Volume 10 , 2017 , e6
Copyright
Copyright © British Association for Behavioural and Cognitive Psychotherapies 2017 

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References

Recommended reading

Linehan, MM (1993). Cognitive-Behavioural Treatment of Borderline Personality Disorder. New York: Guilford Press.Google Scholar
Linehan, MM (2014). DBT Skills Training Manual (second edition). New York: Guilford Press.Google Scholar

References

American Psychological Association (APA) (2013). Diagnostic and Statistical Manual of Mental Disorders (DSM-V) (fifth edition). Washington, DC: APA.Google Scholar
Braun, V, Clarke, V (2006). Using thematic analysis in psychology. Qualitative Research in Psychology 3, 77–101. doi: 10.1191/1478088706qp063oa Google Scholar
Chapman, AL, Turner, BJ, Dixon-Gordon, KL (2011). To integrate or not to integrate dialectical behaviour therapy with other therapy approaches? Clinical Social Work 39, 170–179. doi: 10.1007/s10615-010-0283-4 Google Scholar
Cohen-Katz, J, Wiley, SD, Capuano, T, Baker, DM, Shapiro, S (2005). The effects of mindfulness-based stress reduction on nurse stress and burnout. Part 2: a quantitative and qualitative study. Holistic Nursing Practise 19, 26–35.Google Scholar
Crawford, MJ, Adedeji, T, Price, K, Rutter, D (2010). Job satisfaction and burnout among staff working in community-based personality disorder services. International Journal of Social Psychiatry 56, 196–206. doi: 10.1177/0020764009105702 Google Scholar
Crawford, MJ, Price, K, Rutter, D, Moran, P, Tyrer, P, Bateman, A, Fonagy, P, Gibson, S, Weaver, T (2008). Dedicated community-based services for adults with personality disorder: Delphi study. British Journal of Psychiatry 193, 342–343. doi: 10.1192/bjp.bp.107.043042 Google Scholar
DiGiorgio, KE, Glass, CR, Arnkoff, DB (2010). Therapists’ use of DBT: a survey study of clinical practice. Cognitive and Behavioral Practice 17, 213–221. doi: 10.1016/j.cbpra.2009.06.003 Google Scholar
Feigenbaum, JD, Fonagy, P, Pilling, S, Jones, A, Wildgoose, A, Bebbington, PE (2011). A real-world study of the cost-effectiveness of DBT in the UK National Health Service. British Journal of Clinical Psychology 51, 121–141. doi: 10.1111/j.2044-8260.2011.02017.x CrossRefGoogle Scholar
Fonagy, P, Gergely, G, Jurist, EL, Target, M (2004). Affect Regulation, Mentalization and the Development of the Self. London: Karnac Books.Google Scholar
Francis, R (2013). Report of the Mid-Staffordshire NHS Foundation Trust Public Enquiry. HC947. London: Stationery Office.Google Scholar
Giorgi, A, Giorgi, B (2003). Phenomenology. In Smith, JA (ed), Qualitative Psychology: A Practical Guide to Research Methods, pp. 25–50. London: SAGE.Google Scholar
Linehan, MM (1993a). Cognitive-Behavioural Treatment of Borderline Personality Disorder. New York: Guilford Press.Google Scholar
Linehan, MM (1993b). Skills Training Manual for Treating Borderline Personality Disorder, New York: Guilford Press.Google Scholar
Linehan, MM, Cochran, BN, Mar, CM, Levensky, ER, Comtois, KA (2000). Therapeutic burnout among borderline personality disordered clients and their therapists: development and evaluation of two adaptations of the Maslach burnout inventory. Cognitive and Behavioural Practice 7, 329–337. doi: 10.1016/s1077-7229(00)80091-7 Google Scholar
National Institute for Health and Care Excellence (NICE) (2009). Borderline personality disorder: recognition and management. NICE guideline on clinical treatment and management; available at: http://www.nice.org.uk/nicemedia/live/12125/43045/43045.pdf (accessed 8 January 2014).Google Scholar
Perseius, KI, Kaver, A, Ekdahl, S, Asberg, M, Samuelsson, M (2007). Stress and burnout in psychiatric professionals when starting to use dialectical behaviour therapy in the work with young self-harming women showing borderline personality symptoms. Journal of Psychiatric and Mental Health 14, 635–643.Google Scholar
Swales, M (2009). Dialectical behaviour therapy: description, research and future directions. International Journal of Behavioral Consultation and Therapy 5, 164–177.Google Scholar
Swales, M (2010a). Implementing DBT: selecting, training and supervising a team. the Cognitive Behaviour Therapist 3, 71–79. doi: 10.1017/S1754470X10000061 CrossRefGoogle Scholar
Swales, M (2010b). Implementing dialectical behaviour therapy: organizational pre-treatment. the Cognitive Behaviour Therapist 3, 145–157. doi: 10.1017/S1754470X10000115 CrossRefGoogle Scholar
Swenson, CR, Torrey, WC, Koerner, K (2002). Implementing dialectical behavior yherapy. Psychiatric Services 53, 171–178.Google Scholar
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