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Process evaluation of dialectical behavior therapy dissemination: Knowledge retention and recursive training effects

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Abstract

Dialectical behavior therapy (DBT) can be challenging to implement with fidelity to the model. Residential treatment settings are frequently overlooked as sites of implementation for DBT despite the potential benefits. This mixed-methods process evaluation examines the impact of DBT training in five residential programs on provider DBT-specific knowledge, staff turnover rates, and staff perceptions of training impact on their practice.

Post-training staff knowledge levels varied considerably, but on average demonstrated substantial DBT-related knowledge retention. Staff turnover rates did not change significantly in four of five programs despite showing an overall trend in reduction. Qualitative results suggest substantial recursive training effects consistent with the DBT model. Themes emerged related to the impact of the training on effectiveness of practice with clients, application of DBT skills in staff personal lives, and positive effects on program culture. Results have implications for better understanding the mechanisms of successful dissemination of DBT across treatment settings.

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Data Availability

The datasets generated during and/or analyzed during the current study are available from the corresponding author on reasonable request.

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Author information

Authors and Affiliations

  1. Graduate Department of Social Work, West Chester University, Anderson Hall, 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, Anderson 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.

Ethics declarations

Conflict of Interest

The authors have no conflicts of interest to report.

Ethical Approval

This study was approved by the West Chester University Institutional Review Board.

Informed Consent Form

Project Title: Implementation of an Evidence-based Practice in a Community Agency.

Investigator: [Author], Department of Graduate Social Work, West Chester University, 610–738-0340.

You are being asked to participate in an evaluation project conducted in collaboration with West Chester University of PA. This form explains the purpose of the project, the procedures to be used, the expected duration or frequency of your participation, and the potential benefits and possible risks of participation. You may ask your trainer Susan Hunt or contact Dr. Amber Holbrook with any questions you have to help you understand the project. A basic explanation of the project is written below. By completing this survey, you are consenting to participate in this project. Your participation is voluntary. You will be given a copy of this form to keep.

1. Nature and Purpose of the Project

Resources for Human Development, Inc. has partnered with West Chester University to evaluate the effectiveness of the Dialectical Behavior Therapy (DBT) training provided to its shelter and residential programs. Your participation in this evaluation is very important to us! We are interested in finding out what you have learned in the training, how the training has affected your practice with clients, and how you feel about your program environment.

2. Explanation of Procedures

You will be asked to complete some survey questions during your staff meeting related to your feelings about your program environment. If you agree to complete the survey and participate in this evaluation, then data from your training quizzes, session rating scales, and DBT group observation tools will also be used. If you choose not to participate in the evaluation, do not complete the survey you are provided.

3. Identification Of Any Experimental Medical Treatments Or Procedures

None

4. Benefits

The DBT training may improve your knowledge and skills in helping clients with mental health and substance use disorders. If you choose to participate in the evaluation of the training by completing the surveys, you will help us to improve the training and provide evidence on how the training may used with residential staff.

5. Discomfort and Risks

Your participation in the evaluation is voluntary and may skip any question or withdraw at any time without any penalty. We do not anticipate there are any risks to you in participating in this survey since you will not be asked any personal questions about your personal health or mental health status.

6. Confidentiality

All information you provide will be kept confidential. Only the trainer and the Principal Investigator will have access to your surveys on your program environment. Your name will be removed from your quizzes and session rating scales before the data is used for the evaluation.

7. Explanation of compensation, if any

No compensation or incentive is provided to you for participating in the evaluation of the DBT training.

8. Name of person to contact in case of research-related injury

Please contact [author] (610–738-0340) at West Chester University if you have any questions.

If you have any questions about your rights as a participant in this research, or if you feel you have been placed at risk, you can contact the Chair of the Institutional Review Board through the Office of Sponsored Research, 610–436-3557.

If at any time you become uncomfortable with this evaluation project you are free to stop your participation.

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Holbrook, A.M., Hunt, S.R. & See, M.R. Process evaluation of dialectical behavior therapy dissemination: Knowledge retention and recursive training effects. Curr Psychol 41, 6014–6023 (2022). https://doi.org/10.1007/s12144-020-01095-3

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