The pregnancy and postpartum period represent a sensitive transitional phase characterized by significant physiological and psychological changes in women’s lives, during which various psychological issues may emerge. A psychological condition frequently encountered in this period is postpartum depression. This may directly affect maternal health and adversely influence the infant and the mother-infant interaction. Among treatment options, psychotherapy and psychopharmacological treatments are prominent, with especially cognitive-behavioral therapy and interpersonal therapy being widely preferred approaches for addressing this disorder. However, both therapeutic methods have certain limitations. Given the limitations of existing treatment methods, there is a pressing need for more effective and innovative intervention approaches to address this disorder. In this context, third-wave cognitive-behavioral therapies offer new treatment alternatives that have the potential to overcome the limitations of traditional therapeutic approaches. In this review, postpartum depression is examined from the perspective of third-wave cognitive-behavioral therapies. The main findings regarding the intervention processes of Acceptance and Commitment Therapy, Dialectical Behavior Therapy, Metacognitive Therapy, Mindfulness-Based Therapies, and Compassion-Focused Therapy are discussed. As a result, with third-wave cognitive-behavioral therapy approaches the negative effects of pregnancy and the postpartum period on women could be alleviated by working on issues such as acceptance of emotions, ruminative thinking, emotion regulation skills, and increasing awareness of internal processes.

Schools are well positioned to address the growing youth mental health crisis by addressing students' social and emotional well-being through regular, consistent and caring connections. However, teachers often report a lack of information on how to address student mental health in the classroom. Dialectical Behavioral Therapy (DBT) focuses on helping individuals understand and manage intense emotions. "Utilizing DBT Skills in Schools" (UDSS) is a virtual training program supporting the integration of DBT into daily classroom activities. The UDSS curriculum, accessed by almost 700 school personnel, was viewed as a valuable asset to address emotion regulation, stress management, and validation skills. Surveys revealed increased knowledge of each DBT skill, a high level of intention to use the skills, and overwhelmingly favorable perceptions of the training. Open-ended responses reflected appreciation of the organization around skills and collaborative focus. The UDSS courses provide a more accessible, less time-intensive training for school professionals to learn introductory DBT skills that can be used with all students. UDSS provides flexible options to gain valuable skills to help teachers identify and manage strong emotions in the classroom.

Addiction to alcohol or drugs is prevalent in the United States, but most individuals with an alcohol or substance use disorder do not receive evidence-based addiction treatment. Dialectical behavior therapy (DBT) is a multi-component cognitive behavioral treatment that includes skills to manage addictive behavior, but its application to inpatient addiction treatment is less explored in the literature. This is a significant clinical gap because those who receive inpatient addiction treatment tend to exhibit more severe and persistent symptoms than outpatients, often requiring more intensive therapy and advanced coping skills training. In this article, adaptations of DBT skills to advance clinical care in inpatient addiction treatment settings are illustrated. First, key differences between teaching DBT skills in inpatient versus outpatient settings are described, and the psychologist's role as a consultant to the multidisciplinary treatment team is emphasized. Second, practical illustrations of how three specific DBT concepts/skills, namely Wise Mind, Dialectical Abstinence, and ABC PLEASE, can be integrated into inpatient addiction treatment are provided. Third, ethical and training related considerations are discussed in relation to the dialectical challenge of balancing the need to preserve fidelity to the DBT treatment model versus the need to increase access to useful DBT skills. Together, this paper provides the first comprehensive account of how psychologists can flexibly utilize DBT skills and dialectical thinking to promote patient behavioral change and foster multidisciplinary collaborative care in inpatient addiction treatment settings.

