FAQs - Frequently Asked Questions

Are you only collecting data from services offering comprehensive DBT (i.e., full-programme)?

We take both full programme and skills (we ask teams to describe the modalities they are offering if it is a modified programme). If teams have both options, they can select what each client is receiving when uploading their data.

Are you able to produce reports for us aggregating the data to locality DBT teams and also across all the consultation teams across the trust as well?

Currently, this is not a feature that is available. Each team logs in to their account, which allows them to upload their team and clients’ data, and download reports on their outcomes, with graphs which show the different assessment moments of each instrument. We are also working on providing more comprehensive reports based on teams’ feedback.

Do you have guidance around NHS Information Governance when using the benchmarking website?

Yes, please download this helpful document that you can present to your governance body, where it is explained that participating in this benchmarking project does not require sharing any sensitive or personal information. If the assessment process is integrated as part of the service they are providing to their clients, benchmarking should be seen as a way to audit those results.

How is the anonymity of clients guaranteed?

Our website generates random (and uneditable) pseudonyms for each generated client. The clients are not connected with their individual therapists (if they have one), and there is no record of age/gender/location or identifiable information that can be traced back to them. The only people who will have the key to the pseudonym and the person’s name and information are the teams introducing it. Our website collects only the score of the selected instruments and age group (e.g. adults, adolescents, older adults).

Why was the EQ-5D chosen?

The EQ-5D is one of the few instruments that cover different health states considering a score below 0 as worse than death, which is often how many individuals with borderline features perceive their lives. DBT wants to bring their lives to the point of having a life worth living and we consider EQ-5D to be a good measure to assess that. Also, this instrument has been used in empirical studies with people with Borderline Personality Disorder (BPD) diagnosis, and it showed sensitivity to change to psychological interventions (see Asselt et al. 2008).

What benefit is there to clients if my team participates?

Participating in the benchmarking project can benefit clients in the long run, since the team who is providing them the treatment are concerned with having the best performance possible for their clients. You can download our flyer so it is clear to your clients what they are participating in. By critically thinking about clients’ outcomes, the teams are manifesting concern to be the best they can be. Additionally, the team will also be contributing to building evidence on DBT effectiveness and regarding the factors that might influence outcomes.

Will data from teams and outcomes be publicly visible to other teams or to the general public?

The data will not be publicly available, and neither will other teams will be able to see it. The data collected from all teams will enter the pool of data from all the teams benchmarking and will contribute for the peer benchmarks, and will allow each team to know where they are in comparison to a pool of other teams anonymously. To guarantee that teams will not be identifiable, we will only provide such graphs when a minimum of 5 teams from the same setting/age group are possible to compare against. This means that each team can only see their own data accurately but will be able to compare where their clients’ outcomes differ from others. You can only see the teams who are benchmarking on the map, but you will not be able to see each team's data.

What measures are we asked to use, and how often?

We ask teams to collect at least one of the three core benchmarking measures: the EQ-5D (a health-related quality of life measure), the Difficulties in Emotion Regulation Scale (DERS) and/or the Borderline Symptoms List (BSL). Teams can also choose to complete additional optional measures - for full details see the 'Instruments' page. We ask teams to collect the measures at 3-time points: at Pre-treatment (when the client is referred to your programme and enters pre-treatment), at Admission (immediately before starting the programme and after successfully completing pre-treatment) and at Discharge (when they complete the programme), though you may assess them more times if you wish (by clicking Additional Assessment).

If I cannot collect discharge data from a client, is this recorded anywhere?

If this happens, you should click on the tab Clients - Discharge Clients, select the pseudonym corresponding to that client and click Discharge Now, and you will be able to select the option: Dropped out. You should still try to collect data from clients who drop out if possible, but if you are unable to obtain it, you can select “Discharge without assessment”.

What if a client drops out of the programme?

If this happens, you should click on the tab Clients - Discharge Clients, select the pseudonym corresponding to that client and click Discharge Now, and you will be able to select the option: Dropped out. You should still try to collect data from clients who drop out if possible, but if you are unable to get it, you can select “Discharge without assessment”.

Are the instruments to benchmark provided?

Yes, once teams are logged in on the website, they can download the instruments and print them if they wish from the Instruments tab, or generate and send links to clients to fill them in.

How is the data being held on the website, and how secure is it?

The website uses industry-standard security settings. Passwords are not stored, data is end-to-end encrypted between you and the server (in specific SSL is forced for all connections, we do not serve over HTTP), and administrator access to the server itself uses strict two-factor authentication. We are using a modern battle-tested backend framework which we regularly update. The website has automatic tests run before each update to ensure that there is no way for an unauthenticated browser of the website to access user data, any team to access any other teams data, or similar event. We use modern techniques to defend against common attacks, including CSRF and a very strict CSP. In the unlikely event of a complete data breach, we deliberately do not store identifying information on clients to ensure total anonymity

How are links to complete self-reported measures filled in, and what information will they see?

Links will be sent by the respective DBT team members and generated once they are logged in. The website has no way of sending them to make sure there is no connection with clients’ identifiable data (like an email). Each link is a one-time use type of link, for that specific client (which means that once used, it will become inactive). The client does not need to log in, and will only see the questionnaires he was sent, with no other information. See the website guide (downloadable here), which shows screenshots of the process.

How is the information going to be used / shared, outside dbt.uk.net?

The information will be shared with NHS England as a whole, reporting on general outcomes from routine practice, since they have been funding the project and have been investing in training therapists in DBT. We will also aim to report peer benchmarks back to the public so that other teams can benchmark their results, and even encourage other teams to join and see where they stand. Reports of the routine practice peer benchmarks might also be shared in scientific events.

How do I download all my client outcome data?

Go to 'Clients' on the main menu bar and then 'All Clients' to view your full list of clients. Just above the graph at the bottom of a page is a green button labelled 'Download Assessments'. This gives you the option to download all the data entered for your clients, in different formats.
You can also download any graph as a picture or PDF by clicking the icon with three horizontal bars in the top right corner of the graph, and then selecting your preferred download option."