Rights statement: This is the peer reviewed version of the following article: Browne, C, Brown, G, Smith, IC. Adapting dialectical behaviour therapy in forensic learning disability services: A grounded theory informed study of “what works”. J Appl Res Intellect Disabil. 2019; 00: 1– 14. https://doi.org/10.1111/jar.12569 which has been published in final form at https://onlinelibrary.wiley.com/doi/full/10.1111/jar.12569 This article may be used for non-commercial purposes in accordance With Wiley Terms and Conditions for self-archiving.
Accepted author manuscript, 428 KB, PDF document
Available under license: CC BY-NC: Creative Commons Attribution-NonCommercial 4.0 International License
Final published version
Research output: Contribution to Journal/Magazine › Journal article › peer-review
<mark>Journal publication date</mark> | 1/07/2019 |
---|---|
<mark>Journal</mark> | Journal of Applied Research in Intellectual Disabilities |
Issue number | 4 |
Volume | 32 |
Number of pages | 14 |
Pages (from-to) | 792-805 |
Publication Status | Published |
Early online date | 27/01/19 |
<mark>Original language</mark> | English |
Background: Emerging evidence indicates effectiveness of dialectical behaviour therapy (DBT) for people with intellectual disabilities (PWID) in forensic settings; however, little is known about “what works” facilitating engagement and change. Methods: Eleven interviews were conducted with nine service users across two secure inpatient services. Grounded theory was used to develop a model of perceived engagement and change. Results: The model provides insights into how change occurs during DBT delivered in forensic settings. DBT constitutes a challenging journey, yet provides the motivation and means to address individual's intra-/interpersonal aggression and progress towards release. Participants experienced engaging with DBT as difficult and coercive, moving from compliance and avoidance to acceptance and change. Key factors included participants’ motivation, beliefs about safety and ability to change, and interactions with staff. Conclusion: Recommendations are made for increasing intrinsic motivation, reducing perceived coercion and distress, and for future research to address potential aversive elements and enhance effectiveness.