Barriers and facilitators affecting the sustainability of dialectical behaviour therapy programmes: A qualitative study of clinician perspectives
Abstract
Dialectical behaviour therapy (DBT) is a psychological treatment developed for individuals experiencing chronic suicidality and high‐risk behaviours. Despite the substantial evidence supporting the effectiveness of DBT, many programmes have problems with its sustainability. The goals of the current qualitative study were to identify factors that impact the sustainability of DBT programmes within a publicly funded mental health system and identify factors that are particularly relevant for youth DBT programmes. Interviews with trained adult and youth DBT clinicians (N = 31) were conducted to explore their experiences providing DBT. Three major themes that emerged as barriers to the sustainability of DBT programmes included the following: systemic challenges, conflicts within the consultation teams and clinician burnout. Factors influencing the success of DBT programmes included the following: systemic support, clinician commitment and “buy in”, and team cohesion. Factors specific to providing DBT with youth (i.e. level of commitment, simplifying the language, and parental investment) and recommendations for sustainability for adults and youth programmes were also identified. Findings of this study provide valuable information on factors impacting DBT programmes within the unique context of a Canadian mental health service system, where community‐based services are publicly funded. These findings have clear clinical utility and can be used to generate solutions to clinicians' perceived barriers and to foster perceived facilitators within similar contexts.
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Staff turnover contributed to discontinuity in Dialectical Behavior Therapy (DBT) team members.
“Staff turnover contributed to discontinuity in Dialectical Behavior Therapy (DBT) team members [78], and appropriate staffing (i.e., ensuring manageable workloads) and blocking time for team members were identified as critical to sustainment of a team-based model in the VA [67].”
From Teamwork and implementation of innovations in healthcare and human service settings: a systematic review (2024) · cites this paper as [78]
Conflicts and lack of safety and trust within DBT teams resulted in their dissolution.
“Another study of DBT teams described conflicts and lack of safety and trust within teams resulting in their dissolution [78].”
From Teamwork and implementation of innovations in healthcare and human service settings: a systematic review (2024) · cites this paper as [78]
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- Authors
- Popowich, A. D., Mushquash, A. R., Pearson, E., Schmidt, F., & Mushquash, C. J.
- Affiliations
- Lakehead University (CA)
- Thunder Bay Regional Health Sciences Centre (CA)
- Corresponding author
- Mushquash, Aislin R.
- Venue
- Counselling and Psychotherapy Research
- Publisher
- Wiley
- Published
- 2019-07-25
- Volume
- 20
- Issue
- 1
- Pages
- 68-80
- ISSN
- 1473-3145 (ISSN-L)
- 1746-1405
- OpenAlex
- W2963826818
- Cited by
- 15
- References
- 46
- Citations by year
- 2026: 1 · 2024: 10 · 2023: 1 · 2022: 1 · 2020: 2
- FWCI
- 0.88
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Counselling and Psychotherapy Research (publishedVersion)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Personality Disorders and Psychopathology
- Social Sciences › Psychology › Clinical Psychology › Psychiatric care and mental health services
- Social Sciences › Psychology › Clinical Psychology › Psychotherapy Techniques and Applications
- Keywords
- dialectical behavior therapy, treatment sustainability, barriers and facilitators, clinician perspectives, clinician burnout, team cohesion, systemic support, publicly funded mental health services, community-based services, suicidality, parental involvement
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