National DBT Service

 

1. What is DBT ?

Dialectical Behaviour Therapy (DBT) is a cognitive behavioural treatment using individual therapy and group classes to help people learn strategies to develop a life that they experience as worth living. DBT skills include mindfulness, emotion regulation, distress tolerance, and interpersonal effectiveness.

2. Who is DBT for?

Our National DBT service is specifically designed for people with chronic emotional dysregulation and related problems. Our residents often have multiple diagnoses including:

  • Borderline Personality Disorder (BPD),
  • Post-Traumatic Stress Disorder (PTSD),
  • Eating Disorders,
  • Substance Abuse Disorders and so on.

As we work intensively with six clients at a time, treatment plans are individualised and treatment targets are organised along the standard DBT hierarchy of life threatening/therapy-interfering/life interfering behaviours.

 3. What happens at Te Whare Mahana as part of the DBT programme?

At Te Whare Mahana, our highly skilled and experienced DBT staff support people with complex diagnoses to learn essential skills for managing their mental health, daily life, and important relationships.

During their stay, residents participate in individual and group therapy, household activities like cooking and eating together, and build confidence in themselves. Residents are constantly supported by staff as they learn and develop skills.

The clinic is based on the grounds of a historic house in Takaka, Golden Bay. There is accommodation for up to six residents at any one time, and it is rare for rooms be empty.

Whanau are welcome to visit any time it is appropriate for the residents, and the maintaining of connections with home communities are encouraged where it is positive for the resident.

4. How long is the programme?

In order for the programme to be effective, there is a minimum stay of six months. The common commitment is around 9-12 months, depending on various factors. We look at the needs of each person and develop an individualised treatment plan.

5. Who are we?

Te Whare Mahana is staffed by a team of experts, trained in all areas of support and mental health. Have a look at our staff profiles here.

6. What is the application process?

Most often, people are referred by a mental health professional or team, though private referrals are possible.

If a person is currently seeing a mental health professional, they can ask them to look into making an enquiry or referral on their behalf.

The referral process determines how suitable the DBT Intensive Treatment programme is for the applicant. We work quite closely with the applicant and their treatment team to work out how beneficial the programme might be, and to determine the safety of the resident, possible fellow residents, and staff.

7. How long does a referral usually take?

The referral process can take up to 4-6 months* depending on a number of factors, including place availability.

This timeline is also subject to how quickly we get requested information, and how long the referrer takes to secure funding. We always encourage referrers to get this process started sooner rather than later.

Part of the referral process is for the applicant to attend a ‘preliminary visit’ to our programme. This gives the applicant a chance to see how the programme runs and to meet the staff and current service users. At that point, regular consults will be scheduled between the applicant and staff at Te Whare Mahana, to help manage the time spent on the waiting list, if any.

*These approximate timeframes given are subject to change due to a number of factors that can affect the waiting list at any given time.

8. What are the Funding Pathways?

Public Funding (recommended): We are currently funded through Ministry of Health (MOH) and we have two main referral pathways:

DHB:    Currently, DHBs can purchase our services direct from MOH (PU-ID: MHA24 Adult Mental Health Services – Housing and Recovery Services – Day Time and Awake Night Support). Typically DHB’s have a Planning and Funding department that approves payments for non-DHB care and treatment programmes, however, some DHB’s have service coordination or specialised care units that must approve referrals to out of area care facilities in the first instance. Referrers generally obtain a formal clinical recommendation for referral from their clinical team and then submit this to their Planning and Funding department for financial approval.

We may be able to assist referrers to navigate these approval requirements so please let us know of any barriers you may encounter.

ACC:    We have a contract with ACC (Service Schedule for Community Rehabilitation Services for Sensitive Claims). Please note that ACC will only support funding for issues related to their injury; most clients have a sensitive claim and would have to be appraised by an ACC assessor to determine if they think that is the best option for the applicant.

Privately Paid Placement:  We also welcome referrals from private pay or health insurance applicants. The price is out of reach for many people, this is why we urge people to utilize the public funding avenues.

If you would like more information on privately paid placement, please contact us.

9. Intake guidelines

Applications and referrals are assessed on a case-by-case basis, but Te Whare Mahana reserves the right to enforce guidelines to ensure the safety of residents and staff.

Approved applications show:

  1. That the applicant is motivated to change their life patterns, willing to make a commitment to change, and wishes to participate in the National DBT Service in order to gain vital life skills.
  2. For most applicants, the primary issue is chronic emotional dysregulation – they find it difficult to control and maintain their own emotions.
  3. The applicant needs to be able to make the commitment to remain abstinent from illicit drugs and alcohol for the duration of the programme. Demonstration of commitment through periods of sobriety may be requested.
  4. Any disordered eating is clinically stable – the applicant can manage it without hospital care.
  5. Any current levels of self-harm are manageable outside of emergency/hospital care.
  6. The applicant’s physical health is stable and independently managed.
  7. There is no history of violence towards others in the past 12 months. Full history of violent acts is to be provided in referral documents.
  8. The applicant is 18 years or older.

An application or referral may be declined if the applicant:

  1. Is not motivated to change problematic behaviours and/or does not wish to commit to the full programme participation.
  2. Has untreated or unstable psychosis or mania.
  3. Has substance dependency that is the primary presenting problem at this time.
  4. Presents a current pattern of unmanaged violence towards others.
  5. Cognitive impairment that would prohibit learning the skills curriculum.
  6. Presents currently, ongoing offending.
  7. Is not able to tolerate residential treatment with up to five other residents.
  8. Apologies, personal pets cannot be accommodated.

 

10. More information

You can contact us to find out more about the National DBT Service.

You can also sign up to our newsletter to keep informed about relevant news or changes.

These links about Dialectical Behavioural Therapy help explain the type of work we do at Te Whare Mahana:

https://youtu.be/Stz–d17ID4

http://www.dbtselfhelp.com/

https://behavioraltech.org/resources/faqs/what-is-dbt/

http://psychcentral.com/lib/an-overview-of-dialectical-behavior-therapy/0001096