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Grounded theory was used to develop a model of perceived engagement and change.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The model provides insights into how change occurs during DBT delivered in forensic settings. DBT constitutes a challenging journey, yet provides the motivation and means to address individual's intra\u2010\/interpersonal aggression and progress towards release. Participants experienced engaging with DBT as difficult and coercive, moving from compliance and avoidance to acceptance and change. Key factors included participants\u2019 motivation, beliefs about safety and ability to change, and interactions with staff.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Recommendations are made for increasing intrinsic motivation, reducing perceived coercion and distress, and for future research to address potential aversive elements and enhance effectiveness.<\/jats:p><\/jats:sec>","DOI":"10.1111\/jar.12569","type":"journal-article","created":{"date-parts":[[2019,1,28]],"date-time":"2019-01-28T03:58:26Z","timestamp":1548647906000},"page":"792-805","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Adapting dialectical behaviour therapy in forensic learning disability services: A grounded theory informed study of \u201cwhat works\u201d"],"prefix":"10.1111","volume":"32","author":[{"given":"Claire","family":"Browne","sequence":"first","affiliation":[{"name":"Clinical Psychology Programme, Faculty of Health and Medicine Lancaster University Lancaster UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gill","family":"Brown","sequence":"additional","affiliation":[{"name":"Clinical Psychology Programme, Faculty of Health and Medicine Lancaster University Lancaster UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1333-2090","authenticated-orcid":false,"given":"Ian C.","family":"Smith","sequence":"additional","affiliation":[{"name":"Clinical Psychology Programme, Faculty of Health and Medicine Lancaster University Lancaster UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2019,1,27]]},"reference":[{"key":"e_1_2_7_2_1","first-page":"792","article-title":"Practice guideline for the treatment of patients with borderline personality disorder: American Psychiatric Association Practice Guidelines","volume":"158","author":"American Psychiatric Association","year":"2001","journal-title":"American Journal of Psychiatry"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1176\/appi.books.9780890425596"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1468-3156.2003.00193.x"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1080\/15228932.2017.1251098"},{"key":"e_1_2_7_6_1","unstructured":"Atherton J. 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