Adapting dialectical behaviour therapy in forensic learning disability services: A grounded theory informed study of "what works". Issue 4 (27th January 2019)

• Record Type: Journal Article
• Authors: Browne, Claire; Brown, Gill; Smith, Ian C.
• Is Part Of: Journal of applied research in intellectual disabilities. Volume 32:Issue 4(2019:Jul.)
• Page Start: 792
• Page End: 805
• Publication Date: 2019-01-27
• Subjects: dialectical behaviour therapy -- emotion regulation -- forensic -- intellectual disabilities -- process of change -- qualitative methods; Learning disabilities -- Periodicals; Mental retardation -- Periodicals; Learning disabled -- Periodicals; People with mental disabilities -- Periodicals; 616.85880072
• DOI: 10.1111/jar.12569
• Languages: English
• ISSNs: 1360-2322

Abstract

Abstract: Background: Emerging evidence indicates effectiveness of dialectical behaviour therapy (DBT) for people with intellectual disabilities (PWID) in forensic settings; however, little is known about "what works" facilitating engagement and change. Methods: Eleven interviews were conducted with nine service users across two secure inpatient services. Grounded theory was used to develop a model of perceived engagement and change. Results: The model provides insights into how change occurs during DBT delivered in forensic settings. DBT constitutes a challenging journey, yet provides the motivation and means to address individual's intra‐/interpersonal aggression and progress towards release. Participants experienced engaging with DBT as difficult and coercive, moving from compliance and avoidance to acceptance and change. Key factors included participants' motivation, beliefs about safety and ability to change, and interactions with staff. Conclusion: Recommendations are made for increasing intrinsic motivation, reducing perceived coercion and distress, and for future research to address potential aversive elements and enhance effectiveness.