The effective use of dialectical behavioural therapy skills by patients post discharge

Borderline Personality Disorder (BPD) is a disorder characterized by morbid impulsivity, lack of emotional control, disturbed interpersonal relationship and frequent self injurious suicidal behaviours. It is associated with high socioeconomic burden and high morbidity and mortality. An etiological factor believed to be responsible for development of BPD is childhood maltreatment (Perroud, 2013). BPD is a complex disorder that is difficult to treat. However dialectical behavioural therapy (DBT) developed by Dr Marsha Linehan in early 1990s has emerged as a promising treatment option for those diagnosed with BPD. DBT is a multi-pronged approach delivered originally in outpatient setting over 12 months and requires highly skilled trained therapist. Many trials have provided evidence to support use of DBT in the treatment of BPD (O’Connell, 2013). The purpose of this study was to determine whether discharged patients are able to use the skills learned in a modified in-patient DBT programme after discharge at a academic psychiatric hospital in South Africa and whether they consider these effective in managing their thoughts, feelings, behaviour and interpersonal relationships. The study also aims to assess the relationship between demographic factors in the study and the use of DBT skills. A prospective, quantitative, descriptive approach was used. A Likert style questionnaire, the dialectical ways of coping checklist, was distributed to ex in-patients who have participated in the modified DBT programme to elicit their rating of the effective use of DBT skills post discharge. A total sample number of 46 participants responded to the questionnaires. The prevalence of the DBT skills among the discharged patients was 33% of the sample regularly used the DBT skills post discharge effectively and 17% did not engage with the DBT skills. Fifty percentage of the sample population had mixed responses to the questionnaire. The study also highlighted that females used substance more than males. Females also attended more support groups than males. DBT skills were used more by those who did not attend follow up. Female population made more use of the dysfunctional coping skills than males.