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

Brackish Water Shrimp Farming and the Growth of Aquatic Monocultures in Coastal Bangladesh

One of the most significant changes in marine and coastal environments since the mid–twentieth century has been the growth of coastal shrimp aquaculture in many tropical and sub–tropical regions of the world. This chapter, which draws on the author’s own archival and field research and the published works of other students of the global shrimp market, examines the growth of brackish water shrimp production from the 1970s to the present in Bangladesh’s coastal belt and its social and ecological impacts. It shows that for most of this period shrimp production was encouraged by the Bangladesh Government to expand in a fragmented and uncoordinated way with varying environmental, economic and social consequences. These included higher levels of soil salinity, increased risk of flooding, loss of agricultural land, a decline in biodiversity, contraction of various traditional occupational activities, growth in new non-agricultural work, a shift to diversified employment strategies among households, higher incomes for shrimp farmers and land renters and economic and social dislocation for others. Government, business and international aid agencies supported the expansion of mono–cultural forms of shrimp production integrated into global trading networks at the expense of local resource extraction activities such as artisanal fishing and forestry