Effectiveness of dialectical behavior therapy skills training group for adults with borderline personality disorder

Abstract

Objective: This study evaluated the effectiveness of the Dialectical Behavior Therapy Skills Training Group (DBT-ST) component of DBT. Method: Participants (N = 114) attended an 18-20-week DBT-ST. The study utilized a quasi-experimental design with a within-persons control group for a measure of borderline personality disorder (BPD) symptoms (at referral), and emergency department (ED) presentations, and psychiatric bed-days (both assessed for 6 months pre-and post-intervention). Primary outcomes were the number of BPD symptoms, psychological distress, depression, rate of ED presentations, and psychiatric inpatient bed-days.Results: After completing DBT-ST, participants had reduced BPD symptoms, psychological distress, and depression (p < 0.001). The waitlist control group showed no improvement in BPD symptoms (p = 0.085). The rate of ED presentations was reduced (p = 0.001). There was no reduction in psychiatric inpatient bed-days (p = 0.160), likely due to insufficient power.Conclusions: DBT-ST participation in addition to treatment-as-usual is an effective treatment for people with BPD.

Implementation of a brief online skills group of dialectical behaviour therapy for emotional dysregulation in Latinx: a withdrawal experimental single-case design

“…This supports the idea (a) group DBT offers something more than generic group effects (which the placebo phase controls for), (b) the skills development content in group DBT is important for clients, and effective when administered online (Gutteling et al ., 2012), and (c) DBT procedures addressed primarily emotional regulation processes (Barney et al ., 2019; Goodman et al ., 2014). Two things are especially notable: (a) a marked difference in clients’ emotional dysregulation when receiving individual plus group DBT sessions but not when group placebo was added to individual therapy and (b) changes in emotional dysregulation associated with a brief 8-week DBT online group compared with the usual length of group DBT (Heerebrand et al ., 2021; Keng et al ., 2021; Safer et al ., 2010).…”

“…For example, Heerebrand et al . (2021) found significant reductions in BPD symptoms and depression following an 18-week DBT skills group compared with waitlist. Keng et al .…”

“…In an attempt to make the treatment more cost-effective and accessible, even shorter programs using only the skills-group component have been evaluated. For example, Heerebrand et al (2021) found significant reductions in BPD symptoms and depression following an 18-week DBT skills group compared with waitlist. Keng et al (2021) found that a 14-week program produced significant reductions in depression and emotion-regulation in adults with BPD, and non-significant reductions in self-harm, suicidal ideation and anxiety.…”

Evaluation of a skills-based peer-led art therapy online-group for people with emotion dysregulation

“…Acceptability of the program is further supported by the strong retention (82%). This is compared to 67% retention in a study of mentalisation-based treatment program with an art therapy component for people with lived experience of BPD [ 36 ], 77% in a randomised controlled trial of art therapy for people with personality disorder [ 32 ], and 73% retention in a recent study evaluating a standard DBT skills only group intervention for people with lived experience of BPD [ 18 ]. Qualitative analysis of participant feedback found key themes indicating improved capacity to regulate emotions and tolerate distress, improved connection with others, enhanced understanding of the self, and hope for living well.…”

“…The traditional model consists of group and individual therapy, with access to phone coaching as needed, often for at least 12 months duration [13]. Recent studies have evaluated the effectiveness of brief therapy [12,14,15] or skills group only adaptations [16][17][18][19] with good outcomes in reducing the emotional and behavioural dysregulation in acute phase of illness (e.g. suicidal behaviour and self-harm).…”