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 DBT is effective for youth with high levels of emotion dysregulation

2019 ◽  
Keyword(s):  
Randomized Controlled Trial ◽  
Treatment Outcomes ◽  
Emotion Dysregulation ◽  
Controlled Trial ◽  
Supportive Therapy ◽  
Behaviour Therapy ◽  
Individual Group ◽  
Dialectical Behaviour Therapy ◽  
Randomized Controlled

In 2019, Molly Adrian and colleagues examined the predictors and moderators of treatment outcomes for suicidal adolescents who participated in a randomized controlled trial evaluating Dialectical Behaviour Therapy (DBT) versus Individual/Group Supportive Therapy (IGST).

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.

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.

scholarly journals Manual Therapy in Cervical and Lumbar Radiculopathy: A Systematic Review of the Literature

2021 ◽  
Vol 18 (11) ◽  
pp. 6176
Author(s):  
Tomasz Kuligowski ◽  
Anna Skrzek ◽  
Błażej Cieślik
Keyword(s):  
Manual Therapy ◽  
Functional Outcomes ◽  
Web Of Science ◽  
Current Knowledge ◽  
Controlled Trial ◽  
Future Research ◽  
Lumbar Radiculopathy ◽  
Inclusion Criteria ◽  
Randomized Controlled ◽  
The Mean

The aim of this study was to describe and update current knowledge of manual therapy accuracy in treating cervical and lumbar radiculopathy, to identify the limitations in current studies, and to suggest areas for future research. The study was conducted according to PRISMA guidelines for systematic reviews. A comprehensive literature review was conducted using PubMed and Web of Science databases up to April 2020. The following inclusion criteria were used: (1) presence of radiculopathy; (2) treatment defined as manual therapy (i.e., traction, manipulation, mobilization); and (3) publication defined as a Randomized Controlled Trial. The electronic literature search resulted in 473 potentially relevant articles. Finally, 27 articles were accepted: 21 on cervical (CR) and 6 in lumbar radiculopathy (LR). The mean PEDro score for CR was 6.6 (SD 1.3), and for LR 6.7 (SD 1.6). Traction-oriented techniques are the most frequently chosen treatment form for CR and are efficient in reducing pain and improving functional outcomes. In LR, each of the included publications used a different form of manual therapy, which makes it challenging to summarize knowledge in this group. Of included publications, 93% were either of moderate or low quality, which indicates that quality improvement is necessary for this type of research.

Modifying CBT to Meet the Challenge of Treating Emotion Dysregulation

2018 ◽  
pp. 106-118
Author(s):  
Jennifer H. R. Sayrs ◽  
Marsha M. Linehan
Keyword(s):  
Emotion Dysregulation ◽  
World View ◽  
Therapy Session ◽  
Behaviour Therapy ◽  
Dialectical Behaviour Therapy ◽  
Essential Component ◽  
Solution Generation ◽  
Flexible Thinking

Dialectics are a cornerstone of dialectical behaviour therapy (DBT; Linehan, 1993), and are considered an essential component of treating emotion dysregulation. Incorporating dialectics may enhance therapeutic collaboration, increase flexible thinking, and maximize solution generation. This chapter briefly describes a dialectical world view, then lays out steps for incorporating dialectics into a therapy session, including adopting a dialectical world view, maintaining balance in treatment, working toward synthesis whenever polarization occurs, and utilizing dialectical strategies. Dialectical strategies are any strategies that involve looking for what is left out, synthesizing two poles, and allowing the synthesis to move the interaction forward to a new position. These strategies include magnifying the tension between opposites (such as devil’s advocate and extending strategies), entering the paradox (such as ‘and versus but’ and ‘making lemonade out of lemons’ strategies), and the use of metaphors. While these strategies were developed within DBT, other treatments utilize dialectical approaches, as well.

