It Takes a Village: A Mixed Method Analysis of Inner Setting Variables and Dialectical Behavior Therapy Implementation

Ditty, Matthew S.; Landes, Sara J.; Doyle, Andrea; Beidas, Rinad S.

doi:10.1007/s10488-014-0602-0

Cited by 61Health Policy Implementation SciencePersonality Disorders and PsychopathologyPsychiatric care and mental health services

It Takes a Village: A Mixed Method Analysis of Inner Setting Variables and Dialectical Behavior Therapy Implementation

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Ditty, Matthew S., Landes, Sara J., Doyle, Andrea, Beidas, Rinad S.·2015·Administration and Policy in Mental Health and Mental Health Services Research

DOI 10.1007/s10488-014-0602-0PMC PMC4400206

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Abstract

Guided by the Consolidated Framework for Implementation Research, this mixed method study explored the relationship between inner setting variables and dialectical behavior therapy (DBT) implementation. Intensively trained DBT clinicians completed an online quantitative survey (n = 79) and a subset were sequentially interviewed using qualitative methods (n = 20) to identify relationships between inner setting variables and DBT implementation. Four interpersonal variables-team cohesion, team communication, team climate, and supervision-were correlated with the quantity of DBT elements implemented. Qualitative themes corroborated these findings. Additional variables were connected to implementation by either quantitative or qualitative findings, but not both.

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Team size was positively correlated with fidelity in a mixed methods study of DBT.
“In a mixed methods study, team size was positively correlated with fidelity, and qualitative data suggested that team size may increase as a result of successful implementation [47].”
From Teamwork and implementation of innovations in healthcare and human service settings: a systematic review (2024) · cites this paper as [47]
Team longevity and history of change were not associated with implementation outcomes.
“In these studies, team longevity and history of change were not associated with implementation outcomes [47, 68].”
From Teamwork and implementation of innovations in healthcare and human service settings: a systematic review (2024) · cites this paper as [47]
Qualitative data indicated that liking one's team members and having a shared team identity were critical to effective implementation in DBT teams.
“In DBT teams, cohesion was associated with fidelity, and qualitative data indicated that liking one’s team members and having a shared team identity were critical to effective implementation [47].”
From Teamwork and implementation of innovations in healthcare and human service settings: a systematic review (2024) · cites this paper as [47]
Greater team climate for innovation was associated with greater fidelity among DBT teams.
“Greater team climate for innovation was also associated with greater fidelity (i.e., implementation of more program elements) among DBT teams [47].”
From Teamwork and implementation of innovations in healthcare and human service settings: a systematic review (2024) · cites this paper as [47]
Communication in DBT teams was positively associated with fidelity.
“Communication in DBT teams was positively associated with fidelity [47].”
From Teamwork and implementation of innovations in healthcare and human service settings: a systematic review (2024) · cites this paper as [47]

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Additional file 1 of Associations between teamwork and implementation outcomes in multidisciplinary cross-sector teams implementing a mental health screening and referral protocol
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Additional file 1 of Teamwork and implementation of innovations in healthcare and human service settings: a systematic review
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Additional file 3 of A structural equation model of CFIR inner and outer setting constructs, organization characteristics, and national DPP enrollment
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Additional file 4 of A structural equation model of CFIR inner and outer setting constructs, organization characteristics, and national DPP enrollment
Madrigal, L., Haardörfer, R., Kegler, M. C., Piper, S., Blais, L. M., Weber, M. B., & Escoffery, C. (2024) · Figshare · doi:10.6084/m9.figshare.26641918
Additional file 1 of A structural equation model of CFIR inner and outer setting constructs, organization characteristics, and national DPP enrollment
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Practice Settings and Dialectical Behavior Therapy Implementation: A mixed method analysis
Ditty, M. S. (2013) · Scholarly Commons (University of Pennsylvania) · Cited by 2 · see citing works
Self-citation
Recommended Citation
Ditty, M. S. (2016)
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Evaluating the national multisite implementation of dialectical behaviour therapy in a community setting: a mixed methods approach
Flynn, D., Joyce, M., Gillespie, C., Kells, M., Swales, M. A., Spillane, A., Hurley, J., Hayes, A., Gallagher, E., Arensman, E., et al. (2020) · BMC Psychiatry · doi:10.1186/s12888-020-02610-3 · Cited by 25 · see citing works
Additional file 2 of Evaluating the national multisite implementation of dialectical behaviour therapy in a community setting: a mixed methods approach
Flynn, D., Joyce, M., Gillespie, C., Kells, M., Swales, M. A., Spillane, A., Hurley, J., Hayes, A., Gallagher, E., Arensman, E., et al. (2020) · Figshare · doi:10.6084/m9.figshare.12308204
Additional file 1 of Evaluating the national multisite implementation of dialectical behaviour therapy in a community setting: a mixed methods approach
Flynn, D., Joyce, M., Gillespie, C., Kells, M., Swales, M. A., Spillane, A., Hurley, J., Hayes, A., Gallagher, E., Arensman, E., et al. (2020) · Figshare · doi:10.6084/m9.figshare.12308195

Authors: Ditty, M. S., Landes, S. J., Doyle, A., & Beidas, R. S.
Affiliations: University of Washington (US)
University of Pennsylvania (US)
Corresponding author: Ditty, Matthew S.
ORCID: Landes, Sara J.
Beidas, Rinad S.
Venue: Administration and Policy in Mental Health and Mental Health Services Research
Publisher: Springer Science and Business Media LLC
Published: 2014-10-16
Volume: 42
Issue: 6
Pages: 672-681
ISSN: 0894-587X (ISSN-L)
1573-3289
DOI: 10.1007/s10488-014-0602-0
PMC: PMC4400206
OpenAlex: W2012972137
Cited by: 61
References: 47
Citations by year: 2026: 4 · 2025: 2 · 2024: 10 · 2023: 9 · 2022: 1 · 2021: 5 · 2020: 6 · 2019: 4 · 2018: 9 · 2017: 7 · 2016: 4
FWCI: 6.64
Type: journal article
Language: en
Open access: green
www.ncbi.nlm.nih.gov
Licence: www.springer.com/tdm (tdm)
Locations: Administration and Policy in Mental Health and Mental Health Services Research (publishedVersion)
PubMed (publishedVersion)
Europe PMC (PubMed Central) (acceptedVersion)
PubMed Central (acceptedVersion)
Funders: National Institute of Mental Health (MH099179, K23MH099179, R25MH080916)
Topics: Health Sciences › Health Professions › General Health Professions › Health Policy Implementation Science
Social Sciences › Psychology › Clinical Psychology › Personality Disorders and Psychopathology
Social Sciences › Psychology › Clinical Psychology › Psychiatric care and mental health services
Keywords: dialectical behavior therapy, treatment implementation, team cohesion, team communication, team climate, clinical supervision, Consolidated Framework for Implementation Research, intensive training
MeSH terms: Behavior Therapy, Communication, Humans, Organization and Administration, Patient Care Team, Surveys and Questionnaires, Organizational Culture, Qualitative Research, Evidence-Based Practice

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It Takes a Village: A Mixed Method Analysis of Inner Setting Variables and Dialectical Behavior Therapy Implementation

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