Managing emotions: A service evaluation of a Dialectical Behaviour Therapy (DBT) informed skills group within community drug and alcohol services

Background Many people with substance use difficulties experience co-occurring mental health difficulties but encounter exclusion from mental health services and difficulties accessing treatment. Dialectical Behaviour Therapy (DBT) was first developed to treat individuals with borderline personality disorder (BPD) but more recently represents a promising treatment approach for people with substance use difficulties. There remains a dearth of literature investigating the feasibility of DBT informed interventions within community drug and alcohol services. Method A service evaluation within a community drug and alcohol service investigated a DBT informed skills programme delivered over seven sessions. Routine outcome measures were administered pre and post intervention for: (i) psychological distress (Clinical Outcome Routine Evaluation [CORE-10], (ii) emotion regulation (Difficulties in Emotion Regulation Scale [DERS]) and (iii) recovery from drug and alcohol dependence (Substance Use Recovery Evaluator [SURE]). Results Pre and post measures for 39 participants were available. Paired Samples T-tests showed statistically significant improvements in the CORE-10 (t(38) =4.776, p<0.001), DERS (t(38) =5.75, p<0.001), and SURE (t(37) =3.68, p<0.001). Conclusion The DBT-informed programme was associated with improvements in emotion regulation, increased recovery from substance use and a reduction in psychological distress. These findings further suggest that DBT informed skills groups can provide a useful therapeutic approach within community settings. Clinical considerations alongside limitations of the evaluation are discussed.