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.

scholarly journals Wellness and resilience for college and beyond: protocol for a quasi-experimental pilot study investigating a dialectical behaviour therapy skill-infused college course

BMJ Open ◽  
2020 ◽  
Vol 10 (6) ◽  
pp. e036833
Author(s):  
Carla D. Chugani ◽  
Barbara Fuhrman ◽  
Kaleab Z. Abebe ◽  
Janine Talis ◽  
Elizabeth Miller ◽  
...  
Keyword(s):  
Mental Health ◽  
Undergraduate Students ◽  
Emotion Dysregulation ◽  
Mental Health Problems ◽  
Behaviour Therapy ◽  
Learning Collaborative ◽  
Dialectical Behaviour Therapy ◽  
University Of Pittsburgh ◽  
College Course ◽  
The University

IntroductionCollege students’ mental health problems and suicidal behaviour are serious, persistent and prevalent public health issues. With the need for mental health support greatly exceeding the availability of on-campus treatment, a recent trend on college campuses is to offer courses designed to teach students strategies for developing mental health or resilience. While these courses are exceptionally popular among students, a paucity of research investigates the health outcomes associated with participation. The purpose of this study is to investigate the acceptability, appropriateness, feasibility and preliminary effectiveness of a college course grounded in skills from dialectical behaviour therapy (DBT) titled, ‘Wellness and Resilience for College and Beyond’.Methods and analysisDuring the spring and fall 2020 semesters, the course will be offered on five campuses in Southwestern Pennsylvania and West Virginia. The course consists of 15 weekly 2.5-hour lessons, weekly homework assignments and a final examination with content drawn from DBT, acceptance and commitment therapy and positive psychology. Undergraduate students aged 18–24 will self-select into the course and control subjects receiving ‘university as usual’ will be recruited to serve as a comparison group. Students who receive the course will complete measures of course acceptability, appropriateness and feasibility. All study participants will complete measures of adaptive coping skills use, emotion dysregulation and suicidality.Ethics and disseminationAll of the study procedures were approved as an exempt protocol for evaluation of educational curricula by the University of Pittsburgh Human Research Protections Office (HRPO); the study was approved as a research study by the institutional review board (IRB) of the fifth study site. The University of Pittsburgh HRPO served as the IRB of record for all except one study site, which required standard IRB review. Data from this study will be disseminated via conference presentations, peer-reviewed publications and via our online stakeholder learning collaborative.Trial registration numberNCT04338256.

Manual-assisted cognitive-behaviour therapy (MACT): a randomized controlled trial of a brief intervention with bibliotherapy in the treatment of recurrent deliberate self-harm

1999 ◽  
Vol 29 (1) ◽  
pp. 19-25 ◽  
Author(s):  
K. EVANS ◽  
P. TYRER ◽  
J. CATALAN ◽  
U. SCHMIDT ◽  
K. DAVIDSON ◽  
...  
Keyword(s):  
Clinical Practice ◽  
Cognitive Behaviour Therapy ◽  
Controlled Trial ◽  
Small Sample ◽  
Cost Of Care ◽  
Behaviour Therapy ◽  
Deliberate Self Harm ◽  
Dialectical Behaviour Therapy ◽  
Cognitive Behaviour ◽  
Self Harm

Background. The treatment of deliberate self-harm (parasuicide) remains limited in efficacy. Despite a range of psychosocial, educational and pharmacological interventions only one approach, dialectical behaviour therapy, a form of cognitive-behaviour therapy (CBT), has been shown to reduce repeat episodes, but this is lengthy and intensive and difficult to extrapolate to busy clinical practice. We investigated the effectiveness of a new manual-based treatment varying from bibliotherapy (six self-help booklets) alone to six sessions of cognitive therapy linked to the booklets, which contained elements of dialectical behaviour therapy.Methods. Thirty-four patients, aged between 16 and 50, seen after an episode of deliberate self-harm, with personality disturbance within the flamboyant cluster and a previous parasuicide episode within the past 12 months, were randomly assigned to treatment with manual-assisted cognitive-behaviour therapy (MACT N=18) or treatment as usual (TAU N=16). Assessment of clinical symptoms and social function were made at baseline and repeated by an independent assessor masked to treatment allocation at 6 months. The number and rate of all parasuicide attempts, time to next episode and costs of care were also determined.Results. Thirty-two patients (18 MACT; 14 TAU) were seen at follow-up and 10 patients in each group (56% MACT and 71% TAU) had a suicidal act during the 6 months. The rate of suicidal acts per month was lower with MACT (median 0·17/month MACT; 0·37/month TAU; P=0·11) and self-rated depressive symptoms also improved (P=0·03). The treatment involved a mean of 2·7 sessions and the observed average cost of care was 46% less with MACT (P=0·22).Conclusions. Although limited by the small sample, the results of this pilot study suggest that this new form of cognitive-behaviour therapy is promising in its efficacy and feasible in clinical practice.

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