Journal articles: 'Dialectical Behavior Therapy (DBT)'

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May, Jennifer M., Toni M. Richardi, and Kelly S. Barth. "Dialectical behavior therapy as treatment for borderline personality disorder." Mental Health Clinician 6, no. 2 (March 1, 2016): 62–67. http://dx.doi.org/10.9740/mhc.2016.03.62.

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Abstract Dialectical behavior therapy (DBT) is a structured outpatient treatment developed by Dr Marsha Linehan for the treatment of borderline personality disorder (BPD). Dialectical behavior therapy is based on cognitive-behavioral principles and is currently the only empirically supported treatment for BPD. Randomized controlled trials have shown the efficacy of DBT not only in BPD but also in other psychiatric disorders, such as substance use disorders, mood disorders, posttraumatic stress disorder, and eating disorders. Traditional DBT is structured into 4 components, including skills training group, individual psychotherapy, telephone consultation, and therapist consultation team. These components work together to teach behavioral skills that target common symptoms of BPD, including an unstable sense of self, chaotic relationships, fear of abandonment, emotional lability, and impulsivity such as self-injurious behaviors. The skills include mindfulness, interpersonal effectiveness, emotion regulation, and distress tolerance. Given the often comorbid psychiatric symptoms with BPD in patients participating in DBT, psychopharmacologic interventions are oftentimes considered appropriate adjunctive care. This article aims to outline the basic principles of DBT as well as comment on the role of pharmacotherapy as adjunctive treatment for the symptoms of BPD.

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Burmeister, Kerstin, Klaus Höschel, Jens Barenbrügge, Christos Chrysanthou, Fred Rist, Andrada Delia Neacsiu, and Anya Pedersen. "Die Dialectical Behavior Therapy Ways of Coping Checklist (DBT-WCCL)." Diagnostica 63, no. 1 (January 2017): 29–41. http://dx.doi.org/10.1026/0012-1924/a000164.

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Zusammenfassung. Ziel dieser Arbeit war die Erprobung und Validierung einer deutschen Version der Dialectical Behavior Therapy Ways of Coping Checklist (DBT-WCCL, Neacsiu, Rizui, Vitaliano, Lynch & Linehan, 2010 ), einem Fragebogen zur Erhebung der Häufigkeit der Nutzung von Skills, wie sie im Rahmen der Dialektisch-Behavioralen Therapie (DBT) vermittelt werden. Hierzu bearbeiteten 150 Patientinnen mit Borderline Persönlichkeitsstörung eine deutschsprachige Übersetzung, sowie Fragebögen zur Symptomschwere. Weitere 40 Patientinnen füllten die DBT-WCCL im Rahmen einer stationären DBT zu 5 Messzeitpunkten aus. Die drei Faktoren der Originalversion ließen sich replizieren. Weiterführende Analysen zeigten gute interne Konsistenzen und Retest-Reliabilitäten. Erwartungsgemäße Zunahmen auf der Subskala zur Erfassung von Skillsanwendung während der stationären DBT sowie erwartungsgemäße Zusammenhänge der DBT-WCCL mit der Skills- und DBT-Erfahrung geben erste Hinweise auf die Validität des Verfahrens.

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Smith, Lisa D., and Patrick L. Peck. "Dialectical Behavior Therapy: A Review and Call to Research." Journal of Mental Health Counseling 26, no. 1 (January 1, 2004): 25–38. http://dx.doi.org/10.17744/mehc.26.1.t84fq51d1t4je7wr.

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Dialectical behavior therapy (DBT; Linehan, 1993a) is a systematic and integrative orientation to treating borderline personality disorder. Borderline personality disorder, or BPD, may present a myriad of challenges and difficulties for the beginning as well as the seasoned mental health professional. Although some empirical support exists for DBT, more is needed. The current article is, in essence, a call for research, but is also an effort at introducing DBT and its foundations and stages of individual and group therapy. The goal is to give the reader a clearer understanding of DBT through a review of the empirical evidence, the therapeutic process, and the implications for mental health counselors.

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Glisenti, Kevin, and Esben Strodl. "Cognitive Behavior Therapy and Dialectical Behavior Therapy for Treating Obese Emotional Eaters." Clinical Case Studies 11, no. 2 (April 2012): 71–88. http://dx.doi.org/10.1177/1534650112441701.

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This study describes the treatment of obese individuals who rated high on emotional eating using four case studies that involved 22 sessions of either cognitive behavioral therapy (CBT) or dialectical behavioral therapy (DBT). Outcomes measures relating to weight, body mass index, emotional eating, depression, anxiety, and stress were all assessed with each participant prior to each baseline (three weekly sessions), during treatment and posttherapy. At the 8-week follow-up, the two cases that had received DBT had lost 10.1% and 7.6% of their initial body weight, whereas the two cases that had received CBT had lost 0.7% and 0.6% of their initial body weight. The two DBT cases also exhibited reductions in emotional distress, frequency of emotional eating or quantity of food eating in response to emotions, whereas the two CBT cases showed no overall reductions in these areas. Important processes from all four cases are described as are the implications to clinicians for developing more effective interventions for obese clients who engage in emotional eating.

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Chen, E. Y., J. Cacioppo, K. Fettich, R. Gallop, M. S. McCloskey, T. Olino, and T. A. Zeffiro. "An adaptive randomized trial of dialectical behavior therapy and cognitive behavior therapy for binge-eating." Psychological Medicine 47, no. 4 (November 17, 2016): 703–17. http://dx.doi.org/10.1017/s0033291716002543.

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BackgroundEarly weak treatment response is one of the few trans-diagnostic, treatment-agnostic predictors of poor outcome following a full treatment course. We sought to improve the outcome of clients with weak initial response to guided self-help cognitive behavior therapy (GSH).MethodOne hundred and nine women with binge-eating disorder (BED) or bulimia nervosa (BN) (DSM-IV-TR) received 4 weeks of GSH. Based on their response, they were grouped into: (1) early strong responders who continued GSH (cGSH), and early weak responders randomized to (2) dialectical behavior therapy (DBT), or (3) individual and additional group cognitive behavior therapy (CBT+).ResultsBaseline objective binge-eating-day (OBD) frequency was similar between DBT, CBT+ and cGSH. During treatment, OBD frequency reduction was significantly slower in DBT and CBT+ relative to cGSH. Relative to cGSH, OBD frequency was significantly greater at the end of DBT (d = 0.27) and CBT+ (d = 0.31) although these effects were small and within-treatment effects from baseline were large (d = 1.41, 0.95, 1.11, respectively). OBD improvements significantly diminished in all groups during 12 months follow-up but were significantly better sustained in DBT relative to cGSH (d = −0.43). At 6- and 12-month follow-up assessments, DBT, CBT and cGSH did not differ in OBD.ConclusionsEarly weak response to GSH may be overcome by additional intensive treatment. Evidence was insufficient to support superiority of either DBT or CBT+ for early weak responders relative to early strong responders in cGSH; both were helpful. Future studies using adaptive designs are needed to assess the use of early response to efficiently deliver care to large heterogeneous client groups.

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Hancock-Johnson, Ella, Charlotte Staniforth, Lucy Pomroy, and Kieran Breen. "Adolescent inpatient completers of dialectical behaviour therapy." Journal of Forensic Practice 22, no. 1 (December 6, 2019): 29–39. http://dx.doi.org/10.1108/jfp-07-2019-0029.

