Mechanisms of Change in Dialectical Behaviour Therapy

2017 ◽  
pp. 514-532
Author(s):  
Tali Boritz ◽  
Richard J. Zeifman ◽  
Shelley F. McMain
Keyword(s):  
Attentional Control ◽  
Research Evidence ◽  
Coping Skills ◽  
Mechanisms Of Change ◽  
Future Research ◽  
Clinical Implications ◽  
Adaptive Coping ◽  
Behaviour Therapy ◽  
Dialectical Behaviour Therapy ◽  
Client Change

Research on processes and mechanisms of change aim to explain how and why an intervention leads to change. Despite some theoretical and empirical progress in understanding processes and mechanisms of change in Dialectical Behaviour Therapy (DBT), this remains an understudied area in the DBT literature. This chapter considers how DBT conceptualizes the etiology and maintenance of dysfunction, and how active ingredients in DBT treatment produce client change. It proposes four key mechanisms of change that have been a focus of scientific efforts in DBT research: (1) increased awareness and acceptance of emotion; (2) increased attentional control; (3) increased ability to modulate emotion; and (4) increased use of adaptive coping skills. Next, it reviews the research evidence to support these putative mechanisms of change. Finally, it discusses clinical implications of this research, and propose recommendations for future research on mechanisms of change in DBT.

A Peer-Clinician Approach to the Delivery of Dialectical Behaviour Therapy Targeted to Young Adults in a Community Mental Health Setting

2020 ◽  
Vol 39 (2) ◽  
pp. 65-69
Author(s):  
Claudie Coulombe ◽  
Stephanie Rattelade ◽  
Miriam McLaughlin ◽  
John Choi
Keyword(s):  
Mental Health ◽  
Young Adults ◽  
Community Mental Health ◽  
Self Efficacy ◽  
Coping Skills ◽  
Mental Health Setting ◽  
Behaviour Therapy ◽  
Dialectical Behaviour Therapy ◽  
Mental Health Difficulties

Stella’s Place created an adapted DBT program, delivered through an integrated peer-clinician approach, to treat young adults with mental health difficulties in a community mental health setting. Evaluation findings revealed significant improvements in participants’ use of coping skills, resiliency, and self-efficacy following their participation in the program.

scholarly journals How Do We Target NSSI in BPD? Exploring The Relationship Between Emotion Dysregulation, Interpersonal Dysfunction, And Non-Suicidal Self-Injury

2021 ◽  
Author(s):  
Jennifer W. Y. Ip
Keyword(s):  
Emotion Dysregulation ◽  
Future Research ◽  
Behaviour Therapy ◽  
Research Directions ◽  
Dialectical Behaviour Therapy ◽  
Self Injury ◽  
Interpersonal Dysfunction ◽  
Future Research Directions ◽  
The Relationship ◽  
Significant Mediator

The current research investigated: 1) the trajectory of changes in emotion dysregulation, interpersonal dysfunction, and nonsuicidal self-injury (i.e., NSSI) over the course of DBT, and 2) whether changes in emotion dysregulation mediate the recovery of other features of BPD in treatment. Individuals with BPD (N = 120) enrolled in a multi-site study were assessed at five timepoints over 12 months of dialectical behaviour therapy (i.e., DBT). Results indicated that interpersonal dysfunction and NSSI decreased linearly over the course of DBT. Emotion dysregulation decreased in a quadratic manner; most of the gains in emotion dysregulation may occur in earlier phases of DBT. Results also revealed that although changes in emotion dysregulation was not a significant mediator of the relationship between changes in interpersonal dysfunction and in NSSI, changes in interpersonal dysfunction predicted changes in emotion dysregulation. Future research directions regarding NSSI, emotion dysregulation, and interpersonal dysfunction within DBT are discussed.

