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Teaching Dialectical Behavior Therapy to Psychiatry Residents: The Columbia Psychiatry Residency DBT Curriculum

Objective Dialectical behavior therapy (DBT) is an evidence-based psychosocial treatment with efficacy in reducing self-harm behaviors in borderline personality disorder (BPD). This study describes and evaluates a clinical curriculum to teach DBT to psychiatry residents, developed at a large urban u...

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Published in:Academic psychiatry 2017-02, Vol.41 (1), p.10-15
Main Authors: Brodsky, Beth S., Cabaniss, Deborah L., Arbuckle, Melissa, Oquendo, Maria A., Stanley, Barbara
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creator Brodsky, Beth S.
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Stanley, Barbara
description Objective Dialectical behavior therapy (DBT) is an evidence-based psychosocial treatment with efficacy in reducing self-harm behaviors in borderline personality disorder (BPD). This study describes and evaluates a clinical curriculum to teach DBT to psychiatry residents, developed at a large urban university hospital. The curriculum objectives are to (1) have psychiatry residents achieve basic understanding of DBT theory and clinical skill, (2) increase residents’ ability and confidence in treating self-harm behaviors (both suicidal behavior and non-suicidal self-injury), and (3) enhance residents’ willingness to treat individuals with BPD. Methods In addition to a 6-week didactic course on DBT offered to all residents ( n  = 62), 25 elected to enroll in a year-long DBT clinical training curriculum over the course of a 5-year period. The DBT clinical training consisted of 15 h of additional didactics, ongoing conduct of individual therapy and group DBT skills training, videotaping of individual therapy sessions, and weekly supervision meetings utilizing videotape to provide feedback. Residents participating in the clinical training program videotaped baseline and later sessions, which were rated for DBT adherence. All 62 graduates of the program were surveyed regarding the impact of the training on their practice of psychiatry. Results Upon graduation, a high percentage (87 % in the curriculum and 70 % in the didactic course only) reported incorporating DBT into their psychiatry practice, as well as willingness and confidence in treating BPD and self-harm behaviors. Residents participating in the clinical training demonstrated significant improvement in their ability to utilize DBT interventions, particularly in structuring sessions, problem assessment, problem solving, and using validation and dialectical strategies. Conclusion This DBT curriculum was effective in preparing psychiatrists-in-training to incorporate evidence-based practices for effective treatment of BPD and self-harm behaviors and can serve as a model for teaching DBT during psychiatry residency training. Limitations include a small sample size and lack of baseline survey measurement of attitudes for pre- and post-curriculum comparison.
doi_str_mv 10.1007/s40596-016-0593-0
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This study describes and evaluates a clinical curriculum to teach DBT to psychiatry residents, developed at a large urban university hospital. The curriculum objectives are to (1) have psychiatry residents achieve basic understanding of DBT theory and clinical skill, (2) increase residents’ ability and confidence in treating self-harm behaviors (both suicidal behavior and non-suicidal self-injury), and (3) enhance residents’ willingness to treat individuals with BPD. Methods In addition to a 6-week didactic course on DBT offered to all residents ( n  = 62), 25 elected to enroll in a year-long DBT clinical training curriculum over the course of a 5-year period. The DBT clinical training consisted of 15 h of additional didactics, ongoing conduct of individual therapy and group DBT skills training, videotaping of individual therapy sessions, and weekly supervision meetings utilizing videotape to provide feedback. Residents participating in the clinical training program videotaped baseline and later sessions, which were rated for DBT adherence. All 62 graduates of the program were surveyed regarding the impact of the training on their practice of psychiatry. Results Upon graduation, a high percentage (87 % in the curriculum and 70 % in the didactic course only) reported incorporating DBT into their psychiatry practice, as well as willingness and confidence in treating BPD and self-harm behaviors. Residents participating in the clinical training demonstrated significant improvement in their ability to utilize DBT interventions, particularly in structuring sessions, problem assessment, problem solving, and using validation and dialectical strategies. Conclusion This DBT curriculum was effective in preparing psychiatrists-in-training to incorporate evidence-based practices for effective treatment of BPD and self-harm behaviors and can serve as a model for teaching DBT during psychiatry residency training. Limitations include a small sample size and lack of baseline survey measurement of attitudes for pre- and post-curriculum comparison.</description><identifier>ISSN: 1042-9670</identifier><identifier>EISSN: 1545-7230</identifier><identifier>DOI: 10.1007/s40596-016-0593-0</identifier><identifier>PMID: 27481266</identifier><language>eng</language><publisher>Cham: Springer International Publishing</publisher><subject>Academic Medical Centers ; Behavior modification ; Behavior Therapy - education ; Borderline Personality Disorder - therapy ; Curricula ; Curriculum ; Didacticism ; Empirical Report ; Female ; Humans ; Internship and Residency ; Male ; Medical Education ; Medicine ; Medicine &amp; Public Health ; New York ; Personality Problems ; Psychiatry ; Psychiatry - education ; Psychotherapy ; Self destructive behavior ; Skills ; Suicide Prevention ; Supervision ; Teaching Methods ; Training</subject><ispartof>Academic psychiatry, 2017-02, Vol.41 (1), p.10-15</ispartof><rights>Academic Psychiatry 2016</rights><rights>Academic Psychiatry 2016.