Widening the Net: Adapting a Dialectical Behavior Therapy Skills–Informed Group Intervention to Better Meet the Needs of an Urban-Poor Psychiatric Psychiatric Inpatient Population

Abstract

Abstract: This article details various considerations in the development of a dialectical behavior therapy skills–informed weekly group intervention for psychiatric inpatients receiving treatment in an economically disadvantaged city safety-net hospital. The authors describe the impact of multiple compounding stressors, such as poverty, racial and ethnic discrimination, housing/food insecurity, complex trauma, education level, and other psychological and psychosocial stressors that informed the development of the intervention. Overarching goals of this intervention focused on treatment engagement, assurance that the intervention met best practices in trauma-informed care, and orienting treatment to focus on patient empowerment. Additionally, this article discusses the process of developing a group-based, DBT skills–informed intervention to be applicable to patients with diverse psychiatric diagnoses and varying levels of functioning on an inpatient unit. The benefits of this treatment approach as well as the considerations taken to adapt it to the multifactorial needs of the patient population are also discussed.