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Purpose Dialectical behaviour therapy (DBT) aims to reduce emotional dysregulation and engagement in less adaptive behaviours for adults with mixed disorders of conduct and emotions (MDCE). However, there is limited evidence available for the effectiveness of DBT skills training for adolescents with MDCE who are resident within a secure impatient setting. The paper aims to discuss these issues. Design/methodology/approach A retrospective study investigated changes in aggressive and self-injurious behaviours in 22 adolescents within a secure inpatient mental health setting with MDCE who had completed one cycle of DBT skills training. Changes in symptomatic problems, behavioural and social impairment were also investigated in 17 of the 22 participants who completed the DBT skills training cycle. Findings There were statistically significant decreases in the frequencies of engagement in total aggressive and deliberate self-harm behaviours after the DBT skills training cycle. There was a significant improvement in symptomatic and behavioural impairment, but not in social impairment. Practical implications The findings of this study suggest that DBT skills training may be beneficial for behavioural and symptomatic outcomes in adolescent inpatients with MDCE. Originality/value This study provides preliminary evidence for the effectiveness of DBT skills training for adolescents with MDCE within a secure inpatient setting. Additional studies are required to investigate the clinical benefits of specific aspects of DBT for individual patients.

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Cooper, Brent, and Jane Parsons. "Dialectical Behaviour Therapy: A social work intervention?" Aotearoa New Zealand Social Work 21, no. 4 (January 1, 2009): 83–93. http://dx.doi.org/10.11157/anzswj-vol21iss4id264.

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This article introduces the mental health treatment, Dialectical Behaviour Therapy (DBT) as a dynamic and challenging therapy well suited to a critical social work perspective. From the authors’ experience of providing DBT in a tertiary health setting over the past three years, the connections between DBT and social work will be espoused with the central tenet being the demonstration that psychiatric social workers are highly skilled once trained in this modality

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Barrett, John J., Kathryn A. Tolle, and Nicholas L. Salsman. "Dialectical Behavior Therapy Skills Training for Persistent Complex Bereavement Disorder." Clinical Case Studies 16, no. 5 (March 24, 2017): 388–400. http://dx.doi.org/10.1177/1534650117699700.

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Although the majority recovers from the death of a loved one, nearly 5% exhibit persistent symptoms of grief, known as Persistent Complex Bereavement Disorder (PCBD). PCBD has adverse health, social, and psychological consequences. We examined the effectiveness of dialectical behavior therapy (DBT) skills training with a 57-year-old African American woman who met the Diagnostic and Statistical Manual of Mental Disorders (5th ed.; DSM-5) criteria for PCBD and Persistent Depressive Disorder. The client met with a graduate student therapist (i.e., the second author) who applied DBT skills training on an individual basis. By the end of treatment, the participant no longer met the criteria for either of these disorders. Reliable and clinically significant reduction in her grief and depressive symptoms, suicidality, and sleep difficulties were noted from pre- to posttreatment and maintained for 2 months post treatment. Furthermore, she improved her ability to regulate her emotions and cognitions using DBT coping skills and eliminated substance abuse. These results prompt the need for more research to further investigate DBT skills training for PCBD.

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Harvey, Lauren J., Caroline Hunt, and Fiona A. White. "Dialectical Behaviour Therapy for Emotion Regulation Difficulties: A Systematic Review." Behaviour Change 36, no. 3 (April 26, 2019): 143–64. http://dx.doi.org/10.1017/bec.2019.9.

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AbstractWhile dialectical behaviour therapy (DBT) appears efficacious in reducing suicidal and self-harming behaviour, it is unclear whether DBT reduces emotion regulation (ER) difficulties, a purported mechanism of change of treatment. This review aims to investigate and evaluate the current evidence to understand the effectiveness of DBT in improving ER difficulties. A qualitative synthesis of studies investigating the effectiveness of DBT on self-reported ER difficulties as measured by the Difficulties in Emotion Regulation Scale (DERS) was performed, identifying eligible studies using PsycINFO, PubMed, MEDLINE and EMBASE databases. Fourteen studies were identified. Current evidence indicates that DBT does not show consistent benefits relative to existing psychological treatments in improving ER difficulties. The literature is compromised by significant methodological limitations increasing risk of bias across study outcomes. Furthermore, high variability across DBT programs and a lack of investigation regarding adherence and participant engagement within interventions was observed. Further research is needed in order to conclude regarding the effectiveness of DBT in improving ER difficulties. Consistent use of active treatment conditions, greater standardisation of DBT-based interventions, in addition to further examination of participant engagement level in DBT-based interventions in the long term may assist understanding as to whether DBT improves ER difficulties.

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Galietta, Michele, and Barry Rosenfeld. "Adapting Dialectical Behavior Therapy (DBT) for the Treatment of Psychopathy." International Journal of Forensic Mental Health 11, no. 4 (October 2012): 325–35. http://dx.doi.org/10.1080/14999013.2012.746762.

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Barnicot, Kirsten, and Mike Crawford. "Dialectical behaviour therapy v. mentalisation-based therapy for borderline personality disorder." Psychological Medicine 49, no. 12 (October 10, 2018): 2060–68. http://dx.doi.org/10.1017/s0033291718002878.

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AbstractBackgroundDialectical behaviour therapy (DBT) and mentalisation-based therapy (MBT) are both widely used evidence-based treatments for borderline personality disorder (BPD), yet a head-to-head comparison of outcomes has never been conducted. The present study therefore aimed to compare the clinical outcomes of DBT v. MBT in patients with BPD.MethodsA non-randomised comparison of clinical outcomes in N = 90 patients with BPD receiving either DBT or MBT over a 12-month period.ResultsAfter adjusting for potentially confounding differences between participants, participants receiving DBT reported a significantly steeper decline over time in incidents of self-harm (adjusted IRR = 0.93, 95% CI 0.87–0.99, p = 0.02) and in emotional dysregulation (adjusted β = −1.94, 95% CI −3.37 to −0.51, p < 0.01) than participants receiving MBT. Differences in treatment dropout and use of crisis services were no longer significant after adjusting for confounding, and there were no significant differences in BPD symptoms or interpersonal problems.ConclusionsWithin this sample of people using specialist personality disorder treatment services, reductions in self-harm and improvements in emotional regulation at 12 months were greater amongst those receiving DBT than amongst those receiving MBT. Experimental studies assessing outcomes beyond 12 months are needed to examine whether these findings represent differences in the clinical effectiveness of these therapies.

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Lyng, J. L., M. A. Swales, and R. P. Hastings. "Dialectical behaviour therapy for younger adults: evaluation of 22 weeks of community delivered dialectical behaviour therapy for females 18–25 years." Irish Journal of Psychological Medicine 32, no. 4 (January 16, 2015): 299–305. http://dx.doi.org/10.1017/ipm.2014.69.

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BackgroundDialectical behaviour therapy (DBT) is a multi-modal psychological therapy with established efficacy in treating borderline personality disorder (BPD). Younger adults represent a group more likely to drop out of treatment than their older counterparts and treatments specifically targeted at this younger cohort may be advantageous.The current studyWe describe an evaluation of a DBT programme in a mental health centre for younger adults 18–25 years who met criteria for BPD (n=11).MethodologyWe used a simple pre/post-test design, measuring BPD symptoms, general mental health symptoms, and coping skills using self-report questionnaires at the beginning of DBT and again following the delivery of 22 weeks of DBT.FindingsStatistically significant reductions were found in BPD symptoms and several mental health symptoms alongside an increase in DBT skills use. Dropout was 31% at 22 weeks of treatment. Methodological weaknesses and avenues for future research are discussed.

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Swales, Michaela Anne. "Implementing Dialectical Behaviour Therapy: organizational pre-treatment." Cognitive Behaviour Therapist 3, no. 4 (September 28, 2010): 145–57. http://dx.doi.org/10.1017/s1754470x10000115.

