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An evaluation of value-based outcomes for women admitted to a dialectical behaviour therapy integrated practice unit: a follow-up study

Published online by Cambridge University Press:  28 October 2022

Elanor Lucy Webb Open the ORCID record for Elanor Lucy Webb [Opens in a new window] ,
Alessandra Girardi ,
Emily Fox  and
Paul Wallang
Elanor Lucy Webb*
Affiliation:
Research and Innovation Centre, St Andrew’s Healthcare, Northampton NN1 5DG, UK
Alessandra Girardi
Affiliation:
Research and Innovation Centre, St Andrew’s Healthcare, Northampton NN1 5DG, UK
Emily Fox
Affiliation:
Low Secure and Specialist Rehabilitation Division, St Andrew’s Healthcare, Northampton NN1 5DG, UK
Paul Wallang
Affiliation:
Research and Innovation Centre, St Andrew’s Healthcare, Northampton NN1 5DG, UK
*
*Corresponding author. E-mail: ELWebb@stah.org
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Abstract

Background:

An earlier evaluation (Fox et al., 2014) highlighted reductions in risk behaviours and restrictive practices for women admitted to low secure dialectical behaviour therapy (DBT) unit. Since then, a value-based healthcare model has been adopted.

Aims:

To explore changes in health, social and psychological functioning, risk, quality of life, and in incidents of violence and restrictive practices, over the initial 12-month period of admission to a specialist DBT service.

Method:

Data were extracted from electronic clinical records for 41 women with emotionally unstable personality disorder admitted to a specialist integrated practice unit (IPU) providing a comprehensive DBT programme. Secondary analysis was conducted on an anonymous dataset of routinely collected outcome measures at baseline admission, and 6 and 12 months post-admission. ANOVAs and pairwise post hoc comparisons, and non-parametric equivalents, were conducted to examine changes in outcomes.

Results:

Findings showed statistically significant improvements in mental health scores on the ReQOL (p<.01), global, wellbeing, problems, functioning and risk scores on the COREOM (all p<.01), and severe disturbance, emotional wellbeing, socioeconomic status, risk and need scores on the HoNOS-Secure (all p<.05). Significant reductions in risk behaviours (p<.01) and restrictive practices (p<.01) were also apparent. The most substantiative improvements were largely demonstrated over a 12-month admission period.

Conclusions:

Admission to the DBT IPU yielded significant improvements on outcomes pertaining to quality of life, psychological distress, and risk. Importantly, these are outcomes that aligned with patients’ perceptions of recovery.

Keywords

dialectical behaviour therapy (DBT)emotionally unstable personality disorder (EUPD)integrated practice unit (IPU)outcomesvalue-based healthcare

Information

Type
Brief Clinical Report
Information
Behavioural and Cognitive Psychotherapy , Volume 51 , Issue 1 , January 2023 , pp. 110 - 115
Copyright
© The Author(s), 2022. Published by Cambridge University Press on behalf of the British Association for Behavioural and Cognitive Psychotherapies

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References

Alderman, N., Knight, C., Stewart, I., & Gayton, A. (2011). Measuring behavioural outcome in neurodisability. British Journal of Neuroscience, 7, 691–695.CrossRefGoogle Scholar
Evans, C., Mellor-Clark, J., Margison, F., Barkham, M., Audin, K., Connell, J., & McGrath, G. (2000). CORE: Clinical Outcomes in Routine Evaluation. Journal of Mental Health, 9, 247–255. https://doi.org/10.1080/jmh.9.3.247.255 CrossRefGoogle Scholar
Fox, E., Krawczyk, K., Staniford, J., & Dickens, G. L. (2014). A service evaluation of a 1-year dialectical behaviour therapy programme for women with borderline personality disorder in a low secure unit. Behavioural and Cognitive Psychotherapy, 43, 676–691.CrossRefGoogle Scholar
Keetharuth, A., Brazier, J., Connell, J., Carlton, J., Taylor Buck, E., Ricketts, T., & Barkham, M. (2017). Development and validation of the Recovering Quality of Life (ReQoL) outcome measures. Policy Research Unit in Economic Evaluation of Health and Care Interventions. Universities of Sheffield and York. EEPRU Research Report 050.Google Scholar
Maddison, P., Marlee, A. L., Webb, D. E., Berry, A. D. I., & Whitelock, T. (2016). The subscale structure of the HoNOS in a forensic population: a framework for a currency and tariff outcome system in mental health. International Journal of Forensic Mental Health, 15, 362–368.CrossRefGoogle Scholar
Porter, M. E., & Lee, T. H.(2013). The strategy that will fix health care. Harvard Business Review, 91, 50–70.Google Scholar
Sugarman, P., & Walker, L. (2007). Health of the Nation Outcome Scales for Users of Secure and Forensic Services (HoNOS-Secure). Available at: https://www.rcpsych.ac.uk/events/in-house-training/health-of-nation-outcome-scales Google Scholar
Tiffin, P., Daniel, M., & Carey, J. (2011). The ability of the HoNOS-secure version 2b to predict care-setting. Paper presented at International Association of Forensic Mental Health Services (June 2011), Barcelona, Spain.Google Scholar
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