Overcoming Barriers to Skills Training in Borderline Personality Disorder: A Qualitative Interview Study

Despite evidence suggesting that skills training is an important mechanism of change in dialectical behaviour therapy, little research exploring facilitators and barriers to this process has been conducted. The study aimed to explore clients’ experiences of barriers to dialectical behaviour therapy skills training and how they felt they overcame these barriers, and to compare experiences between treatment completers and dropouts. In-depth qualitative interviews were conducted with 40 clients with borderline personality disorder who had attended a dialectical behaviour therapy programme. A thematic analysis of participants’ reported experiences found that key barriers to learning the skills were anxiety during the skills groups and difficulty understanding the material. Key barriers to using the skills were overwhelming emotions which left participants feeling unable or unwilling to use them. Key ways in which participants reported overcoming barriers to skills training were by sustaining their commitment to attending therapy and practising the skills, personalising the way they used them, and practising them so often that they became an integral part of their behavioural repertoire. Participants also highlighted a number of key ways in which they were supported with their skills training by other skills group members, the group therapists, their individual therapist, friends and family. Treatment dropouts were more likely than completers to describe anxiety during the skills groups as a barrier to learning, and were less likely to report overcoming barriers to skills training via the key processes outlined above. The findings of this qualitative study require replication, but could be used to generate hypotheses for testing in further research on barriers to skills training, how these relate to dropout, and how they can be overcome. The paper outlines several such suggestions for further research

A Comparison of Theme Endorsement by Treatment Completers and Treatment Dropouts.

<p>A Comparison of Theme Endorsement by Treatment Completers and Treatment Dropouts.</p

Author Reflexivity.

<p>Author Reflexivity.</p

Supporting quotes for Theme 4: An Environment that Supports Change (N = 31).

<p>Supporting quotes for Theme 4: An Environment that Supports Change (N = 31).</p

Supporting Quotes for Theme 1: Difficulties Learning the Skills (N = 34).

<p>Supporting Quotes for Theme 1: Difficulties Learning the Skills (N = 34).</p

Supporting quotes for Theme 3: A Personal Journey to a New Way of Life (N = 32).

<p>Supporting quotes for Theme 3: A Personal Journey to a New Way of Life (N = 32).</p

Remotely induced warming of Antarctic Bottom Water in the eastern Weddell gyre

Four repeat hydrographic sections across the eastern Weddell gyre at 30°E reveal a warming (by ~0.1°C) and lightening (by ~0.02–0.03 kg m−3) of the Antarctic Bottom Water (AABW) entering the gyre from the Indian sector of the Southern Ocean between the mid-1990s and late 2000s. Historical hydrographic and altimetric measurements in the region suggest that the most likely explanation for the change is increased entrainment of warmer mid-depth Circumpolar Deep Water by cascading shelf water plumes close to Cape Darnley, where the Indian-sourced AABW entering the Weddell gyre from the east is ventilated. This change in entrainment is associated with a concurrent southward shift of the Antarctic Circumpolar Current's (ACC) southern boundary in the region. This mechanism of AABW warming may affect wherever the ACC flows close to Antarctica

Coordinated International Action to Accelerate Genome-to-Phenome with FAANG, the Functional Annotation of Animal Genomes Project

We describe the organization of a nascent international effort, the Functional Annotation of Animal Genomes (FAANG) project, whose aim is to produce comprehensive maps of functional elements in the genomes of domesticated animal species.This article is from Genomic Biology 16 (2015): 57, doi:10.1186/s13059-015-0622-4.</p

Coordinated international action to accelerate genome-to-phenome with FAANG, the Functional Annotation of Animal Genomes project

We describe the organization of a nascent international effort, the Functional Annotation of Animal Genomes (FAANG) project, whose aim is to produce comprehensive maps of functional elements in the genomes of domesticated animal species