Table 1 Barriers to Implementing DBT
Implementation domain | Construct | N | % | Example |
|---|---|---|---|---|
Intervention characteristics | Financing Perceived difficulty of implementing DBT | 35 29 | 52 40 | “Cost of DBT training can be prohibitive…concern about this in future in current economic climate - despite evidence base for longer term money saving - trusts often view things in short term when lots monies need to be saved” “All DBT staff have had a long break since last running the programme and so it is harder for us to re-start the programme” |
Inner setting | Practitioner turnover Available resources | 40 28 | 59 41 | “Until very recently we had no practitioner turnover this really helped with the initial establishment of DBT and refining it. We have recently had someone leave and one person is on mat leave…The people who have left are our least psychologically experienced team members and so these people delivered the groups whilst others did more primary therapy. At the moment existing team members are now doing both and this is not sustainable long term.” “Failure to provide funding for a second laptop for second consecutive group and time in lieu for out-of-hours telephone consult hindered implementation.” |
Implementation process | External change events | 23 | 34 | – |