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Administration and Policy in Mental Health and Mental Health Services Research

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01-11-2015 | Original Article

It Takes a Village: A Mixed Method Analysis of Inner Setting Variables and Dialectical Behavior Therapy Implementation

Authors: Matthew S. Ditty, Sara J. Landes, Andrea Doyle, Rinad S. Beidas

Published in: Administration and Policy in Mental Health and Mental Health Services Research | Issue 6/2015

Abstract

Guided by the Consolidated Framework for Implementation Research, this mixed method study explored the relationship between inner setting variables and dialectical behavior therapy (DBT) implementation. Intensively trained DBT clinicians completed an online quantitative survey (n = 79) and a subset were sequentially interviewed using qualitative methods (n = 20) to identify relationships between inner setting variables and DBT implementation. Four interpersonal variables—team cohesion, team communication, team climate, and supervision—were correlated with the quantity of DBT elements implemented. Qualitative themes corroborated these findings. Additional variables were connected to implementation by either quantitative or qualitative findings, but not both.

Aarons, G. A., Hurlburt, M., & Horwitz, S. M. (2011). Advancing a conceptual model of evidence-based practice implementation in public service sectors. Administration and Policy in Mental Health and Mental Health Services Research, 38, 4–23.PubMedCentralCrossRefPubMed

Aarons, G. A., & Palinkas, L. A. (2007). Implementation of evidence based practice in child welfare: Service provider perspectives. Administration and Policy in Mental Health and Mental Health Services Research, 34, 411–419.CrossRefPubMed

Amner, K. (2012). The effect of DBT provision in reducing the cost of adults displaying the symptoms of BPD. British Journal of Psychotherapy, 28, 336–352.CrossRef

Association, American Psychological. (2001). Practice guideline for the treatment of patients with borderline personality disorder. American Journal of Psychiatry, 158, 261–276.

Beidas, R. S., Edmunds, J. E., Marcus, S. C., & Kendall, P. C. (2012). Training and consultation to promote implementation of an empirically supported treatment: A randomized trial. Psychiatric Services, 63, 660–665.PubMedCentralCrossRefPubMed

Bohus, M., Haaf, B., Simms, T., Limberger, M. F., Schmahl, C., Unckel, C., et al. (2004). Effectiveness of inpatient dialectical behavioral therapy for borderline personality disorder: A controlled trial. Behaviour Research and Therapy, 42, 487–499.

Carmel, A., Rose, M. L., & Fruzzetti, A. E. (2013). Barriers and solutions to implementing dialectical behavior therapy in a public behavioral health system. Administration and Policy in Mental Health and Mental Health Services Research, 41, 1–7.

Carter, G. L., Willcox, C. H., Lewin, T. J., Conrad, A. M., & Bendit, N. (2010). Hunter DBT project: Randomized controlled trial of dialectical behaviour therapy in women with borderline personality disorder. Australian and New Zealand Journal of Psychiatry, 44, 162–173.CrossRefPubMed

Creswell, J. W. (2007). Qualitative inquiry and research design: Choosing among five approaches (2nd Ed. ed.). Thousand Oaks, CA: Sage Press.

Damschroder, L. J., Aron, D. C., Keith, R. E., Kirsh, S. R., Alexander, J. A., & Lowery, J. C. (2009). Fostering implementation of health services research findings into practice: A consolidated framework for advancing implementation science. Implementation Science, 4, 50.PubMedCentralCrossRefPubMed

Damschroder, L. J., & Lowery, J. C. (2013). Evaluation of a large-scale weight management program using the consolidated framework for implementation research (CFIR). Implementation Science, 8, 51.PubMedCentralCrossRefPubMed

Fixsen, D., Blase, K., Naoom, S., & Wallace, F. (2009). Core implementation components. Research on Social Work Practice, 19, 531.CrossRef

Fixsen, D. L., Naoon, S. F., Blase, K. A., Friedman, R. M., & Wallace, F. (2005). Implementation research: A synthesis of the literature. Tampa, FL: University of South Florida, Louis de la Parte Florida Mental Health Institute, the National Implementation Research Network.

Fowler, F. J. (1995). Improving survey questions: Design and evaluation (Vol. 38). Thousand Oaks, CA: Sage Publications.

Glisson, C., & Green, P. (2011). Organizational climate, services, and outcomes in child welfare systems. Child Abuse and Neglect, 35, 582–591.CrossRefPubMed

Herschell, A. D., Kogan, J. N., Celedonia, K. L., Gavin, J. G., & Stein, B. D. (2009). Understanding community mental health administrators’ perspectives on dialectical behavior therapy implementation. Psychiatric Services, 60, 989–992.CrossRefPubMed

Hogan, M. F. (2003). New Freedom Commission report: The president’s New Freedom Commission: Recommendations to transform mental health care in America. Psychiatric Services, 54, 1467–1474.CrossRefPubMed

Kivimaki, M., & Elovainio, M. (1999). A short version of the Team Climate Inventory: Development and psychometric properties. Journal of Occupational and Organizational Psychology, 72, 241–246.CrossRef

Koons, C. R., Robins, C. J., Lindsey Tweed, J., Lynch, T. R., Gonzalez, A. M., Morse, J. Q., et al. (2001). Efficacy of dialectical behavior therapy in women veterans with borderline personality disorder. Behavior Therapy, 32, 371–390.

Lehman, W. E., Greener, J. M., & Simpson, D. D. (2002). Assessing organizational readiness for change. Journal of Substance Abuse Treatment, 22, 197–209.CrossRefPubMed

Linehan, M. M. (1993). Cognitive-behavioral treatment of borderline personality disorder. New York, NY: Guilford.

