Dialectical Behavior Therapy Treatment Research Articles

Subjektive Therapiebeurteilung jugendlicher Patientinnen mit Essstörungen und deren Übereinstimmung mit Eltern- und Therapeutenbeurteilungen

The subjective evaluation of a psychotherapeutic treatment may be an essential aspect of the recovery from an eating disorder. Our study investigates the subjective treatment evaluation by patients with eating disorders and the accordance with their parents' and psychotherapist's evaluation. In a sample of 41 eating-disorder patients (M(Age) = 16.3; SD = 1.26), their parents and psychotherapists, we used a questionnaire (FBB) to assess satisfaction with Dialectical Behavioral Therapy treatment. Our results show good ratings, as well as good correlations between patients and parents. The findings implicate the importance of assessing a subjective therapy rating in addition to objective parameters.

Dialectical Behavior Therapy With Suicidal Adolescents

Dialectical Behavior Therapy With Suicidal Adolescents

Dialectical Behavior Therapy With Suicidal Adolescents

Dialectical Behavior Therapy With Suicidal Adolescents

Treating co-occurring Axis I disorders in recurrently suicidal women with borderline personality disorder: A 2-year randomized trial of dialectical behavior therapy versus community treatment by experts.

This study evaluated whether dialectical behavior therapy (DBT) was more efficacious than treatment by nonbehavioral psychotherapy experts in reducing co-occurring Axis I disorders among suicidal individuals with borderline personality disorder (BPD). Women with BPD and recent and repeated suicidal and/or self-injurious behavior (n = 101) were randomly assigned to 1 year of DBT or community treatment by experts (CTBE), plus 1 year of follow-up assessment. For substance dependence disorders (SDD), DBT patients were more likely to achieve full remission, spent more time in partial remission, spent less time meeting full criteria, and reported more drug- and alcohol-abstinent days than did CTBE patients. These findings suggest that improvements in co-occurring SDD among suicidal BPD patients are specific to DBT and cannot be attributed to general factors associated with nonbehavioral expert psychotherapy. Further, group differences in SDD remission were not explained by either psychotropic medication usage or changes in BPD criterion behaviors. DBT and CTBE did not significantly differ in the reduction of anxiety disorders, eating disorders, or major depressive disorder.

Australasian Dialectical Behaviour Therapy Pilot Outcome Study: Effectiveness, Utility and Feasibility

This paper aims to describe the outcome of 10 patients treated in a New Zealand pilot study of dialectical behaviour therapy (DBT) for people with borderline personality disorder (BPD), and to ascertain the clinical utility and feasibility of implementing DBT into a standard New Zealand public mental health service. Patients had a clinical and an International Personality Disorder Examination diagnosis of BPD and received 6 months of standard DBT treatment. Rating scales used were the Millon Clinical Muliaxial Inventory, 3rd edition (MCMI-III) and the Symptom Checklist 90-Revised (SCL-90-R), which were completed pre treatment and post treatment. Pre-post treatment data were completed on inpatient resource usage. Qualitative patient interviews were conducted post treatment. There were statistically significant improvements in functioning on 10 of the 24 MCMI-III subscales (p < 0.03 to p < 0.0008), including notably the borderline personality subscale (p < 0.01) and the anxiety (p < 0.05) and depression (p < 0.001) subscales. There was a statistically significant improvement on the Global Severity Index of the SCL-90-R (p < 0.001) and on 10 of the 12 SCL-90-R scales (p < 0.05 to p < 0.001). The hospital bed days used decreased from 0.57 days per patient per month to 0.2 days per patient per month. These preliminary results document the clinical effectiveness of DBT. Dialectical behaviour therapy has practical and clinical utility of relevance to Australasian public mental health services. A DBT service can be successfully implemented within existing public mental health services.

A one year study of adolescent males with aggression and problems of conduct and personality: A comparison of MDT and DBT.

