Abstract
Aims and MethodDialectical behaviour therapy is an evidence-based treatment for people with borderline personality disorder. We describe implementation and outcomes of a new service.ResultsHospital use and frequency of self-harm were reduced dramatically with dialectical behaviour therapy. Moreover, the therapy can be implemented successfully in a relatively short time at modest costs.Clinical ImplicationsDialectical behaviour therapy provides a useful model of treatment for people with borderline personality disorder and/or self-harm in community mental health settings.
Highlights
Dialectical behaviour therapy provides a useful model of treatment for people with borderline personality disorder and/or selfharm in community mental health settings
We describe the evolution of a small service for dialectical behaviour therapy in Newham, East London, since its inception in 2003
The project provides care coordination according to the care programme approach (CPA; Department of Health, 1999), including consultant responsibility and medication management
Summary
Hospital use and frequency of selfharm were reduced dramatically with dialectical behaviour therapy. Dialectical behaviour therapy provides a useful model of treatment for people with borderline personality disorder and/or selfharm in community mental health settings. Borderline personality disorder is a common and often severe mental health problem with a median prevalence from nine epidemiological studies of 1.6% (De Girolomo & Dotto, 2000). Emerging evidence about positive treatment outcomes challenges widely held doubts about whether borderline personality disorder is treatable. Blennerhassett & O’Raghallaigh (2005) recently considered whether dialectical behaviour therapy could be translated to community mental health settings given the limited resources and shortage of trained staff. They predicted that this therapy would be confined to specialist settings. We present the structure of the programme, demographic data, treatment outcomes and costs
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