ABSTRACT Objective This study aimed to evaluate the effectiveness of a digital self‐help intervention based on dialectical behavior therapy (DBT) principles, delivered via a WeChat mini‐program, in reducing binge‐eating symptoms among Chinese adults. Methods In a randomized controlled trial, 101 adult females with binge‐eating–related disorders (BN, BED, or AN‐BP) were randomly assigned to a 4‐week DBT‐based mini‐program or a psychoeducation control. The primary outcome was binge‐eating severity (binge eating scale, BES); secondary outcomes included eating disorder psychopathology (EDE‐Q), emotion regulation (DERS‐16), impulsivity (BIS‐11), depression (PHQ‐9), and anxiety (GAD‐7). Between‐group effects were examined from baseline to post‐treatment using linear mixed‐effects models under the intention‐to‐treat principle. The intervention group was further followed for 1 and 3 months to assess maintenance of effects. Post‐treatment qualitative interviews explored user experience using reflexive thematic analysis. Results Compared with the control group, participants in the DBT condition showed a significantly greater reduction in binge‐eating severity from baseline to post‐treatment (Cohen's d = 1.07, p = 0.013). Both groups demonstrated large within‐group improvements in eating disorder cognitions (EDE‐Q), while changes in emotion regulation, impulsivity, and mood symptoms were nonsignificant. Within the intervention group, gains in binge‐eating and EDE‐Q scores were largely maintained at follow‐up. Qualitative findings indicated high perceived helpfulness and usability, with feedback emphasizing the program's structured design and practical skills, alongside suggestions for improving efficiency and self‐monitoring features. Discussion Findings provide preliminary evidence that Wise Eating is a feasible, scalable, and culturally relevant low‐intensity DBT‐based intervention for binge eating in China. Future trials should include more diverse samples, longer durations, and enhanced engagement strategies. Trial Registration: ClinicalTrials.gov identifier: NCT07143214

Dialectical behavior therapy (DBT) is an empirically validated treatment for chronic, difficult-to-treat, life-threatening mental health conditions. DBT can be challenging to implement and maintain in managed care systems because of the need for substantial infrastructure and intensive clinician training. As a result, most clients receive components of DBT, known as DBT-informed care. This model is valuable in its own right, including for individuals with less severe clinical symptoms. Additionally, clinicians who provide DBT experience professional benefit. Cinematherapy, the incorporation of film in therapy, uses psychodynamic and social-cognitive mechanisms of change based on the premise that movies can provide catharsis and validation, enhance self-exploration, and support new learning. This article offers guidance for using the movie Inside Out as a DBT-informed therapy intervention for adults. The film demonstrates the value of accepting, before changing, emotions and of the crucial role of validation in psychosocial development and therapeutic healing.

Borderline Personality Disorder (BPD) is highly comorbid with depression and anxiety, creating additional difficulty in treating the conditions and poorer prognosis than BPD alone. Dialectical behaviour therapy (DBT) and Mentalisation-Based Treatment (MBT) are specialised psychotherapies for BPD that have demonstrated positive effects for reducing BPD symptoms and scores on depression and anxiety measures. Although developed for treating PTSD, Internal Family Systems (IFS) therapy is effective for addressing past trauma that is also common in BPD. This systematic review investigated the effectiveness of DBT, MBT and IFS for treating BPD with comorbid depression and/or anxiety (BPD+D/A). Using the PRISMA protocol, five academic databases were searched for relevant studies and relevant treatment outcomes. Findings were extracted from 12 included studies. Only studies with a confirmed diagnosis of comorbid depression and/or anxiety disorders were included. This review found that DBT and MBT demonstrated significant reductions in BPD and depressive/anxious symptomatology, emotional and interpersonal difficulties, and impulsive behaviours. These therapeutic approaches also demonstrated reduced numbers of visits to emergency departments, reduced numbers of contacts with mental health services and reduced duration of contacts. None of the studies investigated IFS therapy outcomes for BPD+D/A. These findings are concordant with past research and have implications for increasing the use of DBT and MBT for BPD+D/A. Findings also demonstrate the effectiveness of brief DBT interventions as a more practical option for service users with BPD who experience frequent crisis periods and may struggle to commit to a traditional 12-month program. However, findings should be interpreted cautiously due to small and majority-female samples, mixed study designs and a lack of follow-up data.

