Chapter 5 - Efficacy of dialectical behavior therapy in the treatment of suicidal behavior

Abstract

Dialectical behavior therapy (DBT) is an evidence-based treatment that conceptualizes suicidal behavior as a dysfunctional method of coping with life’s problems. The goal of this chapter is to first define several subcategories of suicidal behavior as part of targeting suicidality in DBT, including suicide crisis behaviors, suicide attempts and nonsuicidal self-injury, suicidal ideation and communications, and suicide-related expectancies and beliefs. The approach to conceptualizing and treating each domain of suicidality is discussed drawing from the theoretical underpinnings and interventions in DBT. This chapter outlines the current efficacy of DBT for reducing suicide-specific outcomes and other self-directed violence. Although evidence remains limited with regard to the efficacy of DBT to reduce suicidal ideation, there is clear evidence that DBT is efficacious for reducing the frequency and severity of self-directed violence among patients with borderline personality disorder, as well as reducing the utilization of psychiatric crisis services.