Dialectical behaviour therapy for younger adults: evaluation of 22 weeks of community delivered dialectical behaviour therapy for females 18–25 years

2015 ◽  
Vol 32 (4) ◽  
pp. 299-305 ◽  
Author(s):  
J. L. Lyng ◽  
M. A. Swales ◽  
R. P. Hastings
Keyword(s):  
Mental Health ◽  
Health Centre ◽  
Drop Out ◽  
Self Report ◽  
Future Research ◽  
Behaviour Therapy ◽  
Mental Health Symptoms ◽  
Younger Adults ◽  
Health Symptoms ◽  
Dialectical Behaviour Therapy

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.

scholarly journals Feasibility and preliminary efficacy of dialectical behaviour therapy skills groups for Veterans with suicidal ideation: pilot

2019 ◽  
Vol 47 (5) ◽  
pp. 616-621 ◽  
Author(s):  
Suzanne E. Decker ◽  
Lynette Adams ◽  
Laura E. Watkins ◽  
Lauren M. Sippel ◽  
Jennifer Presnall-Shvorin ◽  
...  
Keyword(s):  
Mental Health ◽  
At Risk ◽  
Pilot Study ◽  
Suicidal Ideation ◽  
Emotion Dysregulation ◽  
Coping Skills ◽  
Post Treatment ◽  
Behaviour Therapy ◽  
Dialectical Behaviour Therapy

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.

Dialectical Behaviour Therapy from 1991–2015

2017 ◽  
pp. 414-466
Author(s):  
Erin M. Miga ◽  
Andrada D. Neacsiu ◽  
Anita Lungu ◽  
Heidi L. Heard ◽  
Linda A. Dimeff
Keyword(s):  
Emotion Dysregulation ◽  
Current Knowledge ◽  
Controlled Trial ◽  
Research Quality ◽  
Future Research ◽  
Behaviour Therapy ◽  
Dialectical Behaviour Therapy ◽  
Clinician Training ◽  
Clinical Presentations ◽  
Problem Behaviours

Dialectical Behaviour Therapy (DBT) is an internationally recognized evidence-based treatment for adults and adolescents reporting multiple problem behaviours related to emotion dysregulation. For clinical interventions, particularly DBT, the randomized controlled trial (RCT) is recognized as the ‘gold standard’ approach to testing effectiveness and efficacy. However, RCTs vary greatly in the rigorousness of research conducted. RCTs assessing DBT’s effectiveness have proliferated since the first published trial in 1994. DBT has been tested for diverse clinical presentations, in different formats, and focused on a variety of outcomes. The plethora of RCT research conducted, which vary in research design, clinician training and adherence among other factors, can make a clear interpretation of findings difficult. As a result, it can be unclear what is known about the effectiveness of DBT, and what is not. This review provides a summary and comprehensive critique of DBT RCTs to date, evaluates research quality assurance, and aims to identify and refine the current knowledge on DBT efficacy and effectiveness, along with areas of future research.

scholarly journals How Do We Target NSSI in BPD? Exploring The Relationship Between Emotion Dysregulation, Interpersonal Dysfunction, And Non-Suicidal Self-Injury

2021 ◽  
Author(s):  
Jennifer W. Y. Ip
Keyword(s):  
Emotion Dysregulation ◽  
Future Research ◽  
Behaviour Therapy ◽  
Research Directions ◽  
Dialectical Behaviour Therapy ◽  
Self Injury ◽  
Interpersonal Dysfunction ◽  
Future Research Directions ◽  
The Relationship ◽  
Significant Mediator

The current research investigated: 1) the trajectory of changes in emotion dysregulation, interpersonal dysfunction, and nonsuicidal self-injury (i.e., NSSI) over the course of DBT, and 2) whether changes in emotion dysregulation mediate the recovery of other features of BPD in treatment. Individuals with BPD (N = 120) enrolled in a multi-site study were assessed at five timepoints over 12 months of dialectical behaviour therapy (i.e., DBT). Results indicated that interpersonal dysfunction and NSSI decreased linearly over the course of DBT. Emotion dysregulation decreased in a quadratic manner; most of the gains in emotion dysregulation may occur in earlier phases of DBT. Results also revealed that although changes in emotion dysregulation was not a significant mediator of the relationship between changes in interpersonal dysfunction and in NSSI, changes in interpersonal dysfunction predicted changes in emotion dysregulation. Future research directions regarding NSSI, emotion dysregulation, and interpersonal dysfunction within DBT are discussed.

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