This study aims to address the challenge of high dropout rates during the absolute bed rest period of Morita therapy in clinical practice in China. It explores the integration of Acceptance and Commitment Therapy (ACT) and Dialectical Behaviour Therapy (DBT) theory and techniques to enhance the operability and completion rate of this critical phase, while preserving the core therapeutic mechanisms of Morita therapy. The research examines the common ground between Morita therapy, ACT, and DBT in core concepts such as acceptance, action orientation, and psychological flexibility, as well as their potential shared biological mechanisms (e.g., modulating the default mode network, facilitating prediction error learning, and promoting neuroplasticity). By reviewing the current state of clinical practice in China, it analyses the underlying causes of implementation difficulties during the absolute bed rest period (e.g., patient psychological characteristics, socio-cultural background, and healthcare system constraints). A structured operational framework is proposed, integrating specific ACT and DBT techniques - such as cognitive defusion, mindfulness, values clarification, and distress tolerance skills - into the different stages of the absolute bed rest period. The integrated framework provides patients with operable, structured skill-based support during the absolute bed rest period. It facilitates the progressive development of awareness, enhances acceptance capacity, improves distress tolerance, and fosters a connection with personal values. This framework not only has the potential to reduce dropout rates but also deepens patients' understanding and practice of the Morita therapy philosophy of 'accepting reality as it is.' It offers a new theoretical foundation and practical pathway for the effective implementation of Morita therapy within the Chinese cultural context. The integration of ACT and DBT techniques shows promise in enhancing the clinical feasibility and patient completion rate of the absolute bed rest period in Morita therapy. It achieves this by adapting to the psychological characteristics and socio-cultural realities of Chinese patients while preserving core therapeutic mechanisms, such as facilitating 'sudden insight' and awakening life energy. Future directions include the development of a structured operational manual and validation of its efficacy through randomised controlled trials, thereby promoting the deeper integration and application of Morita therapy in contemporary mental health practice.

Effectiveness of a CBT and DBT-based partial hospital program across ethnoracial identities.

Clinical training in facilitating dialectical behavior therapy as a transdiagnostic treatment for Latinx individuals.

The promise of self-guided digital health interventions (DHIs) is consistently hampered by their poor engagement. While past research has identified various predictors of engagement, effect sizes have been small, and many have failed to replicate across studies. This poor predictive performance may, in part, be due to the field's overreliance on predictor assessments at pre-intervention (i.e., at baseline), which overlooks the possibility that those factors driving engagement can fluctuate across the user journey. Self-regulated learning (SRL) is a potentially relevant process underlying engagement with DHIs, as majority deliver their therapeutic content as self-guided psychoeducation materials. The present study therefore examined whether key SRL variables fluctuated across a 6-week randomized controlled trial of a dialectical behavior therapy DHI for adults with recurrent binge eating (n = 113), and also whether these changes influenced their predictive ability of three engagement outcomes: number of (1) modules and (2) weekly assessments completed, and (3) skill activities unlocked. Longitudinal analyses revealed considerable temporal variation in SRL variables over time, and that majority of this variance was attributed to within-person differences (intraclass correlations <.40). Correlation coefficients between SRL variables and engagement outcomes increased in strength with time, indicating that later measurements of SRL had greater predictive ability compared to their measurements at baseline. Broadly, our findings highlight the need for researchers to more carefully plan future DHI trials investigating engagement by factoring the temporal dimension of engagement and its predictors into study design.

Six months of dialectical behavior therapy (DBT) was more efficacious than a 6‐month course of treatment with a selective serotonin reuptake inhibitor (SSRI) antidepressant in reducing suicide‐related events in patients with borderline personality disorder, a randomized trial has found. However, SSRI treatment was more efficacious than DBT in reducing diagnoses of major depressive disorder at 6 months.

This study focused on the implementation of dialectical behavior therapy (DBT), an evidence-based treatment for youths with nonsuicidal self-injury and suicidal ideation, in a psychiatric residential treatment center (RTC) for children and adolescents who have complex psychological, psychiatric, substance use, and developmental disorders. In a pilot hybrid effectiveness-implementation trial, the authors compared functioning scores of adolescent patients who received DBT (N=113) with the scores of those who received treatment as usual (N=114) in an RTC. Data were collected from 227 adolescents admitted to the RTC over a 2-year period (July 2018-June 2020). Chi-square and t-test analyses were used to explore demographic differences and differences in functioning between the two groups. Adolescents in the DBT group demonstrated improved overall functioning between admission and discharge, but analyses indicated a nonsignificant difference between adolescents who received DBT and those who received treatment as usual. This nonrandomized study suggests that DBT may be a useful psychotherapeutic treatment for adolescents, although findings are preliminary.