Abstract This study examines the effectiveness of Mode Deactivation Therapy, (MDT) and Dialectical Behavior Therapy, (DBT) in a Residential Treatment Center for adolescent males. All clients were admitted to the same Residential Treatment Center. Clients presented with physical aggression, suicidal ideation, with mixed personality disorders/traits. One group of clients was treated with MDT, while the other group received DBT treatment. Keywords: Mode Deactivation Therapy (MDT), Dialectical Behavior Therapy (DBT), Treatment Adolescents, Conduct Disorder, Personality Disorders, Aggression, Suicidal Ideation. Introduction Mode Deactivation Therapy, (MDT) was developed by Apsche (2004,2006) to treat issues among adolescent clients that were not successfully addressed in previous treatment events. These adolescents had complex topologies and were heterogeneous in their complex problems. In numerous studies, Linehan (1993) has shown that DBT can be effective in treating Borderline Personality Disorder in adult females. In a one year randomized study, Linehan, et. al., (1991), (who recently reported that DBT is effective in treating suicidal adolescents) found that DBT significantly reduced psychiatric inpatient stays and lessened parasuicidal behavior. Its use also encouraged treatment compliance. Miller, et. al., (2006) found DBT effective in reducing suicidal ideations in adolescents being treated in an inpatient setting. Apsche, Siv & Matteson, (2005) presented a case study comparing the effects of MDT and DBT. It appeared that MDT reduced physical aggression and self injurious behavior; whereas DBT, in this case, had been less than effective. Apsche & Bass, (2006) presented a study comparing 40 adolescent males presenting with aggression and suicidal ideations. MDT was significantly more effective than DBT treatment in this study. For a complete review of MDT, see Apsche, (2006). For a complete review of DBT, see Linehan, (1993). The sample size for each group type, MDT and DBT, was calculated based on the potential residential length of stay. Each group participant was randomly assigned to groups based on a census of 30. Since this was a clinical study, there were no study drop-outs. Also, due to the nature of the residential treatment center, the clients in the study were not homogenous and presented with more severe behavioral problems than target populations in typical research therapy. Kazdin & Weisz (2003). Written informed consent was obtained from all of the clients' parents or guardians. The sample was composed of twenty adolescent males, ten for each group, within ages ranging from 15-18, (mean=16.1 MDT 15.9 DBT.) Method Participants The sample was comprised of 20 male adolescents at a residential treatment center. All subjects were referred to the residential treatment center for anger, aggressions, and externalizing problem behaviors. The clients were referred to their treatment group randomly. The first client assignment was to the DBT group and was determined by a coin toss. The second assignment was to the MDT group, followed by DBT client assignment on an alternating basis, until each group was filled. The DBT group therapists were all trained in DBT at the official DBT training center. The MDT group therapists were trained by the creator and developer of MDT (the first author of the paper). Dialectical Behavior Therapy A total of ten male adolescents were assigned to the DBT group. The group consisted of African Americans, 3 European Americans and 1 Hispanic American, the principal Axis I diagnosis was conduct disorder (5), Oppositional Defiant Disorder (4) and Post Traumatic Stress Disorder (6). Axis II diagnoses for the group included Mixed Personality Disorder (3), Borderline Personality traits (3), and Narcissistic Personality Traits (2), and Dependent Personality Disorder (2). …

Effectiveness of inpatient dialectical behavioral therapy for borderline personality disorder: a controlled trial

Dialectical Behavioral Therapy (DBT) was initially developed and evaluated as an outpatient treatment program for chronically suicidal individuals meeting criteria for borderline personality disorder (BPD). Within the last few years, several adaptations to specific settings have been developed. This study aims to evaluate a three-month DBT inpatient treatment program. Clinical outcomes, including changes on measures of psychopathology and frequency of self-mutilating acts, were assessed for 50 female patients meeting criteria for BPD. Thirty-one patients had participated in a DBT inpatient program, and 19 patients had been placed on a waiting list and received treatment as usual in the community. Post-testing was conducted four months after the initial assessment (i.e. four weeks after discharge for the DBT group). Pre–post-comparison showed significant changes for the DBT group on 10 of 11 psychopathological variables and significant reductions in self-injurious behavior. The waiting list group did not show any significant changes at the four-months point. The DBT group improved significantly more than participants on the waiting list on seven of the nine variables analyzed, including depression, anxiety, interpersonal functioning, social adjustment, global psychopathology and self-mutilation. Analyses based on Jacobson’s criteria for clinically relevant change indicated that 42% of those receiving DBT had clinically recovered on a general measure of psychopathology. The data suggest that three months of inpatient DBT treatment is significantly superior to non-specific outpatient treatment. Within a relatively short time frame, improvement was found across a broad range of psychopathological features. Stability of the recovery after one month following discharge, however, was not evaluated and requires further study.

Practical psychotherapy: Adaptation of dialectical behavior therapy by a VA Medical Center.

Practical psychotherapy: Adaptation of dialectical behavior therapy by a VA Medical Center.

The application of dialectical behavior therapy for patients with borderline personality disorder on inpatient units.

Inpatient treatment of individuals with borderline personality disorder (BPD) is typically fraught with difficulty and failure. Patients and staff often become entangled in intense negative therapeutic spirals that obliterate the potential for focused, realistic, and effective treatment interventions. We describe an inpatient treatment approach to BPD patients which is an application of Dialectical Behavior Therapy (DBT), a cognitive-behavioral therapy for patients with BPD which has been shown to be effective in reducing suicidal behavior, hospitalization, and treatment dropout and improving interpersonal functioning and anger management. The inpatient DBT staff creates a validating treatment milieu and focuses on orienting and educating new patients and identifying and prioritizing their treatment targets. Inpatient DBT treatment techniques include contingency management procedures, skills training and coaching, behavioral analysis, structured response protocols to suicidal and egregious behaviors on the unit, and consultation team meetings for DBT staff.

The application of dialectical behavior therapy to adolescent borderline clients

Dialectical Behavior Therapy (DBT) has been shown to be effective for adult, female borderline personality disordered patients and shows promise to be the treatment of choice for emotionally unstable patients in general. In this article we present an overview of the application of the DBT treatment to adolescent borderline clients, and illustrate the intervention in a 13-year-old male who presented for treatment with symptoms of identity disturbance, role confusion, frequent suicide ideation, and impulsive self-damaging behavior. Our intention is to illustrate the use of DBT with this population, and to explain by example some of the modifications we think are useful in using DBT with inner-city minority youth. © 1998 John Wiley & Sons, Inc.