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c470t-cae6e4b0a5d489fe3878368af4aa79ded3c03540017074f3e66fc224742f06b23</citedby><cites>FETCH-LOGICAL-c470t-cae6e4b0a5d489fe3878368af4aa79ded3c03540017074f3e66fc224742f06b23</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.proquest.com/docview/2932563540/fulltextPDF?pq-origsite=primo$$EPDF$$P50$$Gproquest$$H</linktopdf><linktohtml>$$Uhttps://www.proquest.com/docview/2932563540?pq-origsite=primo$$EHTML$$P50$$Gproquest$$H</linktohtml><link.rule.ids>230,314,780,784,885,21378,21394,27924,27925,33611,33612,33877,33878,43733,43880,74221,74397</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/27481266$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Brodsky, Beth S.</creatorcontrib><creatorcontrib>Cabaniss, Deborah L.</creatorcontrib><creatorcontrib>Arbuckle, Melissa</creatorcontrib><creatorcontrib>Oquendo, Maria A.</creatorcontrib><creatorcontrib>Stanley, Barbara</creatorcontrib><title>Teaching Dialectical Behavior Therapy to Psychiatry Residents: The Columbia Psychiatry Residency DBT Curriculum</title><title>Academic psychiatry</title><addtitle>Acad Psychiatry</addtitle><addtitle>Acad Psychiatry</addtitle><description>Objective Dialectical behavior therapy (DBT) is an evidence-based psychosocial treatment with efficacy in reducing self-harm behaviors in borderline personality disorder (BPD). This study describes and evaluates a clinical curriculum to teach DBT to psychiatry residents, developed at a large urban university hospital. The curriculum objectives are to (1) have psychiatry residents achieve basic understanding of DBT theory and clinical skill, (2) increase residents’ ability and confidence in treating self-harm behaviors (both suicidal behavior and non-suicidal self-injury), and (3) enhance residents’ willingness to treat individuals with BPD. Methods In addition to a 6-week didactic course on DBT offered to all residents ( n  = 62), 25 elected to enroll in a year-long DBT clinical training curriculum over the course of a 5-year period. The DBT clinical training consisted of 15 h of additional didactics, ongoing conduct of individual therapy and group DBT skills training, videotaping of individual therapy sessions, and weekly supervision meetings utilizing videotape to provide feedback. Residents participating in the clinical training program videotaped baseline and later sessions, which were rated for DBT adherence. All 62 graduates of the program were surveyed regarding the impact of the training on their practice of psychiatry. Results Upon graduation, a high percentage (87 % in the curriculum and 70 % in the didactic course only) reported incorporating DBT into their psychiatry practice, as well as willingness and confidence in treating BPD and self-harm behaviors. Residents participating in the clinical training demonstrated significant improvement in their ability to utilize DBT interventions, particularly in structuring sessions, problem assessment, problem solving, and using validation and dialectical strategies. 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This study describes and evaluates a clinical curriculum to teach DBT to psychiatry residents, developed at a large urban university hospital. The curriculum objectives are to (1) have psychiatry residents achieve basic understanding of DBT theory and clinical skill, (2) increase residents’ ability and confidence in treating self-harm behaviors (both suicidal behavior and non-suicidal self-injury), and (3) enhance residents’ willingness to treat individuals with BPD. Methods In addition to a 6-week didactic course on DBT offered to all residents ( n  = 62), 25 elected to enroll in a year-long DBT clinical training curriculum over the course of a 5-year period. The DBT clinical training consisted of 15 h of additional didactics, ongoing conduct of individual therapy and group DBT skills training, videotaping of individual therapy sessions, and weekly supervision meetings utilizing videotape to provide feedback. Residents participating in the clinical training program videotaped baseline and later sessions, which were rated for DBT adherence. All 62 graduates of the program were surveyed regarding the impact of the training on their practice of psychiatry. Results Upon graduation, a high percentage (87 % in the curriculum and 70 % in the didactic course only) reported incorporating DBT into their psychiatry practice, as well as willingness and confidence in treating BPD and self-harm behaviors. Residents participating in the clinical training demonstrated significant improvement in their ability to utilize DBT interventions, particularly in structuring sessions, problem assessment, problem solving, and using validation and dialectical strategies. Conclusion This DBT curriculum was effective in preparing psychiatrists-in-training to incorporate evidence-based practices for effective treatment of BPD and self-harm behaviors and can serve as a model for teaching DBT during psychiatry residency training. Limitations include a small sample size and lack of baseline survey measurement of attitudes for pre- and post-curriculum comparison.</abstract><cop>Cham</cop><pub>Springer International Publishing</pub><pmid>27481266</pmid><doi>10.1007/s40596-016-0593-0</doi><tpages>6</tpages><oa>free_for_read</oa></addata></record>
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subjects Academic Medical Centers
Behavior modification
Behavior Therapy - education
Borderline Personality Disorder - therapy
Curricula
Curriculum
Didacticism
Empirical Report
Female
Humans
Internship and Residency
Male
Medical Education
Medicine
Medicine & Public Health
New York
Personality Problems
Psychiatry
Psychiatry - education
Psychotherapy
Self destructive behavior
Skills
Suicide Prevention
Supervision
Teaching Methods
Training
title Teaching Dialectical Behavior Therapy to Psychiatry Residents: The Columbia Psychiatry Residency DBT Curriculum
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