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AbstractImplementing change in organizational systems is challenging, and implementing a new psychotherapeutic approach is no different. A literature exists on issues in implementation across a wide range of domains (technological, healthcare, justice). However, little of it is utilized in endeavours to implement innovations in psychological treatments. This paper draws on the implementation literature and on the experiences of the British Isles DBT Training Team (BIDBT) in implementing Dialectical Behaviour Therapy (DBT) in mental healthcare systems in the UK over the last 13 years. This paper describes principles and strategies of ‘organizational pre-treatment’ as a necessary prerequisite to implementation.

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Finney, Natasha, and Eman Tadros. "Integration of Structural Family Therapy and Dialectical Behavior Therapy With High-Conflict Couples." Family Journal 27, no. 1 (September 27, 2018): 31–36. http://dx.doi.org/10.1177/1066480718803344.

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There is a gap in existing literature regarding the integration of family therapies and dialectical behavior therapy (DBT) with high-conflict couples and families. A case application is utilized to highlight how the integration of structural family therapy (SFT) and DBT can inform the conceptualization and treatment of clients. The following case study involves a high-conflict, Children’s Services Bureau–referred couple presenting to therapy with reported multiple stressors and problems. For the purposes of this article, therapeutic change occurs within the family unit, by accepting each member as they are, while at the same time working together to change maladaptive familial structures. The aim of this article is to begin closing the gap in research by exploring how structural family therapy and dialectical behavior can be integrated to create a comprehensive theory and approach to treatment.

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Wetterborg, Dan, Peter Dehlbom, Niklas Långström, Gerhard Andersson, Alan E. Fruzzetti, and Pia Enebrink. "Dialectical Behavior Therapy for Men With Borderline Personality Disorder and Antisocial Behavior: A Clinical Trial." Journal of Personality Disorders 34, no. 1 (February 2020): 22–39. http://dx.doi.org/10.1521/pedi_2018_32_379.

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In addition to suicidal behaviors, men with borderline personality disorder (BPD) often display antisocial behavior that could impair contacts with mental health services. While research has established effective treatments for women with BPD, this is not yet the case for men. The authors evaluated 12 months of dialectical behavior therapy (DBT) for 30 men with BPD and antisocial behavior, using a within-group design with repeated measurements. The authors found moderate to strong, statistically significant pre-to posttreatment reductions of several dysfunctional behaviors, including self-harm, verbal and physical aggression, and criminal offending (rate ratios 0.17–0.39). Symptoms of BPD and depression were also substantially decreased. The dropout rate was 30%, and completing participants reported high satisfaction with treatment and maintained their improvements at 1-year follow-up. The authors conclude that DBT could be an effective treatment alternative for men with BPD and antisocial behavior, and it merits future studies with more rigorous design.

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Christensen, Darren R., Nicki A. Dowling, Alun C. Jackson, Meredith Brown, James Russo, Kate L. Francis, and Azusa Umemoto. "A Proof of Concept for Using Brief Dialectical Behavior Therapy as a Treatment for Problem Gambling." Behaviour Change 30, no. 2 (April 11, 2013): 117–37. http://dx.doi.org/10.1017/bec.2013.10.

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Fourteen ‘treatment resistant’ problem gamblers received 9 weeks of Dialectical Behavior Therapy (DBT) at specialist problem gambling services delivered in Melbourne, Australia. This study is the first to investigate the effectiveness of a brief DBT treatment for problem gambling, with a focus on measuring change in the four DBT process skills (mindfulness, distress tolerance, emotion dysregulation, and negative relationships). Although there were no statistically significant improvements in measures of gambling behaviour, 83% of participants were abstinent or reduced their gambling expenditure pre- to post-treatment. Participants also reported statistically and clinically significant improvements in psychological distress, mindfulness, and distress tolerance. Moreover, there were no increases in alcohol or substance use. These results are discussed in the context of focusing on a single DBT process skill, and the benefits of using group-based approaches.

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Baillie, Aubrey, and Sean Slater. "Community dialectical behaviour therapy for emotionally dysregulated adults with intellectual disabilities." Advances in Mental Health and Intellectual Disabilities 8, no. 3 (April 29, 2014): 165–73. http://dx.doi.org/10.1108/amhid-05-2013-0033.

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Purpose – The purpose of this paper is to reflexively examine the challenges of implementing a community dialectical behaviour therapy (DBT) service for adults with intellectual disabilities (ID) and describes the practical lessons learned about how to maximise the effectiveness of DBT with this client group. Design/methodology/approach – A brief overview of DBT is provided and reference is made to literature which highlights the potential benefits of providing a DBT service to clients with an ID. This is followed by a discussion of the clinical presentation of the clients receiving DBT in the service that is the focus of this case study. Using a reflexive approach, a detailed discussion follows of the challenges faced in implementing a community DBT service for the clients served. Findings – Solutions to a variety of challenges faced in four years of service delivery are described, key lessons learned are highlighted, together with issues meriting further research. Research limitations/implications – This case study and its implications are limited to community DBT services. Another limitation is that, although outcome data have been collected over the past two years, the dataset is not yet large enough to draw statistical conclusions. Practical implications – The paper describes adaptations to treatment structure and strategy which the authors believe are necessary to improve treatment outcomes in community DBT services for adults with ID. In particular, the practical experience suggests that a didactic approach to teaching DBT skills is not effective and should be replaced by the “community of learners” approach that involves the trainer contingently responding to client input. Pre-set lesson plans inhibit the trainers’ ability to respond contingently. Originality/value – The existing literature on providing a DBT service for people with an ID has principally focused on providing a rationale for providing this type of intervention, and on assessing outcomes. Given that this is still a relatively new type of provision for this client group, a detailed examination of process issues is called for.

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S, Komal, and Nandha KP. "Application of Dialectical Behavior Therapy (DBT) for Opioid Dependence: Case Study." International Journal of Current Research and Review 13, no. 13 (2021): 91–96. http://dx.doi.org/10.31782/ijcrr.2021.131321.

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Harned, Melanie S., Kathryn E. Korslund, Sara C. Schmidt, and Robert J. Gallop. "The Dialectical Behavior Therapy Adherence Coding Scale (DBT ACS): Psychometric properties." Psychological Assessment 33, no. 6 (June 2021): 552–61. http://dx.doi.org/10.1037/pas0000999.

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Doorn, Katie Aafjes-van, Céline Kamsteeg, Kathy Portier, and Geetali Chitre. "A Dialectical Behavior Therapy Skills Group in a Psychoanalytic Community Service: A Pilot Study." Journal of Cognitive Psychotherapy 34, no. 1 (January 1, 2020): 21–46. http://dx.doi.org/10.1891/0889-8391.34.1.21.

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This exploratory study reports on the implementation and effectiveness of a 20-week Dialectical Behavior Therapy (DBT) skills group provided to 8 outpatients (7 women, average age 33 years old) within a psychoanalytic community clinic. We report on the practical implementation of this DBT skills group, and describe how the theoretical/technical differences between DBT and psychoanalysis were negotiated by the two co-therapists. The effectiveness of the skills group was evaluated on standardized measures of borderline personality symptoms, depression, anxiety, interpersonal problems, quality of life, and mindfulness skills that patients completed before and after treatment. At post-treatment, patients evaluated the DBT skills group on a satisfaction questionnaire and therapists completed a countertransference measure. Pre–post outcome data indicated reduced symptom levels of anxiety, depression, and improved quality of life. Both therapists reported moderate therapist responses typically associated with borderline personality disorder psychopathology. Their therapist responses were not associated with symptom levels or change but were related to patient satisfaction. Accumulative pilot studies like these add to the practice-based evidence of DBT components offered within psychoanalytically-oriented community clinics. However, given the exploratory nature of this study, strong conclusions are precluded until further effectiveness research is conducted.

