Client and clinician experiences of dialectical behaviour therapy : a discourse analysis : a thesis presented in partial fulfilment of the requirements for the degree of Doctor of Clinical Psychology at Massey University, New Zealand
Loading...
Date
2010
DOI
Open Access Location
Authors
Journal Title
Journal ISSN
Volume Title
Publisher
Massey University
Rights
The Author
Abstract
Dialectical Behaviour Therapy (DBT) is recommended as the treatment of choice for
people with borderline personality disorder (BPD) in New Zealand. This research
presents four studies examining the experience of DBT. Discourse analysis was used to
examine 27 clinical journal articles with the aim of identifying discourses about BPD and
DBT likely to be read by practising clinicians. A second study examined interview data
from five practising DBT clinicians in a New Zealand District Health Board (DHB). The
third study looked at interview data from five clients, who were undertaking the DBT
programme at the same DHB. A fourth study used three case studies to discuss client
changes in mindfulness and quality of life, as they participated in DBT. The discourses
associated with BPD were of BPD as an illness, as a stigmatising label with connotations
of a difficult client group, as a means of ‘making sense’ of the clients’ experience, and as
emotion dysregulation and a skills deficit. DBT was constructed as providing skills which
enabled clients (and clinicians) to manage distress in their lives. Clients described
themselves as changing in a fundamental way, and assuming new identities, which was
a frightening (albeit positive) process. DBT was constructed as well researched and
theory based, and as a coherent whole which was also divisible into functional elements.
Clients and clinicians were found to utilise different discourses to position themselves
and to validate their behaviour in various situations. DBT was constructed as helpful
within all the studies, and was promoted as a worthwhile therapy by all participants.
Description
Keywords
Borderline Personality Disorder, Dialectical Behaviour Therapy, Discourse analysis, New Zealand