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DBT success criteria?

Posted By Anneli

"DBT success criteria?"

About: Adult Mental Health Community / Personality Disorder Hub Mandala Centre

(as a carer),

My daughter had 2 rounds of DBT, which was not a success. DBT staff marked their own homework, stating that the DBT was a success because she had written a CV. DBT success criteria should include things like reduction in self-harm, reduction in hospital admissions etc. My daughter had signed up for professional help with severe mental illness, not a CV writing workshop.

Why are DBT staff not using professional methods to evaluate and record the success or otherwise of DBT? If honest feedback is argued with, changes are not made, outcomes don't improve....

DBT was unsuccessful because it was not autism informed, carers were banned from making contact with staff and staff often put my daughter at increased risk due to poor decision making.

The bigger concern is why does the Trust not accurately record the success of DBT,  and quite possibly other treatments too?

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Responses

Response from Sallyanne Wilson, Head of Service - Community Therapy South Nottighamshire, Nottingham West Locality, Health Partnerships last month
Sallyanne Wilson
Head of Service - Community Therapy South Nottighamshire, Nottingham West Locality,
Health Partnerships

Manage community services in the NHS

Submitted on 06/06/2025 at 14:12
Published on Care Opinion at 14:12

Good Afternoon - Thankyou for taking the time to feedback - Your comments have come to me for review, but unfortunately I do not manage these services so will be unable to support or influence any changes. Apologies for this.

If you would like to make a further complaint - please do contact our PALS services. These can be contacted as below.


I am sorry I am not able to help further with this situation but I hope you are able to get your concerns looked into further.

Sallyanne Wilson

Head of Service Community Therapy Services / P1 - South Nottinghamshire

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Update posted by Anneli (a carer)

Hi

If my post has incorrectly come to you, please can it be passed on to the correct service for review?

DBT is run by Personality Disorders Pathway at Nottinghamshire Healthcare NHS Foundation Trust.

Thank you

Update posted by Anneli (a carer)

Since posting here I have, after many months of asking, now been given a list of the Trust's DBT Primary Tatgets (ie success criteria). My daughter did not tick any of them. We have no idea why DBT staff are still insisting that their DBT was a success for my daughter when it wasn't.

My daughter nearly died, and ended up in critical care due to poor decision making.

When we raised serious concerns we were met with much resistance and arguing. There seems zero accountability.

DBT was unsuccessful due to not being autism informed, carers not allowed to communicate with DBT staff and therefore staff staff putting my daughter at much increased risk due their decisions. This is all very poor, but the lack of accountability and how we have been treated when we dared to raise concerns should also be of great concern to the Trust. Sadly it seemed nobody could care less. Nobody even bothered to reply here.

Autistic people deserve to have autism informed therapy. Whilst my daughter did acquire some DBT skills it was always impossible for her to use these skills when having a meltdown. For years we never understood why autism was never mentioned in any of her DBT sessions. Re mental health care/ treatment for an autistic person, we believe that autism should be at the heart of any care/plan/treatment, otherwise it simply will not work. From DBT staff there was a big lack of understanding re autism.

There needs to be accountability in the form of accurate and professional recording of the success or otherwise of DBT. There is zero point in using primary targets if services continue to mark their own homework and can judge that DBT was successful, despite zero primary targets being met.

Response from Drew Szmit, Lived Experience Development Lead, Personality Disorder Hub, Nottinghamshire Healthcare NHS Foundation Trust 2 weeks ago
We are preparing to make a change
Drew Szmit
Lived Experience Development Lead, Personality Disorder Hub,
Nottinghamshire Healthcare NHS Foundation Trust

I recruit, develop, support and manage our lived experience workers on the "personality disorder" pathway, and I develop, evaluate and promote our 2 and 1-day "personality disorder" awareness training for internal and external colleagues. I also work closely with colleagues across multiple organisations to promote, develop and embed the principles of recovery orientated practice and support the development and ongoing delivery of peer support and lived experience practice provisions.

Submitted on 18/06/2025 at 10:45
Published on Care Opinion at 11:49

Please accept my apology for the late response.

Thank you for taking the time to provide this feedback and raise these important issues. As you’re aware, we’re not able to discuss individual patient care on this forum. However, off the back of the discussions we have had with you around these themes, we are making certain changes that we hope will improve the experiences of people using our services.

Thank you for the further comment, too. We very much regret that our responses to you on these issues have not resolved your complaint.

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