title: Evaluation of an implementation initiative for embedding Dialectical Behavior Therapy in community settings.
abstract: We examined the effectiveness of Dialectical Behavior Therapy (DBT) training in community-based agencies. Data were gathered at four time points over a 2-year period from front-line mental health therapists (N=64) from 10 community-based agencies that participated in a DBT implementation initiative. We examined change on therapist attitudes toward consumers with Borderline Personality Disorder (BPD), confidence in the effectiveness of DBT, and use of DBT model components. All measures were self-report. Participating in DBT training was associated with positive changes over time, including improved therapist attitudes toward consumers with BPD, improved confidence in the effectiveness of DBT, and increased use of DBT components. Therapists who had the lowest baseline scores on the study outcomes had the greatest self-reported positive change in outcomes over time. Moreover, there were notable positive correlations in therapist characteristics; therapists who had the lowest baseline attitudes toward individuals with BPD, confidence in the effectiveness of DBT, or who were least likely to use DBT modes and components were the therapists who had the greatest reported increase over time in each respective area. DBT training with ongoing support resulted in changes not commonly observed in standard training approaches typically used in community settings. It is encouraging to observe positive outcomes in therapist self-reported skill, perceived self-efficacy and DBT component use, all of which are important to evidence-based treatment (EBT) implementation. Our results underscore the importance to recognize and target therapist diversity of learning levels, experience, and expertise in EBT implementation.
authors: Western Psychiatric Institute & Clinic, University of Pittsburgh School of Medicine, 3811 O' Hara Street, Pittsburgh, PA 15213, United States. Electronic address: herschellad@upmc.edu.
authors: Amy D
authors: AD
authors: Herschell
authors: Western Psychiatric Institute & Clinic, University of Pittsburgh School of Medicine, 3811 O' Hara Street, Pittsburgh, PA 15213, United States.
authors: Oliver J
authors: OJ
authors: Lindhiem
authors: Western Psychiatric Institute & Clinic, University of Pittsburgh School of Medicine, 3811 O' Hara Street, Pittsburgh, PA 15213, United States; Community Care Behavioral Health Organization, 112 Washington Boulevard, Pittsburgh, PA 15219, United States.
authors: Jane N
authors: JN
authors: Kogan
authors: RAND Corporation, 4570 Fifth Avenue, Suite 600, Pittsburgh, PA 15213, United States.
authors: Karen L
authors: KL
authors: Celedonia
authors: RAND Corporation, 4570 Fifth Avenue, Suite 600, Pittsburgh, PA 15213, United States.
authors: Bradley D
authors: BD
authors: Stein
mesh_terms: D000328:Adult; D000704:Analysis of Variance; D001291:Attitude of Health Personnel; D001521:Behavior Therapy / Q000193:education / Q000379:methods*; D001883:Borderline Personality Disorder / Q000628:therapy*; D003156:Community Mental Health Services / Q000379:methods* / Q000458:organization & administration; D055317:Evidence-Based Practice; D005260:Female; D006282:Health Personnel / Q000193:education* / Q000523:psychology; D006284:Health Plan Implementation; D006801:Humans; D008297:Male; D015337:Multicenter Studies as Topic; D010043:Outcome and Process Assessment, Health Care; D010414:Pennsylvania; D011369:Professional-Patient Relations; D000078329:Workforce
keywords: Dialectical Behavior Therapy; Evidence-based treatment; Implementation