(PS3-48) Evaluating the Effectiveness of Dialectical Behaviour Therapy Training on Clinician Attitudes Towards Patients with Borderline Personality Disorder

Introduction: Negative clinician attitudes towards patients with borderline personality disorder (BPD) have a significant impact on treatment outcomes. They may translate into behaviours that undermine the therapeutic relationship or lead to clinician burnout, negatively impacting the quality of services rendered, and increasing the risk of patient dropout. The attendance of training programmes has been found to improve clinician attitudes in several studies[1],[2].

Objectives: This study examined whether a 3-day training in Dialectical Behaviour Therapy (DBT) changed clinician attitudes and beliefs, and whether these changes persisted.

Methodology: Thirty-two healthcare workers attended a 3-day DBT training and completed a self-report questionnaire pre- and post-workshop at a 3-month follow-up. The questionnaire included sociodemographic variables (e.g. age, gender, ethnicity, educational levels), professional variables (e.g. job role, work setting, frequency of contact with BPD patients, years of clinical experience, formal training in psychotherapy), as well as the Attitude to Personality Disorder Questionnaire (APDQ), the Borderline Patients– Cognitive Attitudes & Treatment Inventory (BP-CAT), and the Borderline Patients– Emotional Attitudes Inventory (BP-EA). Paired samples t-test was conducted to determine the effect of DBT training on clinician attitudes.

Results: Twenty-one participants completed the survey questionnaires at both time points (N=21). In comparing pre-workshop and 3-month post-workshop conditions, the results indicate a significant difference between attitudes towards personality disorders (p=.026). Significant differences were also found between antagonistic judgments towards patients with BPD (p=.003), negative emotions towards patients with BPD (p=.006), and experiences of difficulty treating patients with BPD (p=.005). These differences remained despite controlling for sociodemographic and professional variables.

Discussion: Our findings indicate that a brief 3-day DBT training can improve clinicians’ general attitudes towards personality disorders, their level of antagonistic sentiments and negative emotions held towards patients with BPD, as well as the level of difficulty experienced treating patients with BPD. These effects were sustained even after three months and were not affected by pre-existing static socio-demographic or professional variables. Our findings have implications for designing future training of clinicians in mental health to achieve positive attitude changes.

Masland, S. R., Price, D., MacDonald, J., Finch, E., Gunderson, J., & Choi-Kain, L. (2018). Enduring effects of one-day training in good psychiatric management on clinician attitudes about borderline personality disorder. Journal of Nervous & Mental Disease, 206(11), 865–869. https://doi.org/10.1097/nmd.0000000000000893 

[2] Krawitz, R. (2004). Borderline personality disorder: Attitudinal change following training. Australian and New Zealand Journal of Psychiatry, 38(7), 554–559. https://doi.org/10.1111/j.1440-1614.2004.01409.x