Benchmarks for Outpatient Dialectical Behavioral Therapy in Adults With Borderline Personality Disorder

2016 ◽  
Vol 28 (8) ◽  
pp. 895-906
Author(s):  
Micki Washburn ◽  
Allen Rubin ◽  
Shu Zhou
Keyword(s):  
Borderline Personality Disorder ◽  
Personality Disorder ◽  
Randomized Clinical Trials ◽  
Behavioral Therapy ◽  
Borderline Personality ◽  
Effect Sizes ◽  
Control Treatment ◽  
Dialectical Behavioral Therapy ◽  
Group Effect ◽  
Treatment As Usual

Purpose: This article provides benchmark data on within-group effect sizes from published randomized clinical trials supporting the efficacy of dialectical behavioral therapy (DBT) for borderline personality disorder (BPD) in adults aged 18–65 years. Method: Within-group effect sizes were calculated via the Glass approach and adjusted for sample size using Hedges’s g then aggregated to produce benchmarks for symptoms commonly associated with BPD, such as self-harm, depression, and anger. Results: Aggregate within-group effect sizes are presented separately for treatment (DBT) and control (treatment as usual) groups and for interviewer assessed and self-reported outcome measures. Discussion: Community-based practitioners can use these benchmarks as a comparison tool to evaluate the ways in which they are adopting or adapting the DBT intervention and to determine if the intervention should be modified or replaced, given their unique practice setting and client population.

scholarly journals Effectiveness of Psychological Treatments for Borderline Personality Disorder and Predictors of Treatment Outcomes: A Multivariate Multilevel Meta-Analysis of Data from All Design Types

2021 ◽  
Vol 10 (23) ◽  
pp. 5622
Author(s):  
Sophie A. Rameckers ◽  
Rogier E. J. Verhoef ◽  
Raoul P. P. P. Grasman ◽  
Wouter R. Cox ◽  
Arnold A. P. van Emmerik ◽  
...  
Keyword(s):  
Borderline Personality Disorder ◽  
Personality Disorder ◽  
Dialectical Behavior Therapy ◽  
Treatment Effectiveness ◽  
Meta Analysis ◽  
Borderline Personality ◽  
Effect Sizes ◽  
Sensitivity Analyses ◽  
Treatment As Usual ◽  
Logarithmic Relationship

We examined the effectiveness of psychotherapies for adult Borderline Personality Disorder (BPD) in a multilevel meta-analysis, including all trial types (PROSPERO ID: CRD42020111351). We tested several predictors, including trial- and outcome type (continuous or dichotomous), setting, BPD symptom domain and mean age. We included 87 studies (N = 5881) from searches between 2013 and 2019 in four databases. We controlled for differing treatment lengths and a logarithmic relationship between treatment duration and effectiveness. Sensitivity analyses were conducted by excluding outliers and by prioritizing total scale scores when both subscale and total scores were reported. Schema Therapy, Mentalization-Based Treatment and reduced Dialectical Behavior Therapy were associated with higher effect sizes than average, and treatment-as-usual with lower effect sizes. General severity and affective instability showed the strongest improvement, dissociation, anger, impulsivity and suicidality/self-injury the least. Treatment effectiveness decreased as the age of participants increased. Dichotomous outcomes were associated to larger effects, and analyses based on last observation carried forward to smaller effects. Compared to the average, the highest reductions were found for certain specialized psychotherapies. All BPD domains improved, though not equally. These findings have a high generalizability. However, causal conclusions cannot be drawn, although the design type did not influence the results.

scholarly journals How do patients with borderline personality disorder experience Distress Tolerance Skills in the context of dialectical behavioral therapy?—A qualitative study

PLoS ONE ◽  
2021 ◽  
Vol 16 (6) ◽  
pp. e0252403
Author(s):  
Anja Schaich ◽  
Diana Braakmann ◽  
Mirco Rogg ◽  
Clara Meine ◽  
Julia Ambrosch ◽  
...  
Keyword(s):  
Borderline Personality Disorder ◽  
Personality Disorder ◽  
Distress Tolerance ◽  
Qualitative Content Analysis ◽  
Behavioral Therapy ◽  
Primary Diagnosis ◽  
Borderline Personality ◽  
Dialectical Behavioral Therapy ◽  
Structured Interviews ◽  
Interpersonal Situations