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Flynn, Daniel, Mary Kells, Mary Joyce, Paul Corcoran, Justina Hurley, Conall Gillespie, Catalina Suarez, Michaela Swales, and Ella Arensman. "Multisite Implementation and Evaluation of 12-Month Standard Dialectical Behavior Therapy in a Public Community Setting." Journal of Personality Disorders 34, no. 3 (June 2020): 377–93. http://dx.doi.org/10.1521/pedi_2018_32_402.

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Dialectical behavior therapy (DBT) is an effective intervention for treating adults with emotional and behavioral dysregulation. The National DBT Project, Ireland was established in 2013 to coordinate the implementation of DBT across public community mental health settings at a national level. This study describes the implementation and evaluation of DBT across multiple independent sites in adult mental health services (AMHS). The Consolidated Framework for Implementation Research was used to guide this national implementation where barriers and facilitators to DBT implementation were considered. Nine AMHS teams completed DBT training and delivered the standard 12-month program. One hundred and ninety-six adults with borderline personality disorder participated in the program, and outcome measures were recorded at four time points. Significant reductions on outcome measures, including frequency of self-harm and suicidal ideation, were observed. This study highlights that DBT can be successfully implemented in community mental health settings as part of a coordinated implementation.

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Lynch, Thomas R., Roelie J. Hempel, Ben Whalley, Sarah Byford, Rampaul Chamba, Paul Clarke, Susan Clarke, et al. "Radically open dialectical behaviour therapy for refractory depression: the RefraMED RCT." Efficacy and Mechanism Evaluation 5, no. 7 (December 2018): 1–112. http://dx.doi.org/10.3310/eme05070.

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Background About one-third of patients who are depressed do not respond to antidepressant medication (ADM) and traditional psychotherapy shows limited benefits. However, most randomised trials have excluded the most sick patients, especially with comorbid personality disorder. Radically open dialectical behaviour therapy (RO DBT) is a new treatment targeting emotionally overcontrolled personality, which is common in refractory depression. Objective To evaluate the efficacy, cost-effectiveness and therapeutic mechanisms of RO DBT for patients with refractory depression. Design The Refractory depression: Mechanisms and Efficacy of RO DBT (RefraMED) trial was a multicentre, parallel-group, randomised trial in which participants were randomised to receive either RO DBT plus treatment as usual (TAU) or TAU alone. Participants were assessed at 7, 12 and 18 months after randomisation. Therapeutic mechanisms were explored in causal analyses. Setting Participants were recruited from three secondary care NHS organisations in the UK: Dorset, Hampshire and North Wales. Participants Patients were eligible if they were aged ≥ 18 years, had a Hamilton Rating Scale for Depression (HRSD) score of at least 15, had a current diagnosis of major depressive disorder in the Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition Axis I, were suffering either refractory or chronic depression and, in their current episode, had taken an adequate dose of ADM for at least 6 weeks without relief. Patients who met criteria for dramatic-erratic personality disorder (Cluster B), bipolar disorder or psychosis or who had a primary diagnosis of substance dependence or abuse were excluded. Interventions The intervention, RO DBT, comprised 29 weekly individual sessions lasting 1 hour and 27 weekly skills classes lasting 2.5 hours. Participants allocated to TAU could access any treatment offered by the NHS or privately. Main outcome measures The reported HRSD score 12 months after randomisation and cost per quality-adjusted life-year (QALY). Results A total of 250 participants were allocated at random: 162 (65%) participants were randomised to RO DBT plus TAU and 88 (35%) were randomised to TAU. The difference between RO DBT and TAU in the primary outcome at 12 months was not statistically significant. Nevertheless, after 7 months, participants randomised to RO DBT had substantially, and significantly, reduced depressive symptoms, relative to TAU, by 5.40 HRSD points [standardised mean difference 1.03 points, 95% confidence interval (CI) 0.94 to 9.85 points; p = 0.02]. Thereafter, RO DBT remained the better treatment with net, but non-significant, reductions of 2.15 HRSD points (standardised mean difference 0.41 points, 95% CI –2.28 to 6.59 points; p = 0.29) after 12 months and 1.69 points (standardised mean difference 0.32 points, 95% CI –2.84 to 6.22 points; p = 0.42) after 18 months. Participants allocated to TAU could access any treatment offered by the NHS or privately. Participants randomised to RO DBT reported significantly better psychological flexibility and emotional coping than TAU participants; these differences increased over time. From the perspective of the NHS and personal social services, RO DBT was not cost-effective; the incremental cost-effectiveness ratio was £220,000 per QALY, which is considerably above the willingness-to-pay threshold of £30,000 set by the National Institute for Health and Care Excellence (NICE). RO DBT participants reported eight possible serious adverse reactions compared with none by TAU participants; however, we believe that this imbalance was a result of major differences in reporting opportunities. The Data Monitoring and Ethics Committee agreed that there was no reason to suspect that RO DBT was harmful. Conclusions Although RO DBT achieved the target effect size (Cohen’s d) with a d of 0.4 at the primary end point of 12 months, this was not significant. RO DBT was not cost-effective by NICE criteria. Nevertheless, RO DBT enhanced psychological flexibility and emotional coping, which are potential mechanisms of change. Limitations Analysing only 190 participants, instead of the target of 245, reduced the statistical power of the trial. Future work Future studies should aim to refine RO DBT, by maintaining clinical effectiveness while reducing costs, and to evaluate it for a wider range of overcontrolled disorders over a longer period. Trial registration Current controlled trials ISRCTN85784627. Funding This project was funded by the Efficacy and Mechanism Evaluation (EME) programme, a MRC and NIHR partnership, and will be published in full in Efficacy and Mechanism Evaluation; Vol. 5, No. 7. See the NIHR Journals Library website for further project information.

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Ghorbani, Sara, Alireza Salemi Kameneh, Alireza Motahedy, and Zahra Alipour. "Comparative Effectiveness of Cognitive-Behavioral Therapy and Dialectical Behavior Therapy on Emotion Regulation, Positive and Negative Affection, Aggressive and Self-Harm Behaviors of 13-16-Year-Old Female Students." International Journal of Multicultural and Multireligious Understanding 7, no. 9 (October 1, 2020): 20. http://dx.doi.org/10.18415/ijmmu.v7i9.1883.

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This study was aimed to compare the effectiveness of cognitive-behavioral therapy with dialectical behavior therapy on emotion regulation, positive and negative affection, aggressive and self-harm behaviors of 13 to 16-year-old female students. The results showed that both CBT and DBT have a significant effect on increasing emotional regulation and positive affect, and decreasing negative affect, reducing aggressive behavior and self-harm. Also there was no significant difference between two treatments in increasing the positive affection and decreasing negative affection, but the effect of DBT on increasing emotional regulation and reducing self-harm and aggressive behaviors was significantly more than CBT.

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Verheul, Roel, Louise M. C. Van Den Bosch, Maarten W. J. Koeter, Maria A. J. De Ridder, Theo Stijnen, and Wim Van Den Brink. "Dialectical behaviour therapy for women with borderline personality disorder." British Journal of Psychiatry 182, no. 2 (February 2003): 135–40. http://dx.doi.org/10.1192/bjp.182.2.135.

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BackgroundDialectical behaviour therapy (DBT) is widely considered to be a promising treatment for borderline personality disorder (BPD). However, the evidence for its efficacy published thus far should be regarded as preliminary.AimsTo compare the effectiveness of DBT with treatment as usual for patients with BPD and to examine the impact of baseline severity on effectiveness.MethodFifty-eight women with BPD were randomly assigned to either 12 months of DBT or usual treatment in a randomised controlled study. Participants were recruited through clinical referrals from both addiction treatment and psychiatric services. Outcome measures included treatment retention and the course of suicidal, self-mutilating and self-damaging impulsive behaviours.ResultsDialectical behaviour therapy resulted in better retention rates and greater reductions of self-mutilating and self-damaging impulsive behaviours compared with usual treatment, especially among those with a history of frequent self-mutilation.ConclusionsDialectical behaviour therapy is superior to usual treatment in reducing high-risk behaviours in patients with BPD.

