DBT Essentials – success in a skills-only intervention to support emotional regulation

The Ironbark Program is a flexible, broad-based intervention designed to improve outcomes for clients with BPD, BPD traits, or emotion dysregulation in mental health residential services. It was developed collaboratively by Spectrum, Austin Health, and Mind Australia.

Prevention and Recovery Care (PARC) services are publicly funded mental health facilities located throughout Victoria. They fit within a step-up/ step-down model, offering clients short-term residential care as an alternative to an inpatient admission, or providing transitional support following discharge from inpatient care.

There was recognition among PARC staff that a primary diagnosis, or traits, of BPD had a significant impact on the client’s ability to effectively engage with the existing PARC program.

This problem was further complicated by the scarcity

of evidence-based interventions for BPD that were suited to a PARC (or equivalent) setting. To address this, Spectrum, Austin Health, and Mind Australia developed and implemented a structured intervention called the Ironbark Program.

Ironbark is a brief group-based intervention designed with content that is specific for working with clients experiencing BPD-related difficulties, but generic enough to meet the needs of PARC clients more broadly.

The program was named after a native tree species called “Ironbark”, which has bark that looks like iron and can protect the tree from the hottest fire. While the markings of the fire remain on the outside, the buds beneath, which are protected by the bark, can regrow.

This image of resilience and recovery is well suited to the aims of the Ironbark Program. The program comprises 12 modules that are underpinned by a DBT-informed common treatment factors approach.

A pilot study is currently being analysed from a staff and service perspective to evaluate the effectiveness of the Ironbark Program in improving outcomes for clients with BPD, BPD traits, or emotion dysregulation and the staff who care for them. The Ironbark program is now being rolled out to multiple PARC sites across Victoria.