Dialectical Behaviour Therapy: Implementing and Evaluating an Evidence-Based Interdisciplinary Intervention for Vulnerable Youth

Wednesday, 24 July 2013: 1:30 PM

Elizabeth McCay, RN, PhD
School of Nursing, Ryerson University, Toronto, ON, Canada
Andria Aiello, RN, MN
School of Nursing, Department of Community Services, Ryerson University, Toronto, ON, Canada
Heather Beanlands, RN, PhD
School of Nursing, Ryerson University, Toronto, ON, Canada
Souraya Sidani, PhD
Faculty of Nursing, Ryerson University, Toronto, ON, Canada
Linda Cooper, RN, PhD
Daphne Cockwell School of Nursing, Ryerson University, Toronto, ON, Canada
Jean Hughes, PhD
School of Nursing, Dalhousie University, Halifax, NS, Canada
Shelley McMain, PhD
Department of Psychiatry, Centre for Addiction and Mental Health (CAMH), Toronto, ON, Canada
Susan Quesnel, MD, FRCPC
Youth Addiction and Concurrent Disorders Service, Centre for Addiction and Mental Health, Toronto, ON, Canada
Carol Howes, MSW
Covenant House, Residential Outreach Programs, Toronto, ON, Canada
Jeff Karabanow, PhD
School of Social Work, Dalhousie University, Halifax, NS, Canada
Bruce MacLaurin, MSW
Faculty of Social Work,, University of Calgary, Calgary, AB, Canada
John Langley, MD
Department of Psychiatry, University of Toronto and St. Michael's Hospital, Toronto, ON, Canada
Stephen Hwang, MD
Keenan Research Centre of the Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, ON, Canada

Learning Objective 1: Recognize the potential to adopt Dialectical Behaviour Therapy (DBT) in a range of diverse settings providing services for vulnerable youth.

Learning Objective 2: Understand the critical role of an implementation science approach in supporting the uptake of evidence-based approaches for vulnerable youth.

Background: This study aims to support the uptake of an evidence-based intervention to improve the mental health and overall functioning of street-involved youth. The study is implementing and evaluating the effectiveness of a 12-week Dialectical Behaviour Therapy (DBT) intervention to reduce emotional distress, enhance interpersonal effectiveness and strengthen resilience amongst youth participating in transitional housing programs across two national sites (Toronto and Calgary). 

Methodology:  This study has adopted an implementation science approach to actively engage stakeholders, address barriers to effective implementation of the evidence-based intervention, and build the capacity of frontline clinicians to respond to the mental health challenges of vulnerable youth. Evaluation is comprised of a mixed method approach; specifically a wait-list control group design to assess the effectiveness of the intervention, as well as a subsample of qualitative interviews to elicit the experience of youth with regard to the intervention.

DBT Training: Agency staff received DBT training using a variety of methods: (1) online DBT training; (2) a series of DBT training sessions/webinars; and (3) a written treatment manual. In order to evaluate the DBT training methods, community agency staff were asked to complete several questionnaires (DBT knowledge and application) at 4 different time points throughout the course of the study.

Findings: Seventy youth have been recruited to date. Forty-one youth have participated or are currently participating in the intervention with 12 youth dropping out after starting the intervention and 17 withdrawing before starting the intervention. Furthermore, 13 agency providers have completed the DBT training and 3 staff will have completed the training in December 2012. The DBT training results will be complete and ready for presentation by July 2013.   

Implications: If shown to be effective, this evidence-based intervention can be readily taught to front-line providers and implemented across a range of settings, thereby building resources for youth.