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Buerger, Arne, Gloria Fischer-Waldschmidt, Florian Hammerle, Kristin von Auer, Peter Parzer, and Michael Kaess. "Differential Change of Borderline Personality Disorder Traits During Dialectical Behavior Therapy for Adolescents." Journal of Personality Disorders 33, no. 1 (February 2019): 119–34. http://dx.doi.org/10.1521/pedi_2018_32_334.

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Despite the expansion of treatment options for adults with borderline personality disorder (BPD), research on treatment options for adolescent BPD is scarce. The aim of this study was to investigate the impact of dialectical behavior therapy for adolescents (DBT-A) on the individual trait level as primary outcome; and the frequency of suicide attempts and nonsuicidal self-injury, self-reported BPD core pathology, and general psychopathology as secondary outcomes. Seventy-two adolescents (aged 12–17 years) with full- or subsyndromal BPD were treated with DBT-A (25 single sessions, 20 sessions of skills training), and 13 patients (18.1%) withdrew during treatment. From baseline to post-treatment, the number of BPD traits decreased significantly (p ≤ .001). All secondary outcomes decreased significantly as well (p ≤ .001). Results of this uncontrolled study suggest that beside self-harm, DBT-A may also have a beneficial impact on other features of BPD.

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Searle, Robert John, and Ianiv Borseti. "Adapted dialectical behaviour therapy skills group service evaluation." Advances in Mental Health and Intellectual Disabilities 15, no. 1 (January 9, 2021): 1–7. http://dx.doi.org/10.1108/amhid-06-2020-0015.

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Purpose The purpose of this paper is to determine the effectiveness of an adapted dialectical behaviour therapy (DBT) treatment programme for individuals with an intellectual disability, via completion of a service evaluation. Design/methodology/approach Outcome measurements were competed at pre-, post- and 12 months follow-up, and the effectiveness of the intervention was assessed using a Friedman analysis. Findings Findings demonstrated that the treatment group showed significant differences in their “psychological distress” scores, but no significant differences were found in their “psychological well-being”, “anxiety” or “quality of life” (WHO-QOL) scores over time. Originality/value Overall, the current study adds to the small but growing literature that supports using the skills training group part of DBT as a stand-alone psychological intervention when working with people with an intellectual disability.

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Field, Thomas A. "A Different Type of Supervision: Training Clinical Mental Health Counseling Interns in Dialectical Behavior Therapy." Journal of Mental Health Counseling 38, no. 3 (July 1, 2016): 233–47. http://dx.doi.org/10.17744/mehc.38.3.04.

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A basic qualitative study examined the role of supervision in learning dialectical behavior therapy (DBT). Ten master's-level clinical mental health counseling interns completed in-depth interviews regarding their experiences of supervision when providing DBT skills training groups to adolescents in an inpatient psychiatric setting. Supervision was described as an activity in tandem with observation and shadowing, with the supervisor functioning as a consultant and teacher. Themes highlighted the importance of structure in mitigating trainee performance anxiety, and a focus on skills training during supervision. Implications for supervising counseling interns in evidence-based practices such as DBT are discussed.

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Choi, Hyunjung. "Evidence for Dialectical Behavior Therapy and Dissemination in Korea: A Systematic Review." Korean Journal of Clinical Psychology 37, no. 3 (August 31, 2018): 443–63. http://dx.doi.org/10.15842/kjcp.2018.37.3.013.

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Tebbett-Mock, Alison Ann, Madeline McGee, and Ema Saito. "Efficacy and sustainability of dialectical behaviour therapy for inpatient adolescents: a follow-up study." General Psychiatry 34, no. 4 (July 2021): e100452. http://dx.doi.org/10.1136/gpsych-2020-100452.

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BackgroundDialectical behaviour therapy (DBT) is an evidence-based treatment for adolescents targeting suicidal and non-suicidal self-injurious behaviours. Research supports DBT’s efficacy in inpatient settings, but implementation and sustainability are understudied.AimsThis study is a follow-up of a previous study by Tebbett-Mock et al and examines the efficacy and sustainability of an adolescent DBT inpatient unit within a psychiatric hospital in the Northeast. We hypothesised that adolescents who received DBT in our follow-up group (DBT Group 2) would not have statistical difference (ie, greater or fewer) of the following compared with the first group of patients who received DBT on the unit the year prior (DBT Group 1) and would have significantly fewer of the following compared with the treatment as usual (TAU) group: (1) constant observation hours for suicidal ideation, self-injury and aggression; (2) incidents of suicide attempts, self-injury and aggression; (3) restraints; (4) seclusions; (5) days hospitalised; (6) times readmitted to the unit within 30 days of discharge.MethodsWe conducted a retrospective chart review for adolescents receiving inpatient DBT (DBT Group 1, n=425; DBT Group 2, n=393) and a historical control group (TAU, n=376). The χ2 tests and one-way analysis of variance were conducted as preliminary analyses to examine group differences on diagnosis, gender and age. Kruskal-Wallis H tests were conducted to examine group differences on outcomes. Mann-Whitney U tests were used as post hoc analyses.ResultsPatients in DBT Group 2 were comparable to DBT Group 1 for the number of constant observation hours for self-injury (U=83 432.50, p=0.901), restraints (U=82 109, p=0.171) and days hospitalised (U=83 438.5, p=0.956). Patients in DBT Group 2 had a significantly greater number of incidents of suicide attempts compared with DBT Group 1 (U=82 662.5, p=0.037) and of self-injury compared with patients in DBT Group 1 (U=71724.5, p<0.001) and TAU (U=65649.0, p<0.001).ConclusionsResults provide support for adolescent inpatient DBT compared with TAU and highlight staff turnover and lack of training as potential barriers to sustainability and efficacy.

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Pistorello, Jacqueline, Alan E. Fruzzetti, Chelsea MacLane, Robert Gallop, and Katherine M. Iverson. "Dialectical behavior therapy (DBT) applied to college students: A randomized clinical trial." Journal of Consulting and Clinical Psychology 80, no. 6 (December 2012): 982–94. http://dx.doi.org/10.1037/a0029096.

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Chwalek, C. M., and C. H. McKinney. "The Use of Dialectical Behavior Therapy (DBT) in Music Therapy: A Sequential Explanatory Study." Journal of Music Therapy 52, no. 2 (May 8, 2015): 282–318. http://dx.doi.org/10.1093/jmt/thv002.

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Blennerhassett, Richard, Lindsay Bamford, Anthony Whelan, Sarah Jamieson, and Jennifer Wilson O'Raghaillaigh. "Dialectical behaviour therapy in an Irish community mental health setting." Irish Journal of Psychological Medicine 26, no. 2 (June 2009): 59–63. http://dx.doi.org/10.1017/s0790966700000227.

