Women’s Dialectical Behaviour Therapy (DBT) Service

The Dialectical Behaviour Therapy (DBT) service offers a therapy programme with strict adherence to the full DBT model. The model has a robust evidence base and has demonstrated success in decreasing risk behaviours, improving relationships and enhancing independent living skills.

The overall aim is to empower individuals to improve their self-worth and build a better quality of life for themselves. The DBT programme aims to deliver world-class DBT interventions within a fixed period of time, during which people can achieve stability and enhance their quality of life. There is a focus on rehabilitation through engagement, placing a strong emphasis on generating a sense of belonging through active community involvement and building meaningful social networks.

The Model

The DBT programme has complete fidelity to the evidence-based DBT model as described by Marsha Linehan. The full DBT programme is supported by a My Motivational Goals Programme (MMGP) that is bespoke to each person. Each individual sets their incentives to provide motivation and structure and reinforce skilful behaviour. The Behavior Intervention Plan (BIP) is developed collaboratively by the team and the patient. It clearly articulates clinical interventions, progress and a discharge plan. The adherence to the DBT programme, combined with the skilful use of goals, allows staff to enhance safety while promoting independence and empowerment. ‘My Motivational Goals Programme’ was co-produced by individuals at Hope House to improve engagement.

The 15-month timescale provides those we support with a clear goal of recovery, from admission back into the community. The Multidisciplinary Team (MDT) will liaise closely with the receiving care team to enhance the effectiveness of the transition for all involved. This may involve transitional visits and training to family/carers to ensure the continued application of acquired skills going forward.

Outcome measures

The programme uses a wide range of outcome measures including:

• HoNOS (Health of the Nation Scales)
• The Warwick-Edinburgh Mental Wellbeing Scale
• (WEMWBS)
• Work and Social Adjustment Scale (WSAS)
• Clinical Outcomes in Routine Evaluation (CORE)
• Borderline Evaluation of Severity over Time (BEST)
• Borderline Symptom List – 23 (BSL-23)
• Patient Reported Outcome Measures (PROM)
• Observational Data Incidents of deliberate self-harm, treatment at a general hospital, observation levels, days requiring enhanced support and mental health status
• My Motivational Goals Programme (MMGP)

Who we support

The service accepts women who are motivated to decrease their problem behaviours and engage in the intensive therapy programme.

• Individuals aged 18 and over
• People who have received a diagnosis of moderate to severe PD with EUPD traits, but not suffering from any additional major mental illness which will interfere with skills acquisition
• Intellectually able to engage with the treatment programme
• Individuals presenting with high-risk self-harming behaviours with a risk of suicide
• Individuals who may or may not be detained under Mental Health Act 1983 (amended 2007)
• Exhibiting problem behaviours linked to difficulties with emotion regulation, distress tolerance and interpersonal difficulties, including self-harm, suicidal acts and substance abuse
• Those presenting with behaviours that challenge or are perceived to challenge, that require enhanced relational security of a Level 2 rehabilitation service
• May have a history of trauma, abuse, and attachment issues
• May be transitioning from CAMHS

For further information or to discuss a potential referral, please dial our 24-hour referral line on 0800 218 2398. Alternatively, you can email referrals@elysiumhealthcare.co.uk or elys.referrals@nhs.net

Nicky McCallum – Out of Area Placement Manager – CNWL MK.

‘I would like to add that we are very impressed with and grateful for the work that you’ve done with our patient during their placement at Hope House. It is because of this work that they are able and happy to step down to a place in the community. Thank you very much.’