Tāngata whaiora / service user perspectives on the effectiveness of a DBT residential treatment programme : a thesis presented in partial fulfilment of the requirements for the degree of Master of Arts in Psychology at Massey University, Aotearoa New Zealand

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Massey University
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The perspectives of tāngata whaiora / service users who have been treated with Dialectical Behaviour Therapy (DBT) in a residential programme in Aotearoa New Zealand were explored to determine which interventions and programme elements were effective and ineffective. People who are typically referred to a DBT residential programme are managing severe and chronic mental distress, use mental health services frequently with complex and multiple mental health diagnoses. This was a qualitative study with the aims of giving tāngata whaiora / service users a voice and provide opportunities for clinicians to enhance their service delivery. The foundations of the study were based on community and clinical psychological epistemologies, and predominantly social constructionist theory. Data was gathered via in-depth interviews with five participants who had been through the programme and analysed using reflexive thematic analysis (TA). Analysis of the data resulted in three main themes and two subthemes that centred around three domains. These domains were related to clinical DBT interventions, environmental and other factors that are not typically assessed when looking at treatment effectiveness, and relationship quality. The results supported much of the international and local literature that explores service user perspectives. The findings from this study appeared to show that DBT was useful to clients particularly learning and practicing DBT skills. Non-clinical interventions and environmental factors also made a difference, such as time in nature and doing recreational activities as a group. Healthy relationships, including those with peers, support networks, and professionals were vital contributors to any resulting wellbeing, and reciprocity and kindness in professional relating increased trust and aided in turning points. Offsite support to consolidate skill use in the community and establish new identities was valued, and a greater focus on physical health and other non-clinical supports such as secure housing is recommend.