Living on the borderline - an evaluation of the client impact and active ingredients of dialectical behaviour therapy for borderline personality disorder in Irish adult mental health settings
Bayley, Austin
(2009)
Living on the borderline - an evaluation of the client impact and active ingredients of dialectical behaviour therapy for borderline personality disorder in Irish adult mental health settings.
PhD thesis, Dublin City University.
The research evaluated the client impact and active ingredients of Dialectical
Behaviour Therapy (DBT) for Borderline Personality Disorder (BPD) in three Adult
Mental Health settings in Dublin. A mixed methodology approach was undertaken
with two phases incorporating a single case study design and qualitative investigation.
Phase 1 was a qualitative investigation of DBT clients who had completed (n=16) and
those who dropped out (n=6) of treatment. The interview schedule examined client
perspectives of treatment components, changes occurring since before DBT and
reasons for dropping out. Phase 2 was a case study approach with clients who were
currently attending DBT (n=10). Outcome measurements were administered and
qualitative investigation was undertaken at two-month intervals to gauge perspectives
of treatment and changes occurring. Records of attendance and admissions were also
used. Four conclusions from the research were drawn. 1) DBT was associated with
tangible improvements in client lives and had considerable impact on level of risk,
well-being and functioning. Level of hopelessness and BPD symptoms showed
significant positive change between baseline and six months. 2) DBT was not suitable
for all participants for specific reasons discussed within. The level of satisfaction with
DBT was overall high and some useful clinical recommendations were gleaned from
service user input. 3) Key active ingredients of and obstacles to treatments were
evaluated. 4) Recommendations for service delivery, development and further
research were outlined.