Suicidal ideation and non-suicidal self-injury (NSSI) among elementary school students represent critical public health concerns that require develop-mentally appropriate, evidence-informed school-based interventions. This study con-ducted a retrospective comparative analysis of two school-based approaches-Sandplay Therapy with Suicidal Ideation and Self-Injury-Focused Engagement (SPT-SAFE) and a School-based Dialectical Behavior Therapy-informed Brief Intervention (DBT-BI)-for elementary school students presenting with suicidal ideation and NSSI. The objective was to describe pre-post-changes in key outcomes within each intervention and to explore whether outcome trajectories differed between the two approaches in a non-randomized, real-world school-based setting. This retrospective study analyzed archival clinical records from 109 elementary school students (SPT-SAFE: N = 59; DBT-BI: N = 50) who received services at a school-based suicide prevention center in South Korea between 2022 and 2024. Seven validated outcome measures assessed suicidal ideation, NSSI frequency, depression, anxiety, aggression, impulsiveness, and self-concept at pre- and post-intervention. Pre-post-changes and exploratory between-group differences were examined using 2 × 2 mixed-design ANOVAs (Group × Time interaction), with baseline-adjusted ANCOVAs conducted as complementary analyses. Suicidal ideation was operationalized using the SIQ-JR total score, and NSSI was operationalized using the FASM summed frequency index. Both interventions were associated with significant reductions in suicidal ideation (F = 29.98, p < 0.001, partial η2 = 0.219) and NSSI frequency (F = 15.95, p < 0.001, partial η2 = 0.130), with large within-group effect sizes and no significant Group × Time interactions. Accordingly, between-group differences were limited and should be interpreted as exploratory rather than comparative-effectiveness evidence. Modest between-group differences favoring DBT-BI were observed for self-concept outcomes (F = 4.14, p = 0.044, partial η2 = 0.037; d = -0.39). These findings suggest that both interventions were associated with pre-post-improvements in suicidal ideation and NSSI frequency within a school-based clinical context.

Abstract: Borderline personality disorder is a severe mental illness and this is the result of biological and social predispositions. The core symptoms of Borderline personality disorder are inability to maintain interpersonal relationship, poor self-image, affective instability and reckless behaviors. Dialectical Behavior Therapy (DBT) is an evidence-based intervention and is widely regarded as the gold-standard treatment for Borderline Personality Disorder. Despite its effectiveness, relapse to baseline levels of functioning is common in BPD. Owing to the paucity of case studies with long-term follow-up, the present study aims to examine and sustain the long-term therapeutic gains achieved through DBT. In view of the robust empirical support for DBT, the present study implemented DBT with a 21-year-old unmarried female presenting with symptoms of low mood, irritability, self-harm, aggressive behavior, interpersonal conflicts, reduced appetite, and disturbed sleep. The intervention comprised 17 weekly DBT sessions. Outcome measures included the Borderline Symptom List-23 (BSL-23), Beck Depression Inventory-II (BDI-II), and Hamilton Anxiety Rating Scale (HAM-A). Post-intervention findings demonstrated a marked reduction in borderline symptom severity, as well as significant improvement in depressive and anxiety symptoms.

