THE FEASIBILITY AND ACCEPTABILITY OF DIALECTICAL BEHAVIOUR THERAPY SKILLS GROUPS: LEARNING FROM EXPERIENCES

Abstract

The thesis explored experiences of group-based Dialectical Behaviour Therapy (DBT) for individuals with psychological difficulties, with a particular focus on perinatal women with Complex-Posttraumatic Stress Disorder (C-PTSD). The thesis consists of three papers: 1) a systematic review, 2) an empirical study, and 3) a paper offering critical reflections on the research process for papers 1 and 2. For the systematic review (paper 1), searching was used to identify all available studies relating to shared patient experience of DBT, irrespective of mental health diagnosis or age, whereby a skills group component was specified. Thirty-two studies were identified for inclusion and were quality assessed. Results were analysed using a thematic synthesis approach. Three main themes were generated: 1) the challenging road to DBT, 2) the difficult journey through DBT, and 3) patients’ path for the future. Findings highlighted the importance of pre-treatment and in-treatment experiences, relational factors, practical skill application, as well as how processes (including peer support, changed perspectives and validation) shaped reported therapeutic outcomes. The empirical paper (paper 2) explored the feasibility and acceptability of a DBT skills group, for perinatal women with C-PTSD, offered in a specialist perinatal mental health setting in the northwest of England. Mixed-methods were used to analyse quantitative (attendance and routine outcome measures) and qualitative (interview) data. Ten participants (six patients and four clinicians) engaged in interviews about their experiences of the DBT groups. Three main themes were identified: 1) therapeutic foundations amid perinatal complexity, 2) holding the group - relationships and continuity and 3) finding the balance between access and connection. Improvements in emotion regulation were observed, with the DBT online skills group seeming a feasible and acceptable intervention for perinatal women (including those with C-PTSD) and clinicians. Paper 3 is a critical reflection on the process of completing the systematic review and empirical study. The author reflected on theoretical, methodological and ethical decisions throughout the research process, considering strengths and limitations of these.

Date of Award	28 Jul 2025
Original language	English
Awarding Institution	The University of Manchester
Supervisor	Anja Wittkowski (Main Supervisor) & Lynsey Gregg (Co Supervisor)