Implementation of brief dialectical behavior therapy skills training among borderline personality disorder patients in Malaysia: feasibility, acceptability, and preliminary outcomes

Abstract

Aim/background Even though dialectical behavior therapy (DBT) has received substantial empirical support in treating patients with borderline personality disorder (BPD), fewer studies have evaluated whether a brief DBT skills group may be effective in improving clinical outcomes in this population. Further, less is known regarding the feasibility and outcomes of DBT beyond Euro-American contexts. This paper describes outcomes from a pilot study examining the feasibility, acceptability, and clinical outcomes following completion of a shortened, 14-week DBT skills group in a sample of Muslim-majority BPD patients in Malaysia. Methods Twenty patients were recruited from a public hospital and attended DBT skills groups in an outpatient clinic. Participants completed measures assessing psychological symptoms, self-harm behaviors, suicidal ideation, emotion regulation difficulties, self-compassion, and well-being pre- and post-intervention. Results There were significant reductions in depressive symptoms, stress, and emotion regulation difficulties, as well as increases in self-compassion and well-being from pre- to post-intervention. A trend was found for decreases in frequency and types of non-suicidal self-harm behaviors, suicidal ideation, and anxiety symptoms. Qualitative content analyses of participants’ feedback indicated that the vast majority of participants perceived a positive impact from the skills group, with mindfulness and distress tolerance being rated frequently as skills that were beneficial. Conclusion These preliminary findings suggest that DBT skills training is feasible and acceptable in a Muslim-majority, low resource clinical setting, and holds promise in improving clinical outcomes among BPD patients in Malaysia.

Pretreatment cognitive performance is associated with differential self-harm outcomes in 6 v. 12-months of dialectical behavior therapy for borderline personality disorder

“…Significant improvements in self-harm occurred in both treatment arms by 6 months and were sustained at 24-month follow-up (McMain et al, 2022). These results converge with a growing body of evidence which suggests that briefer forms of DBT for BPD are effective on a range of outcomes including self-harm (Keng et al, 2021;Westad, Hagen, Jonsbu, & Solem, 2021). By extension, lengthier treatments may not be necessary for all individuals with BPD (Griffiths et al, 2019).However, there is considerable heterogeneity in BPD treatment response; approximately half of BPD patients are considered non-responders following DBT and other BPD interventions (Woodbridge, Townsend, Reis, Singh, & Grenyer, 2022).…”

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).…”

“…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. Zapolski and Smith (2017) found mixed results in a brief (9-week) DBT skills group for adolescents, finding a significant decrease in intent to engage in risky behaviours, but no significant changes in negative mood.…”

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

“…Acceptability is often measured through a combination of simple quantitative scales, and qualitative feedback. This method has previously been utilised by pilot programs in the treatment of people with BPD (e.g., [ 54 , 55 ]). In the current study, program acceptability was assessed through online survey evaluation questions at completion.…”