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Dialectical behaviour therapy (DBT) aims to reduce emotional dysregulation and engagement in less adaptive behaviours for adults with mixed disorders of conduct and emotions (MDCE). However, there is limited evidence available for the effectiveness of DBT skills training for adolescents with MDCE who are resident within a secure impatient setting. The paper aims to discuss these issues.

A retrospective study investigated changes in aggressive and self-injurious behaviours in 22 adolescents within a secure inpatient mental health setting with MDCE who had completed one cycle of DBT skills training. Changes in symptomatic problems, behavioural and social impairment were also investigated in 17 of the 22 participants who completed the DBT skills training cycle.

There were statistically significant decreases in the frequencies of engagement in total aggressive and deliberate self-harm behaviours after the DBT skills training cycle. There was a significant improvement in symptomatic and behavioural impairment, but not in social impairment.

The findings of this study suggest that DBT skills training may be beneficial for behavioural and symptomatic outcomes in adolescent inpatients with MDCE.

This study provides preliminary evidence for the effectiveness of DBT skills training for adolescents with MDCE within a secure inpatient setting. Additional studies are required to investigate the clinical benefits of specific aspects of DBT for individual patients.

The purpose of this paper is to provide wider research evidence for the use of the Short Dynamic Risk Scale (SDRS) in risk management with individuals who have an Intellectual Disability (ID) and reside in a secure psychiatric inpatient setting. The outcomes are supportive of previous research, showing that outcomes on the SDRS are related to maladaptive behaviours recorded for individual with ID.

All participant data taken from the hospital healthcare reporting system were entered into a PASW database. The ratings for each of the SDRS and Short-Term Assessment of Risk and Treatability (START) items were entered and totalled, with a separate total score for the SDRS with the additional three items. In order to capture the behavioural monitoring data, average severities weightings of each of the Overt Aggression Scale-modified for neuro-rehabilitation (OAS-MNR) categories for the three weeks following completion of the individual’s SDRS were calculated and recorded. In addition, average severity weightings reflecting the presence of sexualised behaviour (St Andrew’s Sexual Behaviour Assessment (SASBA) in the subsequent three weeks following SDRS completion was included. Using the most recent START assessment completed allowed for analysis of the predictive ability of the START of the same behavioural data.

A series of Spearman’s correlations were run to determine the relationship between outcomes on the SDRS and engagement in risk behaviours as rated by the OAS-MNR scales. There was a moderate positive correlation between all 11-items of the SDRS and OAS-MNR recordings. A series of Spearman’s correlations were conducted to determine the relationship between outcomes on the START Vulnerability items and engagement in risk behaviours as rated by the OAS-MNR scales. There was a weak negative correlation between all individual START vulnerability item ratings and OAS-MNR recordings.

The current pilot study provides wider research evidence for the use of the SDRS in risk management with individuals who have an ID and reside in a secure psychiatric inpatient setting.

This paper compares outcomes on the START and SDRS in relation to an individual’s risk recordings to support identification of whether either have practical and clinical utility. To the authors’ knowledge, this has not been completed before.