Dialectical behaviour therapy skills training for substance use disorders and dual diagnosis

Abstract

Background: People with Dual Diagnosis (DD) present with different intervention needs and respond differently to clients with a single diagnosis. Quantitative research suggests that Dialectical Behaviour Therapy Skills Training (DBT-ST) can produce positive outcomes for people with DD. However, little is understood regarding the mechanisms which produce this change. Aim: This study aimed to explore the experience of people with DD who participated in an adapted DBT-ST intervention in the context of an Irish addiction service. The study focused on identifying aspects of DBT-ST which were perceived as producing or impeding change. Procedure: Four participants who completed a 24-week, adapted DBT-ST intervention for DD were recruited via purposive sampling. Data were gathered using semi-structured interviews. Anonymised transcripts were analysed using Interpretative Phenomenological Analysis. Five superordinate themes and 11 subthemes were identified on analysing the entire data set. Conclusions: Findings bring us closer to understanding the perceived intervention needs of people with DD in Ireland. Participants viewed DBT-ST as supporting relapse prevention by enhancing capacity to manage emotions and problem solve in high risk situations. Findings suggest that a non-judgmental environment, enhanced assertiveness skills and rediscovering meaningful activities also promoted change. Findings have implication for service provision for this cohort.