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AbstractObjectives:Dialectical behaviour therapy (DBT) is a recommended treatment of patients with borderline personality disorder, yet there are few descriptions of the approach in public community mental health settings where the majority of such patients present. This study describes the development and evaluation of a DBT programme in an Irish setting.Methods:The DBT programme was run over a six month period. Participants were assessed at baseline and post intervention with the following instruments: The Structured Clinical Interview for DSM III R personality disorders (SCID II), the clinical Outcomes in Routine Evaluation (CORE) and the symptom checklist 90 Revised (SCL-90-Revised). Inpatient bed usage was determined from case note review.Results:Outcome data was available for eight subjects. Significant improvement (p < 0.005) was seen on all CORE subscales. SCL-90-R showed significant improvement (p < 0.05) on the global severity index and on the positive symptom distress index. A decrease in self harming behaviour was found. Subjects' inpatient bed days dropped from a mean of 58 in the year pre intervention to a mean of four days in the year post intervention. A novel finding was that 43% of subjects who originally fulfilled criteria for avoidant personality disorder no longer did so post intervention.Conclusions:The study found that DBT can be applied in a community mental health setting with benefits similar to more specialist settings. Significant difficulties were encountered in implementing the programme. The clinical implications are that specialist psychotherapy services need to be an integral part of psychiatric services to achieve better outcomes for patients with borderline personality disorder.

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Stanley, Barbara, Beth Brodsky, Joshua D. Nelson, and Rebecca Dulit. "Brief Dialectical Behavior Therapy (DBT-B) for Suicidal Behavior and Non-Suicidal Self Injury." Archives of Suicide Research 11, no. 4 (August 31, 2007): 337–41. http://dx.doi.org/10.1080/13811110701542069.

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Warlick, Craig A., Nicole M. Farmer, Bruce B. Frey, Kaylee Vigil, Abigail Armstrong, Thomas S. Krieshok, and Juliet Nelson. "Cost Borne by the Counselor: Comparing Burnout Between Dialectical Behavior Therapy (DBT) Counselors and Non‐DBT Counselors." Journal of Counseling & Development 99, no. 3 (June 8, 2021): 302–14. http://dx.doi.org/10.1002/jcad.12376.

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Florez, Ivonne Andrea, and J. Scott Bethay. "Using Adapted Dialectical Behavioral Therapy to Treat Challenging Behaviors, Emotional Dysregulation, and Generalized Anxiety Disorder in an Individual With Mild Intellectual Disability." Clinical Case Studies 16, no. 3 (January 13, 2017): 200–215. http://dx.doi.org/10.1177/1534650116687073.

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Individuals with intellectual disability (ID) are at increased risk of presenting challenging behaviors and comorbid mental illness. Preliminary findings show decreased challenging behaviors and overall increased functioning in individuals with ID and mental health problems who receive adapted dialectical behavior therapy (DBT). However, more research and documentation on how to adapt DBT in this population is warranted given that DBT is a promising intervention in individuals with ID. This article presents the case of an individual with mild ID who received adapted DBT for the treatment of challenging behaviors, emotional dysregulation, and generalized anxiety disorder. Treatment lasted 1 year and was conducted in a residential facility for individuals with ID. Improvement of symptoms and decrease in frequency of challenging behaviors were observed throughout the case. This case study demonstrates the potential utility of adapted DBT for individuals with ID and underscores the importance of teaching skills to clients with ID to help them become agents of their own change.

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Gaglia, Amy, Jurgen Essletzbichler, Kirsten Barnicot, Nyla Bhatti, and Stefan Priebe. "Dropping out of dialectical behaviour therapy in the NHS: the role of care coordination." Psychiatrist 37, no. 8 (August 2013): 267–71. http://dx.doi.org/10.1192/pb.bp.112.041251.

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Aims and methodDialectical behaviour therapy (DBT) is associated with particularly high drop-out rates in the National Health Service (NHS). This paper seeks to investigate the characteristics of patients with borderline personality disorder dropping out from DBT and the role of care coordination in this phenomenon. Data for the 102 patients receiving DBT in east London, 58% of whom had dropped out of treatment prematurely, were analysed.ResultsIn a multivariable analysis, a history of care coordination was the only variable significantly correlated with drop out: 88% of patients with a history of care coordination dropped out prematurely compared with 52% of patients without such history.Clinical implicationsThe experience of comprehensive care within the care programme approach, particularly care coordination at the start of DBT, affects the retention of patients in DBT. Further qualitative research is required to understand how care coordination and DBT drop out are related, which could lead to changes in how the therapy is delivered in the UK and influence decisions regarding the use of care coordination with patients with borderline personality disorder.

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Kienast, T., H. von Hoerner, S. Reiske, B. Renneberg, J. Wrase, and A. Heinz. "Dialectical Behavior Therapy for Inpatients with Borderline Personality Disorder and Concomitant Alcohol Dependence: Results of a Pilot Study." European Psychiatry 24, S1 (January 2009): 1. http://dx.doi.org/10.1016/s0924-9338(09)70325-6.

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Purpose of study:Psychotherapy with patients suffering from borderline personality disorder (BPD) and concomitant alcoholism requires an integrative approach. Dialectical Behavioral Therapy (DBT) is an evaluated and effective program for patients with BPD, whereas behavior therapy, commitment therapy and self-help groups have all been found to be effective in the treatment of alcoholism. In this pilot study, we give an initial report of the concept and efficacy of an eight week inpatient therapy program integrating an evaluated therapy of alcoholism with standard DBT. The changes of symptoms were evaluated using the Borderline Symptom List (BSL), the European Addiction Severity Index (EuropASI), Lifetime Parasuicide Count (LPC), and Beck-Depression-Inventory.Findings:Five case reports were included. All show improvements in various subscores of BSL and EuropASI, and had a decrease in the LPC score.Summary:With this pilot study we test the efficacy of an extended DBT program for inpatients with BPD and alcoholism who failed outpatient treatment, and found significant improvements in the study in all outcome measures. This promising result points to the necessity for clinical trials that compare standard care with extended DBT in larger cohorts.

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Abdelkarim, A., D. Nagui Rizk, M. Esmaiel, and H. Helal. "Social media group parallel to dialectical behavior therapy skills training group, the pros and cons." European Psychiatry 33, S1 (March 2016): S556. http://dx.doi.org/10.1016/j.eurpsy.2016.01.2054.

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IntroductionIn the past few years, social media has gained a high popularity as a dynamic and interactive computer-mediated communication tools. Although it has become a part of everyday life for most of our clients, yet we did not have the opportunity to study its impact on compliance to therapy.ObjectiveAssessment of impact of parallel social media group to dialectical behavior therapy (DBT) skills training group in a sample of Egyptian patients suffering from borderline personality disorder (BPD).AimThe aim of the current study was to estimate impact of parallel social media group on compliance to DBT skills training group and its adverse events.MethodsPatients with BPD enrolled to an outpatient comprehensive DBT program in Alexandria were assigned either to group (A) skills training, where a parallel Facebook group was crated aiming at increasing to compliance to the original group, or group (B) skills training alone and dropout rates were calculated based on completion of 6 months full skills training. We considered patients out of the group if they missed 4 sessions in a raw.ResultsTwo patients of 15 patients who joined group (A) missed four consecutive sessions with a dropout rate of 13%, whereas group (B) showed 43% drop out rate as 10 out of 23 patients did not complete the group. The difference was statistically significant. We reported only one privacy issue dealt with it immediately.ConclusionUtilization of social media group could lead to increase patient compliance to DBT skills training group.Disclosure of interestThe authors have not supplied their declaration of competing interest.

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Ekdahl, S., E. Idvall, and K. I. Perseius. "Family skills training in dialectical behaviour therapy: The experience of the significant others." European Psychiatry 33, S1 (March 2016): S210. http://dx.doi.org/10.1016/j.eurpsy.2016.01.504.

