The DOI matches its Crossref record; 31 of the 31 references it cites were found in a registry or an index.
Implementing Dialectical Behaviour Therapy: Programme survival in routine healthcare settings
Abstract
BACKGROUND: The National Institute of Health and Clinical Excellence recommends considering Dialectical Behaviour Therapy (DBT), an efficacious treatment for borderline personality disorder, especially when reduction in self-harm is a clinical priority [ NCCMH (2009) . Borderline Personality Disorder: Treatment and Management. Leicester: The British Psychological Society and the Royal College of Psychiatrists]. Treatment teams began using DBT in the UK in 1994. Concerns have been raised, however, about the sustainability of DBT programmes in routine clinical practice [Pitman, A., & Tyrer, P. (2008). Implementing clinical guidelines for self-harm - highlighting key issues arising from the NICE guideline for self-harm. Psychology and Psychotherapy: Theory, Research and Practice, 81, 377-397]. AIMS: This study sought to establish the sustainability of UK DBT programmes and to explore factors that impacted on effective implementation. METHOD: All teams trained in DBT in the UK between 1994 and 2007 were contacted. Each team was categorised as either active or inactive. The date of programme cessation was established. Team leaders of active, and as far as possible inactive, programmes were interviewed about aspects of implementation. RESULTS: The survival curve demonstrated that DBT programmes ran an increased risk of failure in the second and fifth years after training. Absence of organisational support and staff turnover were the most commonly reported implementation challenges. CONCLUSIONS: Sustainable implementation of DBT, as with other evidence-based interventions, requires organisational support that incorporates a strategy for further staff training and development.
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“However, it has not been evaluated outside a research setting.”
From Emotion regulation group therapy for deliberate self-harm: A multi-site evaluation in routine care using an uncontrolled open trial design (2017) · cites this paper as [17]
Citations
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Lieb, K., Zanarini, M. C., Schmahl, C., Linehan, M. M., & Bohus, M. (2004) · The Lancet · doi:10.1016/s0140-6736(04)16770-6 · Cited by 1,369
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Linehan, M. M., Schmidt, H., Dimeff, L. A., Craft, J. C., Kanter, J., & Comtois, K. A. (1999) · The American Journal on Addictions · doi:10.1080/105504999305686 · Cited by 1,043
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Clarkin, J. F., Levy, K. N., Lenzenweger, M. F., & Kernberg, O. F. (2007) · American Journal of Psychiatry · doi:10.1176/ajp.2007.164.6.922 · Cited by 997 · cited 2×
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“Clients with a borderline personality disorder (BPD) diagnosis are among the highest utilisers of psychiatric services (including individual and group therapies, and day and in-patient treatment), greater than clients with either depression or other personality disorders (Bender et al., 2001).”
BackgroundLinehan, M. M., Dimeff, L. A., Reynolds, S. K., Comtois, K. A., Welch, S. S., Heagerty, P., & Kivlahan, D. R. (2002) · Drug and Alcohol Dependence · doi:10.1016/s0376-8716(02)00011-x · Cited by 741
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- Henggeler S.W., 1995, Journal of Consulting & Clinical Psychology, 63, 709, 10.1037/0022-006X.63.5.709 · DOI
- NCCMH, 2009, Borderline personality disorder: Treatment and management.
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Items 101–112 of 112
Chapter 25. Translational Research in Borderline Personality Disorder
Schmahl, C. G., & Herpertz, S. C. (2021) · American Psychiatric Association Publishing eBooks · doi:10.1176/appi.books.9781615379699.lg25
Chapter 21. Co-occurring Substance Use Disorders
Gorfinkel, L., Prins, S. J., Elliott, J. C., Meyers, J. L., & Hasin, D. S. (2021) · American Psychiatric Association Publishing eBooks · doi:10.1176/appi.books.9781615379699.lg21
Chapter 9. Longitudinal Course and Outcomes
Grilo, C. M., & Skodol, A. E. (2021) · American Psychiatric Association Publishing eBooks · doi:10.1176/appi.books.9781615379699.lg09
Pixar’s Inside Out as a Dialectical Behavior Therapy–Informed Intervention for Adults
Brazaitis, K., & Stetson, A. C. (2025) · American Journal of Psychotherapy · doi:10.1176/appi.psychotherapy.20250001
Dialectical Behaviour Therapy: Curriculum, Training, and Clinician Guide
Swales, M. A. (2025) · Springer eBooks · doi:10.1007/978-3-032-00353-9_9
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
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
Harris, M., Lamers, C., & Swales, M. A. (2026) · Borderline Personality Disorder and Emotion Dysregulation · doi:10.1186/s40479-026-00344-4
Revisão integrativa sobre as diretrizes NICE para intervenções em saúde mental
Gaudêncio, C., Franken, I., Souza, S., & Silva, M. (2026) · Caderno Pedagógico · doi:10.54033/cadpedv23n5-053
Correa-Ramírez, M., Villalón, F., Orto, C. V. E. D., Pérez, Carrasco, C., Solar, V. D., Franco, N., de León, C. P., Garay, L., Bustos, V., et al. (2026) · Research Square · doi:10.21203/rs.3.rs-10123024/v1
DBT in Wales: From adolescent therapeutic community to a national implementation programme
Swales, M. A. (2026) · Clinical Psychology Forum · doi:10.53841/bpscpf.2026.1.399.18
Metadata
- Authors
- Swales, M. A., Taylor, B., & Hibbs, R. A. B.
- Affiliations
- Bangor University (GB)
- Corresponding author
- Swales, Michaela Anne
- Venue
- Journal of Mental Health
- Publisher
- Informa UK Limited
- Published
- 2012-09-07
- Volume
- 21
- Issue
- 6
- Pages
- 548-555
- ISSN
- 0963-8237 (ISSN-L)
- 1360-0567
- OpenAlex
- W2161394252
- Cited by
- 112
- References
- 31
- Citations by year
- 2026: 6 · 2025: 5 · 2024: 4 · 2023: 7 · 2022: 2 · 2021: 39 · 2020: 8 · 2019: 5 · 2018: 11 · 2017: 5 · 2016: 5 · 2015: 7 · 2014: 5 · 2013: 3
- FWCI
- 5.43
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Journal of Mental Health (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Department of Biotechnology, Ministry of Science and Technology, India
- Topics
- Social Sciences › Psychology › Clinical Psychology › Personality Disorders and Psychopathology
- Health Sciences › Health Professions › General Health Professions › Health Policy Implementation Science
- Social Sciences › Psychology › Clinical Psychology › Psychiatric care and mental health services
- Keywords
- dialectical behavior therapy, borderline personality disorder, self-harm, program sustainability, implementation barriers, organizational support, employee turnover, routine clinical practice, evidence-based interventions
- MeSH terms
- Behavior Therapy, Borderline Personality Disorder, United Kingdom, Humans, Mental Health Services, Prospective Studies, Program Evaluation, Survival Analysis, Self-Injurious Behavior, Treatment Outcome
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