Integrating Dialectical Behavioural Therapy (DBT) for young people with the complexity of drug and alcohol misuse concerns

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1 Integrating Dialectical Behavioural Therapy (DBT) for young people with the complexity of drug and alcohol misuse concerns

2 Lauren Mullaney Senior Psychologist Triple Care Farm Ph Lisa Spackman Clinical Program Development Officer (Psychologist) Triple Care Farm Ph

3 Background Triple Care Farm is a dual diagnosis, drug and alcohol residential rehabilitation service for year olds. TCF works with a range of presenting complex issues.

4 Objectives for today Image taken from:

5 Question: What do people say to you when they find out you work in Drug and Alcohol OR What do people say to you when they find out you are a consumer of treatment for drug and alcohol concerns?

6 So, why do you do the work that you do? What is it that drives you?

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8 Image taken from:

9 DBT is a therapy among equals; we are not the experts. DBT can be practiced by a wide range of therapists from different professional backgrounds and varying experience levels (Brassington & Krawitz, 2006).

10 Dialectical Behaviour Therapy (DBT) is a comprehensive cognitive behavioural treatment for complex, difficult-to-treat mental disorders. Marsha Linehan, 1993

11 Current Evidence Base Mental Health Concern Suicide and self-harm behaviours Borderline Personality Disorder Binge Eating Disorders/Bulimia Nervosa/Anorexia Nervosa Substance Dependence, and co-occurring substance misuse and mental health issues Populations Adolescents and adults, crosscultural, outpatient and inpatient settings, forensic settings Women, inpatient and outpatient settings, families Adults, adolescents, outpatient and inpatient settings Adolescents and adults, outpatient and inpatient settings Major depressive disorder/dysthymia Adolescents and adults, Elderly, outpatient and inpatient settings Irritability and anger Women in an outpatient setting Bi Polar I and Bi Polar II Adults in an outpatient setting

12 Current Evidence Base Mental Health Concern/Target Behaviour Anti-social personality disorders and violence Populations Adult men in a forensic setting Offending behaviours Domestic abuse victims Impulsive behaviour problems Female adolescents in a forensic setting Adult women in an outpatient setting Adults in a forensic setting Trichotillomania Intellectual Disability Adult women in a outpatient setting Adults in a forensic setting ADHD Adults in an outpatient setting

13 Current Evidence Base (Uncontrolled Studies) Mental Health Concern Elder abuse Survivors of childhood sexual abuse PTSD Populations Adult caregivers in an outpatient settings Adult women in a residential program Adult women in a residential program For more information, you can visit the Behavioural Tech website

14 The modular practice elements approach; based on the idea that therapeutic interventions are comprised of numerous discrete and separable elements (Chorpita et al., 2007; Garland et al., 2008; Mitchell, 2011). Aims to respect and build on the strengths of current practice rather than replacing it.

15 1. Mindfulness 2. Distress Tolerance 3. Interpersonal Effectiveness 4. Emotion Regulation

16 Be mindful of core values TCF s group program draws upon the key principles supported by Project Air Strategy and DBT philosophy; Demonstrate empathy Listen to the person s current experience Validate the person s current emotional state Maintain a non-judgemental stance Stay calm and respectful Foster trust to allow strong emotions to be freely expressed Be clear consistent and reliable Remember aspects of challenging behaviour has had survival value in past Be human and be prepared to acknowledge both the serious and the funny sides of life Convey encouragement and hope about the person s capacity for change while validating their current emotional state

17 Orientation and introductions 5 minutes Here and now, interpersonal focus 20 minutes Mindfulness activity 5 minutes Practice review 20 minutes Short Break 5 minutes Skills training 60 minutes Mindfulness activity and/or additional summary time 10 minutes

18 Simplified handouts Minimal handouts are used Each student is given a 47 page, A5 workbook, which includes basic information for all group content, as well as plenty of space for note taking, drawing etc. Information about groups, and additional resources are also available to students through the complimentary website Designed to be used on smart phones, tablets and desktop Includes mindfulness tracks, links to further reading, videos etc., and can connect young people to external services like lifeline and online counselling

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21 Thankyou for your time! If you are interested in accessing either the group facilitator manual or skills workbook, please contact TCF, as we are happy to share resources If you have any further questions please don t hesitate to contact mullaneyl@missionaustralia.com.au