This thesis explores two distinct topics which both contribute to our understanding of professional practice with clients with complex presentations. Chapter one presents a systematic review of the effectiveness of DBT training for mental health professionals in routine clinical settings. Following a systematic search of four databases, twenty-four studies providing quantitative data were reviewed and outcomes were organised using the Kirkpatrick Four-Level Model of Training Evaluation. While overall study quality and confidence in the results was low, findings suggested that more intensive training models with implementation support were associated with better outcomes. Implications, limitations and directions for future research are discussed. Chapter two is an empirical study using Foucauldian discourse analysis to explore how clinical psychologists understand and talk about boundaries in clinical practice. Four discourses were identified: ‘the messiness of boundaries’, ‘responsibility’, ‘keep yourself safe’, and ‘big cogs play’. The analysis highlights how these discourses shape knowledge, power, and behaviour in therapeutic and organisational contexts. The implications and limitations of the study are discussed. Chapter Three reflects on how the two papers contribute to clinical theory, practice, and future research.
- Boundaries
- Foucault
- FDA
- Clinical Psychologists
- DBT
- dialectical behaviour therapy
- Dialectical Behaviour Therapy, Borderline Personality Disorder, Stigma, Therapist Experience, Mental Health Issues, Consultation Team, Adherence Rating, DBT ACS, DBT ACI, Self-Practice/Self-Reflection, Informal Exposure, Affect Phobia
- implementation
- Systematic Review
Shaping the Therapist: Discourses of Boundaries and DBT Training
Harris, M. (Author). 8 Sept 2025
Student thesis: Professional Doctorates