(PS13-B48) Qualitative Study on Clinicians' Experience Using Dialectic Behavioral Therapy Skills in Groups of Individuals with Heterogeneous Identities

It has been suggested by several Dialectical Behavior Therapy (DBT) studies that cultural adaptations for specific groups could enhance learning in DBT (Haft et al, 2022). The primary mode of adaptation suggested is specifically DBT skills group, where there may be aspects of skills that do not culturally translate (Arundell et al., 2021). While both the prevalence of DBT clients with intersectional identities and ethnoracial adaptations of DBT as an evidence-based treatment (EBT) have been investigated (Harned et al., 2022), there is a dearth in the literature on the prevalence and efficacy of cultural adaptations of DBT skills in heterogenous groups. This study aimed to fill those gaps in the literature, using a qualitative approach, to better understand the need for adaptation and the prevalence of adaptations in DBT from the perspective of clinicians, while bolstering the body of work regarding ethnoracial and otherwise identity-based adaptations of DBT. The research focused on adaptations within DBT skills group, as this has been the mode most frequently suggested for adaptation. This survey sought to explore clinician experiences by employing a qualitative approach, in order to give a voice to the unique perspective of DBT practitioners. Our approach examined three broad primary qualitative questions: 1) How often and by what means are clinicians engaging in cultural adaptations within DBT skills group, 2) What trainings are clinicians seeking and/or wanting related to culturally adapting DBT skills, and 3) How are clients responding to these changes. Participants (n=28) were recruited (data cleaning is ongoing) for an online cross-sectional survey via DBT therapist list serv. Participants shared de-identified demographic information, professional information, and their adaptations for DBT skills in an open-ended qualitative questionnaire. The sample consisted of a variety of professional backgrounds (78.57% clinician/practitioners, 14.29% industry, 7.14% researchers). Themes that emerged from the data included a necessity of skill adaptation to generalize across heterogeneous groups (with an emphasis on adaptations for client identity), a high rate of positive client responses to these adaptations, and the presence of anxiety and shame in conversations regarding adaptation. The data also suggested barriers in the ways in which clinicians learn to adapt DBT skills (for example, shame when bringing up adaptations on team), and– importantly– a strong desire from clinicians to deepen their understanding of cultural humility. Although studies suggest approximately 20+ participants might reach saturation for online open-ended qualitative data, a limitation of this study is the response rate, which will be discussed in this presentation. Importantly, this study highlights the necessity of further research into cultural adaptations of DBT skills and the creation of additional avenues of education and support for DBT clinicians leading culturally heterogeneous skills groups.