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IntroductionBorderline personality disorder (BPD) is a severe psychiatric health problem with reputation of being difficult to deal with and to treat. Significant others (SOs) of patients with BPD show higher levels of psychological distress compared with the general population. Strengthening the coping strategies of SOs plays an important role in the recovery of the patient. Support and education for SOs is important, both for SOs themselves and for the patients recovery.ObjectivesResearch around support and education for SOs is of great importance not only for SOs and patients, but also for psychiatric staff, in order to offer help and support, for the whole family.AimThe aim was to describe significant others’ experiences of dialectical behaviour therapy-family skills training (DBT-FST), their life situation before and after DBT-FST, and measurement of their levels of anxiety and depressive symptoms.MethodsThe study had a descriptive mixed method design. Data were collected with free text questionnaires (n = 44), group interviews (n = 53) and the HAD scale (n = 52) and analysed by qualitative content analysis and descriptive and inferential statistics.ResultsThe results show that life before DBT-FST was a struggle. DBT-FST gave hope for the future and provided strategies, helpful in daily life. For the subgroup without symptoms of anxiety and depression before DBT-FST, anxiety increased significantly. For the subgroup with symptoms of anxiety and depression the symptoms decreased significantly. This indicates, despite increased anxiety for one group, that DBT-FST is a beneficial intervention and most beneficial for those with the highest anxiety and depressive symptoms.Disclosure of interestThe authors have not supplied their declaration of competing interest.

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Haynos, Ann F., Alan E. Fruzzetti, Calli Anderson, David Briggs, and Jason Walenta. "Effects of dialectical behavior therapy skills training on outcomes for mental health staff in a child and adolescent residential setting." Journal of Hospital Administration 5, no. 2 (January 4, 2016): 55. http://dx.doi.org/10.5430/jha.v5n2p55.

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Training in Dialectical Behavior Therapy (DBT) skills coaching is desirable for staff in psychiatric settings, due to the efficacy of DBT in treating difficult patient populations. In such settings, training resources are typically limited, and staff turnover is high, necessitating brief training. This study evaluated the effects of a brief training in DBT skills coaching for nursing staff working in a child and adolescent psychiatric residential program. Nursing staff (n = 22) completed assessments of DBT skill knowledge, burnout, and stigma towards patients with borderline personality disorder (BPD) before and after a six-week DBT skills coaching training. Repeated measure ANOVAs were conducted to examine changes on all measures from pre- to post- treatment and hierarchical linear regressions to examine relationships between pre- training DBT knowledge, burnout, and BPD stigma and these same measures post-training. The brief DBT skill coaching training significantly increased DBT knowledge (p = .007) and decreased staff personal (p = .02) and work (p = .03) burnout and stigma towards BPD patients (p = .02). Burnout indices and BPD stigma were highly correlated at both time points (p < .001); however, while pre-training BPD stigma significantly predicted post-training client burnout (p = .04), pre-training burnout did not predict post-training BPD stigma. These findings suggest that brief training of psychiatric nursing staff in DBT skills and coaching techniques can result in significant benefits, including reduced staff burnout and stigma toward patients with BPD-related problems, and that reducing BPD stigma may particularly promote lower burnout.

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Wolpow, Suzan, Melissa Porter, and Ellen Hermanos. "Adapting a dialectical behavior therapy (DBT) group for use in a residential program." Psychiatric Rehabilitation Journal 24, no. 2 (2000): 135–41. http://dx.doi.org/10.1037/h0095107.

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Brodsky, Beth S., Deborah L. Cabaniss, Melissa Arbuckle, Maria A. Oquendo, and Barbara Stanley. "Teaching Dialectical Behavior Therapy to Psychiatry Residents: The Columbia Psychiatry Residency DBT Curriculum." Academic Psychiatry 41, no. 1 (August 1, 2016): 10–15. http://dx.doi.org/10.1007/s40596-016-0593-0.

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Panos, Patrick T., John W. Jackson, Omar Hasan, and Angelea Panos. "Meta-Analysis and Systematic Review Assessing the Efficacy of Dialectical Behavior Therapy (DBT)." Research on Social Work Practice 24, no. 2 (September 19, 2013): 213–23. http://dx.doi.org/10.1177/1049731513503047.

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Christina, Diana, and Irwanto Irwanto. "PERAN PENDEKTAN KONSELING BERBASIS DIALECTICAL BEHAVIOR THERAPY (DBT) DALAM MENDUKUNG PEMULIHAN TRAUMA PADA PEREMPUAN YANG MENGALAMI KDRT." Jurnal Muara Ilmu Sosial, Humaniora, dan Seni 3, no. 1 (April 7, 2019): 116. http://dx.doi.org/10.24912/jmishumsen.v3i1.4043.

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Kekerasan dalam rumah tangga mengacu pada segala bentuk perilaku semena-mena yang tidak hanya berupa kekerasan fisik, tetapi juga kekerasan verbal dan seksual. Kekerasan dalam rumah tangga adalah sebuah fenomena yang telah menarik perhatian dunia karena perilaku kasar yang diterima perempuan dari pasangannya dalam jangka panjang, yang mengarah pada konsekuensi buruk kesehatan mental seperti PTSD dalam bentuk pikiran yang mengganggu, mimpi buruk, kilas balik, hypervigilances, dan emosi-emosi negatif berlebih (kesedihan, kemarahan, kekecewaan, keputusasaan) yang dapat menyebabkan pikiran untuk bunuh diri. Dua wanita yang mengalami kekerasan dalam rumah tangga dan saat ini tinggal di tempat penampungan berpartisipasi dalam penelitian ini. Mereka diberikan teknik konseling berbasis Dialectical Behavior Therapy (DBT) untuk membantu mereka menerima pengalaman mereka tanpa dihakimi dan untuk meningkatkan kapasitas mereka untuk mengendalikan pikiran dan emosi mereka. Konseling berbasis DBT diberikan dalam tiga sesi; toleransi terhadap tekanan, mindfulness, dan regulasi emosi. Kami melibatkan dua peserta perempuan yang diberi tempat tinggal sementara. Screening menggunakan Beck Depression Index (BDI-II) yang menunjukkan setidaknya tingkat depresi menengah atas, dan checklist tentang jenis kekerasan, dampak fisik dan psikologis yang disebabkan oleh perilaku pasangannya yang kasar. Setelah tiga sesi konseling berbasis DBT, peserta mulai mendapatkan kendali atas hidup mereka, menunjukkan peningkatan dalam kepercayaan diri dan menjunjung tinggi keyakinan bahwa mereka dapat maju. Domestic violence refers to any kind of abusive behavior that is not only physical, but also verbal and sexual violence. Domestic violence is a phenomenon that has garnered the worldwide attention due to the long term abusive behaviors that women have received from their partners, which leads to serious mental health consequences such as PTSD in the forms of intrusive thought, nightmares, flashback, hypervigilances, and overwhelming negative emotions (sadness, anger, disappointment, hopelessness) that may lead to suicidal thoughts. Two women who experienced domestic abuse and currently living in a shelter particiated in this study. They were provided with a counseling technique based on (DBT) to help them accept their experiences without any judgement and to enhance their capacity to controlling their thoughts and emotion. Counseling based on DBT was given in three sessions; distress tolerance, mindfulness, and emotion regulation. We involved two female participants who were provided with a temporary shelter. Screening using a Beck Depression Index (BDI-II) showed at least moderate depression level and above, and a checklist form about the type of violence, physical and psychological impact caused by their abusive partner’s behavior. After three sessions of counseling based on DBT, participants started to gain control of their lives, show improvements in self-confidence and uphold a belief that they can move forward.

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Decker, Suzanne E., Lynette Adams, Laura E. Watkins, Lauren M. Sippel, Jennifer Presnall-Shvorin, Mehmet Sofuoglu, and Steve Martino. "Feasibility and preliminary efficacy of dialectical behaviour therapy skills groups for Veterans with suicidal ideation: pilot." Behavioural and Cognitive Psychotherapy 47, no. 5 (March 21, 2019): 616–21. http://dx.doi.org/10.1017/s1352465819000122.

