RESEARCH ON DIALECTICAL BEHAVIOR THERAPY FOR PATIENTS WITH BORDERLINE PERSONALITY DISORDER
Section snippets
DIALECTICAL BEHAVIOR THERAPY COMPARED WITH TREATMENT AS USUAL
Despite its public health significance, little research is available on the psychosocial treatment of suicidal behavior, and less is available on the treatment of suicidal behavior and other severe dysfunctional behavior among patients meeting criteria for BPD.36 Therefore, the first criteria of evaluating DBT is to determine the feasibility of the treatment to work for the intended problems compared with TAU. But because by definition a naturalistic TAU control group requires investigators to
RANDOMIZED CLINICAL TRIALS OF DIALECTICAL BEHAVIOR THERAPY VERSUS MORE RIGOROUS CONTROL CONDITIONS
Preliminary findings from two additional randomized clinical trials underway at the University of Washington have been reported.32, 33 In these studies, Linehan et al32, 33 evaluated the efficacy of DBT by comparing it with more rigorous control conditions developed specifically to maximize internal validity and to control for effects on clinical outcomes by factors not controlled for in previous DBT studies.
In a replication study32 treating individuals with BPD and parasuicidal behavior, DBT
RESULTS FROM EFFECTIVENESS STUDIES: QUASIEXPERIMENTAL DESIGNS AND NONSTANDARD DIALECTICAL BEHAVIOR THERAPY
Several quasiexperimental studies from program evaluations, pilot studies, and preliminary work as part of randomized clinical trials have been presented, expanding the research base on the efficacy of DBT in other settings compared with different controls or extended to different treatment populations. Often, these studies do not investigate comprehensive standard DBT but rather investigate a component of the comprehensive package or a modification of standard components. Consequently, the
DATA ON MECHANISMS OF CHANGE IN DIALECTICAL BEHAVIOR THERAPY
A few studies provide data regarding mechanisms of change in DBT. Conducted simultaneously with the first randomized clinical trial, Linehan et al29 investigated the effectiveness of a DBT skills-training group (GST) alone (i.e., without individual psychotherapy, skills coaching, or a therapist consultation team). Suicidal women with BPD (n = 19) were referred by their current and continuing non-DBT individual counselors or psychotherapists for DBT skills training and were randomly assigned to
SUMMARY
Research evidence to date indicates that, although DBT was developed for the treatment of patients with suicidal behavior, it can be adapted to treat BPD patients with comorbid substance-abuse disorder and be extended to other patient populations and the treatment of other disorders. Across studies, DBT seems to reduce severe dysfunctional behaviors that are targeted for intervention (e.g., parasuicide, substance abuse, and binge eating), enhance treatment retention, and reduce psychiatric
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