Effectiveness of Dialectical Behavior Therapy

Effectiveness of Dialectical Behavior Therapy – Part Two

The effectiveness of Dialectical Behavior Therapy (DBT) for people with Borderline Personality Disorder was assessed in two major trials. The first trial compared the effectiveness of Dialectical Behavior Therapy relative to treatment as usual (TAU), while the second trial examined the effectiveness of DBT skills training when added to standard community psychotherapy.

During the follow-up year of the study, patients in the Dialectical Behavior Therapy group had higher Global Assessment Scores and a better work performance than did the patients in the treatment as usual (TAU) group. In the first six months, DBT patients had fewer suicidal acts, lower anger scores, and better social adjustment than TAU patients did.

In the final six months of the study, DBT patients had fewer in-patient treatment days and better interviewer-rated social adjustment than the TAU patients did.

The second trial had two parts: First of all, it compared standard community psychotherapy (SCP) plus the group skills component of Dialectical Behavior Therapy with SCP alone without added skills training. Secondly, the trial compared the SCP group from the first part of the present study with the experimental group in the previously described, randomized control trial. In this latter comparison, assignment to conditions was not random; however, all the subjects were screened in the same way, during the same time frame, and were all subject to blind assessment.

During the treatment year, there were no significant differences between the two groups with regard to staying in therapy; however, in comparing standard DBT patients to SCP patients, the DBT patients had fewer parasuicidal episodes, fewer episodes leading to medical treatment, and fewer psychiatric in-patient days. DBT patients also reported less anger than did the SCP patients.

This research, then, does provide some evidence proving that Dialectical Behavior Therapy is successful with patients who have Borderline Personality Disorder. This evidence is primarily derived from the randomized control trial in which DBT was found to be superior on a number of variables to treatment as usual (TAU).

Dialectical Behavior Therapy, in summary, is a novel method of psychotherapy designed to meet the specialized needs of patients with Borderline Personality Disorder and their therapists. It directly addresses the problem of keeping these patients in therapy, and the difficulty of maintaining therapist motivation and professional well-being. It is based on a clear and potentially testable theory of Borderline Personality Disorder, and encourages a positive and validating attitude to these patients in the light of this theory. This approach incorporates what is valuable from other (traditional) forms of therapy, and is based on a clear acknowledgement of the value of a strong relationship between the patient and his/her therapist. Therapy is clearly structured in stages, and at each stage, a clear hierarchy of targets is defined.

This method offers a particularly helpful approach to the management of parasuicide, with a clearly defined response to such behaviors. The techniques used in Dialectical Behavior Therapy are varied and extensive, addressing essentially every aspect of therapy. They are based on a dialectical philosophy which recommends a flexible yet balanced, systemic approach to the therapeutic approach.

Techniques for achieving change are balanced by techniques of acceptance. Problem solving is surrounded by validation, and confrontation is balanced by understanding. The patient is helped to understand his/her problem behaviors, and then to deal with situations more effectively. He/she is taught the necessary skills to enable him/her to do so, and helped to deal with any problems that she may have in applying them in her natural environment. Generalization outside therapy is not assumed, but encouraged directly. Advice and support is available between sessions via telephone consultations, and the patient is encouraged and helped to take responsibility for dealing with life's challenges him/herself. This method is supported by research evidence which suggests that it is successful in reducing self-injury and time spent in psychiatric in-patient treatment.

About the Author

David Oliver is the founder of BorderlineCentral.com a one stop source of information on how to cope and deal with borderline personality disorder.

FREE Borderline News,
Tips, Tricks and Secrets

Name:

E-mail:

Other:

This Week's Borderline Personality Disorder News

The Cutting Truth of Borderline Personality Disorder
FYI Living
Cutting and other forms of self-mutilation may be hard for many people to understand. People who self-harm are more likely to have an underlying emotional problems, such as Borderline Personality Disorder (BPD). According to a study by German researchers, people with BPD may engage in self-injury because they get a sense of emotional relief from physical pain. BPD is a complex set of... Read More

Click here for all Borderline News.

BorderlineCentral
Your One Stop Source For Information On
Borderline Personality Disorder