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AbstractBackground:Veterans are at high risk for suicide; emotion dysregulation may confer additional risk. Dialectical behaviour therapy (DBT) is a well-supported intervention for suicide attempt reduction in individuals with emotion dysregulation, but is complex and multi-component. The skills group component of DBT (DBT-SG) has been associated with reduced suicidal ideation and emotion dysregulation. DBT-SG for Veterans at risk for suicide has not been studied.Aims:This study sought to evaluate the feasibility and acceptability of DBT-SG in Veterans and to gather preliminary evidence for its efficacy in reducing suicidal ideation and emotion dysregulation and increasing coping skills.Method:Veterans with suicidal ideation and emotion dysregulation (N = 17) enrolled in an uncontrolled pilot study of a 26-week DBT-SG as an adjunct to mental health care-as-usual.Results:Veterans attended an average 66% of DBT-SG sessions. Both Veterans and their primary mental health providers believed DBT-SG promoted Veterans’ use of coping skills to reduce suicide risk, and they were satisfied with the treatment. Paired sample t-tests comparing baseline scores with later scores indicated suicidal ideation and emotion dysregulation decreased at post-treatment (d = 1.88, 2.75, respectively) and stayed reduced at 3-month follow-up (d = 2.08, 2.59, respectively). Likewise, skillful coping increased at post-treatment (d = 0.85) and was maintained at follow-up (d = 0.91).Conclusions:An uncontrolled pilot study indicated DBT-SG was feasible, acceptable, and demonstrated potential efficacy in reducing suicidal ideation and emotion dysregulation among Veterans. A randomized controlled study of DBT-SG with Veterans at risk for suicide is warranted.

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Russell, Samantha, and Belinda Siesmaa. "The experience of forensic males in dialectical behaviour therapy (forensic version): a qualitative exploratory study." Journal of Forensic Practice 19, no. 1 (February 13, 2017): 47–58. http://dx.doi.org/10.1108/jfp-01-2016-0003.

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Purpose Dialectical behaviour therapy (DBT) has been widely used in a number of different settings with published outcomes and literature supporting its validity and efficacy. What is less understood is DBT’s application to forensic populations. The purpose of this paper is to qualitatively explore the experiences of high risk and adult male forensic clients (diagnosed with borderline personality disorder (BPD) and antisocial personality disorder (ASPD)) in a forensic adapted version of DBT. Design/methodology/approach Six clients who had completed four modules of DBT and individual therapy engaged in semi-structured interviews which were transcribed and analysed using thematic analysis. Findings The findings identified emerging themes relating to group processes and treatment outcomes. Specifically, the importance of motivation, shared learning, professionalism, reinforcement and reflection in creating a positive experience of DBT were identified. In addition clients identified feeling supported, a sense of belonging, personal achievement, increased knowledge and skills application as being part of their experience of DBT. Research limitations/implications Whilst efforts were made to manage limitations, potential confounders include the impact of the researcher’s direct involvement in the facilitation of DBT and the small sample size. Practical implications This study provides support for the use of DBT with forensic males diagnosed with ASPD and BPD and the importance of the group component to the treatment modality. It emphasises the importance of group cohesion and the development of interpersonal factors including feeling supported, sense of belonging and a sense of achievement. Originality/value This paper provides a unique contribution to the understanding of the application of DBT with forensic male clients with personality disorder. It is the first known study to use qualitative methods to explore forensic male clients’ experiences of group and individual DBT. This paper provides insight into the key themes of clients’ experiences of DBT. These identified themes lend support to the importance of motivation of clients and the experience of shared learning, reinforcement and reflection. Furthermore, feeling supported, having a sense of belonging and a sense of personal achievement were identified as key to the positive experience of clients.

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Patterson, Christopher, Jonathan Williams, and Robert S. P. Jones. "DBT and intellectual disabilities: the relationship between treatment fidelity and therapeutic adaptation." Advances in Mental Health and Intellectual Disabilities 14, no. 3 (March 9, 2020): 61–67. http://dx.doi.org/10.1108/amhid-10-2019-0031.

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Purpose There is growing literature on the application of Dialectical Behaviour Therapy (DBT) with adults with intellectual disabilities (IDs). To draw upon the evidence-base from mainstream approaches, adapted interventions must remain true to their theoretical foundations and retain key components. The purpose of this paper was to establish the extent to which DBT has been adapted for adults with ID, and whether existing adapted protocols can still be considered DBT. Design/methodology/approach The theoretical underpinnings and key components of DBT were identified. Six DBT studies were critiqued according to these criteria. Findings In terms of content, only one intervention comprised all necessary elements. All of the remaining interventions included a skills group; two included individual therapy and another two included group consultation. None of the remaining interventions provided 24-h telephone support. Furthermore, none of the studies explicitly described using dialectical strategies. Originality/value To the best of the authors’ knowledge, this is the first paper to critically examine the evidence-base for the use of DBT in ID, particularly its fidelity.

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Rajalin, M., and J. Jokinen. "FC13-01 - Dialectical behavior therapy-based skills training for family members of suicide attempters." European Psychiatry 26, S2 (March 2011): 1882. http://dx.doi.org/10.1016/s0924-9338(11)73586-6.

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A suicide attempt is a challenge both for the patient and for family members. Family members of suicide victims have an increased risk for depression and anxiety. This pilot study evaluated the effect of Family Connections (FC), a Dialectical Behavior Therapy-based manualized skills training program, for family members of suicide attempters. The DBT-based skills training program aims to enhance the knowledge of wide range research based aspects of suicidal behavior and treatment recommendations. Furthermore it includes skills training for interpersonal relationships and also offers family members an opportunity to share their experiences.Thirteen participants completed the 9-week program with pre- and post selfreport questionnaires. The results showed significant reduction in Burden Assessment Scale (BAS) and in three out of four subscales of Questions about Family Members (QAFM):perceived criticism (PC), critical comments (CC), and emotional over involvement (EOI).These results provide support for the need and importance of a DBT-based skills training program addressed specifically to family members of suicide attempters.

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Erb, Sarah, Antonina Farmer, and Robyn Mehlenbeck. "A Condensed Dialectical Behavior Therapy Skills Group for Binge Eating Disorder: Overcoming Winter Challenges." Journal of Cognitive Psychotherapy 27, no. 4 (2013): 338–58. http://dx.doi.org/10.1891/0889-8391.27.4.338.

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Although binge eating disorder (BED) is a recent diagnostic category, research for efficacious and effective treatment is well underway. This case study describes a dialectical behavior therapy (DBT) skills group for BED implemented in an outpatient community clinic. Although based on Safer, Telch, and Chen’s (2009) manual for BED and bulimia nervosa (BN), notable adaptations included shortening the group’s duration from 20 to 12 weeks, adding an interpersonal effectiveness module and DBT-informed “Holiday Plan” worksheets, and providing inclement weather alternatives. Despite the added challenges associated with winter treatment of BED (e.g., holiday meals, weather-related schedule interruptions), the 3 women who completed treatment no longer met criteria for BED at termination and their feedback suggested that the treatment was highly acceptable. Group members demonstrated clinically significant reductions in disordered eating behavior and improvements in self-esteem, emotion regulation, and quality of life. Treatment gains were maintained at 1-year follow-up. Our discussion includes treatment implications and recommendations for future research.

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O'Connell, B., and M. Dowling. "Dialectical behaviour therapy (DBT) in the treatment of borderline personality disorder." Journal of Psychiatric and Mental Health Nursing 21, no. 6 (November 5, 2013): 518–25. http://dx.doi.org/10.1111/jpm.12116.

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Journal articles on the topic 'Dialectical Behavior Therapy (DBT)'

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