Linehan, M. M., Armstrong, H. E., Suarez, A., Allmon, D., & Heard, H. L. (1991). Cognitive-behavioral treatment of chronically parasuicidal borderline patients. Archives of General Psychiatry, 48, 1060–1064.CrossRefPubMed

Linehan, M. M., Comtois, K. A., Murray, A. M., Brown, M. Z., Gallop, R. J., Heard, H. L., … & Lindenboim, N. (2006). Two-year randomized controlled trial and follow-up of dialectical behavior therapy vs therapy by experts for suicidal behaviors and borderline personality disorder. Archives of General Psychiatry, 63, 757–766.

Linehan, M. M., Dimeff, L. A., Reynolds, S. K., Comtois, K. A., Welch, S. S., Heagerty, P., et al. (2002). Dialectical behavior therapy versus comprehensive validation therapy plus 12-step for the treatment of opioid dependent women meeting criteria for borderline personality disorder. Drug and Alcohol Dependence, 67, 13–26.CrossRefPubMed

Linehan, M. M., Schmidt, H., Dimeff, L. A., Craft, J. C., Kanter, J., & Comtois, K. A. (1999). Dialectical behavior therapy for patients with borderline personality disorder and drug dependence. The American Journal on Addictions, 8, 279–292.CrossRefPubMed

Loo, R., & Loewen, P. (2002). A confirmatory factor-analytic and psychometric examination of the team climate inventory: Full and short versions. Small Group Research, 33, 254–265.CrossRef

Lynch, T. R., Trost, W. T., Salsman, N., & Linehan, M. M. (2007). Dialectical behavior therapy for borderline personality disorder. Annual Review of Clinical Psychology, 3, 181–205.CrossRefPubMed

Martinez, R. G., Lewis, C. C., & Weiner, B. J. (2014). Instrumentation issues in implementation science. Implementation Science, 9, 118.PubMedCentralCrossRefPubMed

McHugh, R. K., & Barlow, D. H. (2010). The dissemination and implementation of evidence-based psychological treatments: A review of current efforts. American Psychologist, 65, 73–84.CrossRefPubMed

McMain, S., Links, P., Gnam, W., Guimond, T., Cardish, R., Korman, L., et al. (2009). A randomized trial of dialectical behavior therapy versus general psychiatric management for borderline personality disorder. American Journal of Psychiatry, 166, 1365–1374.CrossRefPubMed

National Institute for Health and Clinical Excellence. (2009, January). Borderline personality disorder: Treatment and management. Retrieved from http://www.nice.org.uk/nicemedia/pdf/CG78NICEGuideline.pdf.

Palinkas, L. A., Aarons, G. A., Horwitz, S., Chamberlain, P., Hurlburt, M., & Landsverk, J. (2011). Mixed method designs in implementation research. Administration and Policy in Mental Health and Mental Health Services Research, 38, 44–53.PubMedCentralCrossRefPubMed

Priebe, S., Bhatti, N., Barnicot, K., Bremner, S., Gaglia, A., Katsakou, C., et al. (2012). Effectiveness and cost-effectiveness of dialectical behaviour therapy for self-harming patients with personality disorder: A pragmatic randomised controlled trial. Psychotherapy and Psychosomatics, 81, 356–365.

Proctor, E. K., Powell, B. J., & McMillen, J. (2013). Implementation strategies: Recommendations for specifying and reporting. Implementation Science, 8, 139.PubMedCentralCrossRefPubMed

Safer, D. L., Telch, C. F., & Agras, W. S. (2001). Dialectical behavior therapy for bulimia nervosa. American Journal of Psychiatry, 158, 632–634.CrossRefPubMed

Schmidt, H., I. I. I., Ivanoff, A., Korslund, K., & Linehan, M. M. (2008). Program Elements of Treatment Questionnaire. Seattle, WA: Behavioral Research & Therapy Clinics.

Substance Abuse and Mental Health Service Administration. (SAMHSA, 2010). Report to congress on borderline personality disorder. http://store.samhsa.gov/shin/content//SMA11-4644/SMA11-4644.pdf.

Swales, M. A., Taylor, B., & Hibbs, R. A. (2012). Implementing dialectical behaviour therapy: Programme survival in routine healthcare settings. Journal of Mental Health, 21, 548–555.CrossRefPubMed

Telch, C. F., Agras, W. S., & Linehan, M. M. (2001). Dialectical behavior therapy for binge eating disorder. Journal of Consulting and Clinical Psychology, 69, 1061–1065.CrossRefPubMed

Torrey, W. C., Bond, G. R., McHugo, G. J., & Swain, K. (2012). Evidence-based practice implementation in community mental health settings: The relative importance of key domains of implementation activity. Administration and Policy in Mental Health and Mental Health Services Research, 39, 353–364.CrossRefPubMed

Verheul, R., van den Bosch, L. M., Koeter, M. W., de Ridder, M. A., Stijnen, T., & Van Den Brink, W. (2003). Dialectical behaviour therapy for women with borderline personality disorder 12-month, randomised clinical trial in The Netherlands. The British Journal of Psychiatry, 182, 135–140.CrossRefPubMed

Title: It Takes a Village: A Mixed Method Analysis of Inner Setting Variables and Dialectical Behavior Therapy Implementation
Authors: Matthew S. Ditty
Sara J. Landes
Andrea Doyle
Rinad S. Beidas
Publication date: 01-11-2015
Publisher: Springer US
Published in: Administration and Policy in Mental Health and Mental Health Services Research / Issue 6/2015
Print ISSN: 0894-587X
Electronic ISSN: 1573-3289
DOI: https://doi.org/10.1007/s10488-014-0602-0

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It Takes a Village: A Mixed Method Analysis of Inner Setting Variables and Dialectical Behavior Therapy Implementation

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