DBT Preferred or Treating BPD
Borderline Personality Disorder (BPD) is characterized by emotion dysregulation, strained interpersonal relationships, and low self-worth; it often results in maladaptive behaviors in defense of an extremely negative affect. Individuals with BPD commit suicide more frequently than the average population and practice non-suicidal self injurious behaviors (NSSI) 75% of the time (Pompili, Girardi, & Ruberto, 2005; Linehan, 1993). Dialectical Behavior Therapy (DBT) is the preferred treatment for BPD and has proven results in lowering suicidal ideations and non-suicidal self injury in various studies that administered assessment both during treatment and one-year post treatment. Typically a year in length, DBT programs report the greatest treatment effects in the first four months of treatment, with the subsequent eight months dedicated to refining and consolidating new skills (Linehan, Armstrong, & Suarez, 1991).
Assessing Effectiveness of Brief Form of DBT
Treatment is rigorous and intensive with weekly individual therapy, weekly group skill sessions, telephone consultations, and clinician team meetings. Such treatment requires a significant investment on the part of patients, financially and otherwise. Thus, Stanley, Brodsky, Nelson, & Dulit (2007) conducted a pilot study to examine the effects of a shorter intervention, Brief Dialectical Behavior Therapy (DBT-B). The researchers’ study consisted of 20 patients with a diagnosis of BPD, all expressing suicidal ideations at the beginning of outpatient treatment. Participants were assessed for urges to self-injure, self-injury episodes, suicidal ideation, and subjective distress at baseline and after six months of DBT.
Practical for Certain Populations
Results of the study indicated that a six-month intervention of DBT did lead to significant reductions in distress, self-injury, suicidal ideation, and hopelessness (Stanley et al., 2007). The program examined by the researchers was also successful in retaining clients throughout the entire course of treatment. These findings are preliminary and as such require more research; however, the implications look quite promising for tailoring programs to populations who struggle to make the financial and time commitments necessary for standard (year-long) DBT programs.
If someone you know could be helped by DBT, please see more details at:
Linehan, M., Heard, H., & Armstrong, H. (1993). Naturalistic follow-up of a behavioral treatment for chronically parasuicidal borderline patients. Archives of General Psychiatry, 50, 971-974.
Pompili, M., Girardi, P., & Ruberto, A. (2005). Suicide in borderline personality disorder: A meta-analysis. Norwegian Journal of Psychiatry, 59, 319-324.
Stanley, B., Brodsky, B., Nelson, J., & Dulit, R. (2007). Brief dialectical behavior therapy (DBT-B) for suicidal behavior and non-suicidal self injury. Archives of Suicide Research, 11, 337-341.