Evaluation of a Combined Mental Health and Addictions Dialectical Behaviour Therapy Program - Kara Boles (2018)

Those living in Northwestern Ontario are at a heightened risk for mental health disorders. Mental health symptoms can be exacerbated when an individual is suffering with co-morbid substance use difficulties. Treating co-morbid mental health and substance use difficulties is often a challenge in a clinical setting. Dialectical Behaviour Therapy (DBT) is empirically validated as a treatment for both mental health and substance use difficulties. This study provides an evaluation of the St. Joseph’s Care Group (SJCG) Mental Health and Addictions DBT program. Specially, examining how effective it is at treating people with co-morbid mental health and substance use difficulties. The sample included 44 outpatient clients who were referred to the DBT program from one of the affiliated SJCG programs. The program is intended for adult outpatients only. Each participant was given a questionnaire aimed at measuring mental health symptoms, quality of life, as well as adaptive and maladaptive coping behaviours. Participants completed the same questionnaire at intake, as well as 6 and 12 months into treatment. Change in symptoms, quality of life, and coping behaviours was analyzed using the SPSS-25 software.  The DBT program resulted in: Improved quality of life, reduced mental health symptomology, as well as reduced dysfunctional coping strategies. Clients also experienced a reduction in problematic behaviours (i.e., drug use, self-harm, alcohol abuse). Further, clients who continued treatment for 12 months experienced a continual improvement in most areas and demonstrated better end-of-treatment scores than those who completed treatment at 6 months. Results from this evaluation suggest that DBT contributes to improvements in multiple aspects of functioning for the clients receiving this service.

Read More
Factors that impact the implementation and sustainability of dialectical behaviour therapy programs: a qualitative study of clinician perspectives - Allie Popwich (2017)

Dialectical behaviour therapy (DBT) is a psychological treatment developed for individuals experiencing significant mental health issues along with high-risk behaviours (e.g., suicidal behaviours, self-harm, substance use, aggression, impulsivity). Despite substantial evidence supporting its use, many DBT programs have problems with sustainability, which leaves individuals with severe mental health issues without the treatment they need. The goals of the current study were to: a) identify factors that impact the functioning of DBT programs in Thunder Bay, Ontario; b) identify factors that are particularly relevant for youth DBT programs; c) make recommendations to foster the facilitators of success and address the barriers that hinder the functioning of DBT programs. Clinicians (N=31) trained in DBT completed a semistructured interview exploring their experiences providing DBT and thoughts on the factors that facilitate or hinder the functioning of the DBT programs. The interviews were transcribed verbatim and then organized into themes using inductive thematic analysis. Three major themes emerged as barriers to the functioning of DBT programs: systemic challenges, conflicts within the consultation teams, and clinician burnout. Factors influencing the success of DBT programs included: systemic support, clinician commitment and “buy in,” and team cohesion. Unique factors specific to providing DBT with youth (i.e., level of commitment, simplifying the language, and parental investment) were also identified. The findings provide novel information on barriers that impact the functioning of DBT programs from clinicians’ perspectives within a Canadian publically funded mental health system. These findings have clear clinical utility and can be used to generate solutions to clinicians’ perceived barriers and to foster perceived facilitators.

Read More
MA ThesisTyler Drawson
Single-Session Counselling in Mental Health Services: Evaluation of a New Program - Victoria Ewan (2016)

Organizations offering mental health services are in need of innovative solutions to address a lack of accessibility and availability in service provision. Waitlists for counselling services are long, often forcing those experiencing mental health difficulties to rely on acute care services in the interim. One option, single-session counselling, allows consumers to access services when they need it, as often as they need it. This service model can be integrated into current services to contend with difficulties related to efficiency and accessibility. The current study evaluated a new single-session counselling program offered in an outpatient community mental health clinic in Northwestern Ontario. The majority of participants rated the service favourably, and experienced a decrease in mental health difficulties and associated impairment. Single-session counselling reduced difficulties associated with the presenting problem, and allowed access to services sooner. Continued implementation of this model of care is supported by the current findings. Dissemination of information describing the nature of single-session counselling, as well as outcomes of program evaluations such as the current study, may help to increase acceptance of its integration into ongoing mental health services.

Read More
MA ThesisTyler Drawson