Friday, January 31, 2014

Does DBT work?

The short answer is YES, the long answer can be found below...
Effectiveness of Dialectic Behavioral Therapy
Dialectic behavioral therapy is recognized as the top treatment choice for symptoms associated with the borderline personality disorder including suicidal ideations, self harm, emotional dysregulation, impulsivity and interpersonal conflicts. Often associated with the treatment of choice for borderline personality disorder (BPD), DBT has been proven useful in the treatment of other disorders. 

Now for the research:
Cochrane review is a database of systematic peer reviews and meta-analysis which summarizes medical research. The Cochrane library contains resources for evidence based practices in medicine including areas in mental health. Cochrane review has declared DBT the most effective treatment for symptoms often classified as BPD (Source: http://summaries.cochrane.org/CD005652/psychological-therapies-for-borderline-personality-disorder), however, the symptoms listed above are universal and can meet requirements for other diagnostic criteria.
To date, Dialectic Behavioral Therapy is the only treatment for the symptoms of BPD that has enough outcome data and improvement rates to enable a Meta analysis. A meta-analysis uses statistical data from individual studies, looking at research as a whole (Source: http://www.cochrane-net.org/openlearning/html/mod12-2.htm).
Eighteen randomized controlled trials have been published demonstrating the effectiveness of DBT in populations with complex problems and disorders. Some examples of past research include: In 1991, Linehan, Arm-strong, Suarez, Allmon, and Heard conducted research using 18-45 year olds in an outpatient setting. Subjects participated in 150 minute skills group including homework for 12 months. The 1991 research study showed that parasuicidal behaviors were more likely to start treatment, 83% completed treatment, and 60% maintained lower parasuicidal behaviors (self harm) a year after treatment. (Source: http://behavioraltech.org/downloads/Research-on-DBT_Summary-of-Data-to-Date.pdf)
In 2011, Hirvikoski, Waaler, Alfredsson, Pihlgren, Johnson, Ruck,and Nordstrom used 51 year olds diagnosed with ADHD in a Swedish outpatient psychiatric unit. Two hours of DBT skills groups were the only course of treatment (without individual or phone coaching) for 24 sessions and still participants showed less symptoms of ADHD. (Source: http://behavioraltech.org/downloads/Research-on-DBT_Summary-of-Data-to-Date.pdf)
In 2010, Kroger, Schweiger, Sipos, Kliem, Arnold, Schunert and Reinecker used 24 to 31 year old with Anorexia and Bulimia in addition to Borderline Personality Disorder. Participants competed three months of inpatient DBT program including Weekly 1 hr individual therapy, 100
Minutes of skills group 3 times per week, and weekly consultation. At the 15 month follow up, participants showed reduction in anorexia and bulimia symptoms (Source: http://behavioraltech.org/downloads/Research-on-DBT_Summary-of-Data-to-Date.pdf).

The National Registry of Evidence-Based Programs and Practices published a summary of all evidence based practices and outcomes since 2006. In 2009, the American Recovery and Reinvestment Act (ARRA) created the Federal Coordinating Council for Comparative  Effectiveness research to provide the most recent health care information by comparing different approaches to managing health issues (including mental health). The purpose of National registry of evidence based programs is to inform and educate and bring evidence based awareness. DBT was mentioned as evidence for treatment of symptoms associated with borderline personality disorder (Stoffers, Völlm at al. 2013).

References
Stoffers, Völlm at al.(2013), Psychological therapies for borderline personality disorder, Cochrane Summary, Retrieved: http://summaries.cochrane.org/CD005652/psychological-therapies-for-borderline-personality-disorder),

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