ABSTRACT
Dialectical Behaviour Therapy (DBT) and Mentalization-Based Treatment/Therapy (MBT) introduce the concept of skills teaching that can be managed across an institution. This close link between the very immediate and intimate individual concerns and whole-system working is unique to this approach. Results need to be shown and communicated. The major studies necessarily take a broad-brush approach. Something more targeted is needed to address specific clinical challenges in particular settings. The difficulty has been that this is an approach developed and refined by clinicians working in pressured environments. During the period 2009–12, the pace of change in the National Health Service (NHS) was quickening, with particular effects on acute services. Allowing people to return to the hospital for groups like this, even when they were discharged by the Acute Service and only under the Community Mental Health Team (CMHT) required laudable flexibility on the part of management, as acute service management tends to avoid anything that might add elements of uncertainty.