Veteran death by suicide is a complex issue made up of many factors. Despite the high need for mental health treatment, and treatments that specifically target suicide, evidence-based psychotherapies (EBPs) are difficult to access, even more so in rural areas. In concordance with the 2018 National Strategy for Preventing Veteran Suicide, VA suicide prevention leadership developed Suicide Prevention 2.0 (SP 2.0) to implement a public health model that includes community-based prevention strategies and improves clinical interventions within VA. The Suicide Prevention 2.0 Clinical Telehealth program was implemented in each of VA's 18 regional Clinical Resource Hubs and expanded clinical intervention strategies within VA by implementing four EBPs for Suicide Prevention (EBP-SP) via telehealth: the Safety Planning Intervention, Problem-Solving Therapy for Suicide Prevention, Cognitive Behavioral Therapy for Suicide Prevention, and Dialectical Behavior Therapy. A wide variety of implementation strategies were used (e.g., access new funding, training, consultation, create new clinical teams). The primary inclusion criterion for veteran referral to SP 2.0 Clinical Telehealth is a recent history of suicidal self-directed violence. Implementation was guided by the Exploration, Preparation, Implementation, and Sustainment (EPIS) framework and RE-AIM was used as an evaluation framework. By April 2023, SP 2.0 Clinical Telehealth services were available in all 18 regions and in 139 of 139 (100%) VA health care systems in the U.S. By the end of September 2024, the program had hired 137 therapists and retained 78.10% in their role, and 100% were trained in two or more EBP-SPs. By the end of September 2024, the program received 23,628 referrals nationwide. Increasing referral rates year over year suggests ongoing sustained reach. SP 2.0 Clinical Telehealth represents the first and only enterprise-wide fully virtual evidence-based treatment program for veterans with a recent history of suicidal self-directed violence. The program's implementation was successful in reaching all VISNs and all VA health care systems in the U.S. The SP 2.0 Clinical Telehealth program can be used as a model for other large health care systems looking to improve provision of evidence-based interventions for suicide prevention.

Symptoms of emotion dysregulation and dissociation are common among people with a history of psychological trauma, and can complicate treatment effectiveness. Phase-based approaches to treatments, which begin with a stabilization and skills phase before moving to trauma-oriented interventions allow for flexible, integrable, and effective approaches that can be applied across various therapeutic modalities and delivery contexts. This narrative review describes empirically supported methods (e.g., Dialectical Behavioral Therapy) for targeting emotion dysregulation within phase-based treatments for trauma and dissociation. The flexibility and efficiency of these approaches can increase access to care (e.g., through telehealth, group formats, and brief interventions) and address current limitations of the mental healthcare system, including provider shortages. This review discusses (1) the current scientific understanding of emotion dysregulation and dissociation secondary to trauma exposure, (2) the range of flexible, evidence-based approaches for treating emotion dysregulation, (3) the translational and practical implications of a phase-based, emotion-regulation-focused treatment for traumatized individuals who experience dissociation, and 4) potential limitations to phase-based approaches including the delaying of trauma processing.

The treatment of patients with complex post-traumatic stress disorder (CPTSD) presents significant challenges due to the complexity and severity of the condition. Individuals who have experienced prolonged trauma exhibit, alongside post-traumatic stress disorder symptoms, disturbances in self-organization (DSO). This state of affairs not only complicates the psychotherapeutic process but also impacts the outcomes, making the treatment challenging. This article provides a narrative review of treatment approaches for CPTSD [including dialectical behavior therapy (DBT), cognitive-behavioral therapy (CBT), trauma-focused therapy (TFT), eye movement desensitization and reprocessing (EMDR), and psychodynamic therapy], with a specific focus on their outcomes and therapeutic factors. Standard evidence-based therapies (e.g., CBT, EMDR, exposure-based treatments) have been shown to be effective in reducing the core symptoms of PTSD but with more variable and often smaller effects for DSO symptoms. Phase-based approaches, including those that integrate evidence-based methods, have shown more significant results in affect regulation, self-concept, and interpersonal functioning. Psychodynamic therapies have shown enduring improvements, especially in the areas of identity and interpersonal relationships. The therapeutic alliance, trust, rupture repair, and the therapist's empathy emerged as key components for treatment efficacy, especially in fostering safety and emotional regulation. These variables enabled corrective relational experiences and maintained engagement in therapy. These findings highlight the need for personalized, phased interventions that combine evidence-based strategies with a strong relational focus, as found in psychodynamic approaches. Addressing both symptom relief and reduction in DSO requires constant attention to the therapeutic process. The quality of the therapeutic alliance and the therapist's responsiveness are fundamental to supporting long-term recovery. The article provides insight into the current issues associated with each treatment approach and future directions.

Effect of dialectical behavior therapy on affective symptoms in borderline personality disorder: A systematic review and meta-analysis.

Normalization of elevated heart rate in patients with borderline personality disorder over the course of inpatient treatment (Dialectical Behavior Therapy): A case control study with psychiatric controls.

A methodological proof-of-concept of a data-driven, personalized, blended digital health intervention for suicidal thoughts and behaviors: A case series.