Distress Tolerance Skills (DTS) are an important component of Dialectical Behavioral Therapy (DBT), a therapy method frequently used for treating patients with Borderline Personality Disorder (BPD). However, little is known about how DTS-training is experienced by individuals with BPD. The aim of this study was to explore BPD patients’ experiences with receiving DTS-training. Qualitative data were collected through semi-structured interviews with 24 individuals (87.5% females) with a primary diagnosis of BPD who received DTS-training in the context of 18 months of DBT treatment. Interview data were analyzed following the procedures of qualitative content analysis. Participants reported various effects of DTS including an immediate reduction of tension. Patients perceived DTS as a tool to cope with difficult interpersonal situations and emergencies and stated that this helped them to feel stable, safe and self-confident. Patients reported difficulties during the initial engagement, the learning process and the application of DTS as well as various facilitating factors. Implications of the findings for further research and for optimizing DTS-training in clinical practice are discussed.

Efficacy of Dialectical Behavioral Therapy for Emotion Dysregulation in Patients with dual diagnosis of Borderline Personality Disorder and Substance Use Disorder

2021 ◽  
Vol 17 ◽  
Author(s):  
Ahmed Rady ◽  
Ahmed Abdelkarim ◽  
Andre Ivanoff ◽  
Tarek Molokhia
Keyword(s):  
Substance Use ◽  
Borderline Personality Disorder ◽  
Personality Disorder ◽  
Substance Use Disorder ◽  
Dual Diagnosis ◽  
Emotion Dysregulation ◽  
Psychological Intervention ◽  
Behavioral Therapy ◽  
Borderline Personality ◽  
Dialectical Behavioral Therapy

Background: The published evidence supports dialectical behavioral therapy (DBT) efficacy to treat patients with borderline personality disorder and particular emphasis on emotion dysregulation as a psychopathological construct. Aim: To assess the efficacy of DBT for improving emotion dysregulation among patients with a dual diagnosis of borderline personality disorder and substance use disorder. Methods: We recruited 40 patients meeting DSM-5 criteria for borderline personality disorder and substance use disorder and assigned them to two groups of 20 participants each. One group underwent DBT therapy, and the other group followed a treatment-as-usual (TAU) protocol over one year. We used the difficulties in emotion regulation scale (DERS) scores at baseline, immediately after therapy, and four months after treatment to assess emotion dysregulation. Results: We found significant improvements (p<0.05) in the DBT group after therapy that was maintained at least for four months afterward based on the DERS scores (including subscale scores). More patients dropped out of the treatment in the TAU group than in the DBT group. Conclusion: DBT is a potentially effective psychological intervention to treat emotion dysregulation in patients with borderline personality disorder and substance use disorder.

Supportive Psychotherapy and Case Management

2017 ◽  
Author(s):  
David J. Hellerstein ◽  
Ron B. Aviram
Keyword(s):  
Borderline Personality Disorder ◽  
Personality Disorder ◽  
Case Management ◽  
Clinical Management ◽  
Behavioral Therapy ◽  
Borderline Personality ◽  
Dialectical Behavioral Therapy ◽  
Supportive Psychotherapy ◽  
Treatment Techniques ◽  
Specialized Care

Psychotherapy of borderline personality disorder (BPD) has often focused on specialized and putatively more effective treatments such as dialectical behavioral therapy. In recent years, accumulating evidence suggests that many BPD patients benefit equally well from well-structured but less specialized care designed to meet their needs. Supportive psychotherapy (SPT) and various forms of clinical management, such as structured clinical management (SCM) and general psychiatric management (GPM), have been successfully adapted for treatment of BPD. This chapter describes the theoretical backgrounds for these approaches, main treatment techniques, and how they can be implemented to provide good outcomes for individuals diagnosed with BPD.

Sign in / Sign up

Export Citation Format

Share Document