Evaluation of a Coordinated National Implementation of DBT in Community Mental Health Services in Ireland
试验速览
- 阶段
- 不适用
- 状态
- 已完成
- 发起方
- 入组人数
- 210
- 主要终点
- Change in self-harm behaviour
研究概览
简要总结
This study aims to evaluate the coordinated implementation of Dialectical Behaviour Therapy in Community Mental Health Services in Ireland.
There are three main objectives of the current study:
- evaluate the effectiveness of DBT for adults and adolescents attending Community Mental Health Services in multiple sites across Ireland
- conduct an economic evaluation of the coordinated implementation of DBT in community settings in Ireland
- evaluate the implementation initiative by means of quantity, quality and experience of the coordinated implementation
详细描述
The National Dialectical Behaviour Therapy (DBT) Project, Ireland was established in the Republic of Ireland in 2013. The aims of the project were twofold: to implement DBT in Community Mental Health Services across Ireland and to evaluate this coordinated implementation of DBT at a national level.
DBT was initially formulated as a treatment for Borderline Personality Disorder (BPD) which is typically characterised by patterns of emotional and behavioural dysregulation that often manifests in self-harm and suicidal ideation. DBT is noted to be an intervention with a growing evidence base that demonstrates its effectiveness in treating individuals with BPD. More than a dozen controlled trials have been completed at multiple independent sites. The results of these trials have reported a reduction in suicidal behaviours, inpatient hospitalisations, depression, hopelessness and suicidal ideation among other constructs which individuals with BPD experience.
While the efficacy of DBT has been demonstrated through multiple controlled trials, few studies have examined the effectiveness of DBT in community mental health settings. In particular, no study has evaluated a coordinated national implementation of DBT across multiple sites in a publicly funded health system. The current study aims to evaluate the the coordinated implementation of DBT in Community Mental Health Services in Ireland
研究设计
- 研究类型
- Interventional
- 分配方式
- Non Randomized
- 干预模型
- Parallel
- 主要目的
- Treatment
- 盲法
- None
入排标准
- 年龄范围
- 13 Years 至 —（Child, Adult, Older Adult）
- 性别
- All
- 接受健康志愿者
- 是
入选标准
- •Meet criteria for diagnosis of either Borderline Personality Disorder (DSM IV/V) or Emotionally Unstable Personality Disorder (ICD-10)
- •A persistent pattern of deliberate self-harm with deliberate self-harm behaviour having occurred within the last 6 months OR one suicidal act having occurred within the last 6 months
- •The individual will have discussed the diagnosis with a member of the DBT team and will have expressed an interest in, and commitment to the 12 month programme.
- •Adolescents:
- •Between/ including the ages of 13 and 18 years
- •Demonstrating emotional behavioural disturbance/ emotional dysregulation
- •A persistent pattern of deliberate self-harm with deliberate self-harm or a suicidal act having occurred within the last 16 weeks OR chronic suicidal ideation
- •the young person and their parent/guardian will have discussed their emotional behavioural disturbance/ emotional dysregulation with a member of the DBT team and will have expressed an interest in, and commitment to the 16 week programme.
排除标准
- •Adults and Adolescents:
- •An active psychosis
- •If the client has severe developmental delays, cognitive impairment or learning disabilities (exceeding mild range)
- •If a clients' substance/drug dependence, eating disorder or any other mental health issue/behaviour is at such a level that it would impede their engaging with any of the modalities of DBT
结局指标
主要结局
Change in self-harm behaviour
时间窗: Pre-intervention, 6 months, 12 months (post-intervention) and 18 months (6 months post-intervention)
Change in frequency of self-harm behaviour. Frequency of self-harm behaviour for a six month period will be recorded by the DBT therapist working with each individual by means of clinical file review. Self-harm behaviour frequency is scored on a scale of 1 to 5 where 1 = Not at all, 2 = Rarely; 3 = Occasionally, 4 = Often, 5 = Most of the time.
Change in suicidal ideation
时间窗: Pre-intervention, 6 months, 12 months (post-intervention) and 18 months (6 months post-intervention)
Questionnaire for Suicidal Ideation (QSI). The QSI is a 6-item self-report questionnaire developed by the researchers to assess suicidal thoughts and ideation.
Change in borderline symptoms
时间窗: Pre-intervention, 6 months, 12 months (post-intervention) and 18 months (6 months post-intervention)
Borderline Symptom List (BSL-23). The BSL-23 is a self-report questionnaire which comprises 23 items measuring borderline-typical symptomatology.
次要结局
- Change in DBT Skill Use(Pre-intervention, 6 months, 12 months (post-intervention) and 18 months (6 months post-intervention))
- Change in hopelessness(Pre-intervention, 6 months, 12 months (post-intervention) and 18 months (6 months post-intervention))
- Change in depression(Pre-intervention, 6 months, 12 months (post-intervention) and 18 months (6 months post-intervention))
研究者
Mary Joyce
Project Co-ordinator
Health Service Executive, Ireland