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Implementation of Dialectical Behavior Therapy in Residential Treatment Programs: A Process Evaluation Model for a Community-Based Agency

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Abstract

Dialectical behavior therapy (DBT) can be challenging to implement in community-based settings. Little guidance is available on models to evaluate the effectiveness or sustainability of training and implementation efforts. Residential programs have much to gain from introduction of evidence-based practices, but present their own challenges in implementation. This paper presents a low-cost process evaluation model to assess DBT training piloted in residential programs. The model targets staff and organizational factors associated with successful implementation of evidence-based practices and matches data collection to the four stages of the DBT training model. The strengths and limitations of the evaluation model are discussed.

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Author information

Authors and Affiliations

  1. West Chester University, Reynolds Hall, Room 205, West Chester, PA, 19383, USA

    Amber M. Holbrook

  2. Resources for Human Development, Inc., 4700 Wissahickon Avenue, Philadelphia, PA, 19144, USA

    Susan R. Hunt

  3. West Chester University, Reynolds Hall, West Chester, PA, 19383, USA

    Mary Renata See

Authors
  1. Amber M. Holbrook
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  2. Susan R. Hunt
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  3. Mary Renata See
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Corresponding author

Correspondence to Amber M. Holbrook.

Appendix

Appendix

DBT Knowledge Assessment Quiz Items

Question

DBT module

Question format

Integrating your Emotional Mind and your Rational Mind is part of which skill?

Emotional regulation

Multiple choice

When you “just notice”, have a “teflon mind”, attach to nothing, you are using which skill?

Mindfulness

Multiple choice

When you want to get your objective met from others, you should try and use which skill?

Interpersonal skills

Multiple choice

What skill are you using when you throw yourself into the moment (“All in”) while at the same time you are letting go of the fear of failure, self-consciousness, and judgment?

Mindfulness

Multiple choice

Which choice is one of the 6 steps of Validation?

Interpersonal effectiveness

Multiple choice

Creating a validating environment is critical to reducing dysregulation because

Bio-social model

Multiple choice

Distress Tolerance Skills are to help us get through a tough situation and not make it worse

Distress tolerance

True/false

If you want an emotion to decrease, do the opposite to the emotion action

Emotional regulation

True/false

When you give “just the facts” about what you notice, you are using your Describe skill

Mindfulness

True/false

Multi-tasking and distraction are examples of Mindfulness

Mindfulness

True/false

People become dysregulated because of an interaction between biological predisposition and an invalidating environment

Bio-social model

True/false

Wise Mind is the synthesis of ____________ mind and the ______________ mind

Mindfulness

Fill in the blank

Accepting yourself while simultaneously learning skills to change is an example of _____________

Dialectics

Fill in the blank

“We all are doing the best we can AND we can do better”

Dialectics

Matching

“Just get through it, and don’t make it worse”

Distress tolerance

Matching

“One thing at a time”

Mindfulness

Matching

“Throw yourself all in”

Mindfulness

Matching

“It is what it is”

Dialectics

Matching

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Holbrook, A.M., Hunt, S.R. & See, M.R. Implementation of Dialectical Behavior Therapy in Residential Treatment Programs: A Process Evaluation Model for a Community-Based Agency. Community Ment Health J 54, 921–929 (2018). https://doi.org/10.1007/s10597-017-0224-6

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