Acceptabilité et faisabilité d'un module TCD-A multi-familles « tolérance à la détresse » proposé à des adolescents ayant un trouble de la personnalité borderline ou des troubles de la régulation émotionnelle

Le trouble de la personnalité borderline est un trouble psychiatrique fréquent qui apparaît à l'adolescence. La thérapie comportementale dialectique adaptée aux adolescents (TCD-A) a montré son efficacité dans la prise en charge psychothérapeutique des adolescents souffrant de conduites suicidaires ou d'auto-agressivité associées au trouble de la personnalité borderline. Au travers de notre étude nous avons souhaité explorer la faisabilité et l'acceptabilité, pour des adolescents présentant un TPL diagnostiqué ou des troubles de la régulation des émotions, d'un module TCD intitulé « tolérance à la détresse » proposé sur le mode d'un groupe multi-familles. Pour ce faire nous avons mis en place un groupe multi-familles de six adolescents et de leurs parents. L'acceptabilité et la faisabilité du protocole étaient excellentes. Les témoignages des adolescents et de leurs parents nous apportent des informations précieuses sur l'intérêt d'un tel groupe et sur les améliorations à introduire. La mise en place d'un tel groupe est une première en France et nous souhaitions montrer par notre étude pilote, sa faisabilité, son acceptabilité et ses effets afin de promouvoir son développement et son implémentation dans le contexte pédopsychiatrique français. Borderline personality disorder is a common psychiatric disorder emerging in adolescence. Dialectical Behavioral Therapy adapted to adolescents (DBT-A) has proven to be effective as a psychotherapeutic treatment for adolescents suffering from borderline-related behaviors, such as suicidal or self-aggressive behaviors. In our study, we were interested in exploring the feasibility and acceptability of a DBT-A module entitled "distress tolerance", which reduces borderline-related behaviors in borderline adolescents or undiagnosed adolescents who experience difficulties in regulating their emotions. To do this, we set up a pilot study with one multi-family treatment group of six adolescents and their parents. The treatment was fully accepted by all adolescents and parents with an excellent acceptability. Comments from adolescents and parents gave us valuable information about the great interest of a multi-family treatment group and potential improvements for its implementation. This is the first study exploring a DBT-A multi-family treatment group in France. It highlights its feasibility, acceptability and potential positive effects. Further studies are needed to promote the implementation and development of such interventions in the context of child and adolescent psychiatry in France. [ FROM AUTHOR] Copyright of Neuropsychiatrie de l'enfance & de l'Adolescence is the property of Elsevier B.V. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full . (Copyright applies to all s.)

Psychoeducation and emotional regulation in times of confinement: Feasibility and interest of YouTube videos of dialectical behavioral therapy

Introduction: Dialectical Behavior Therapy (DBT) aims to decrease emotional dysregulation, particularly through psychoeducation groups targeting skills learning. In March 2020, the confinement due to COVID-19 abruptly interrupted these groups. We continued skills training through YouTube videos. Our objective is to evaluate the feasibility of this format during the confinement. Method(s): All the participants in the DBT skills group carried out in Strasbourg were included (n = 37). The psychoeducational videos were published biweekly during the confinement on the YouTube channel "GREMO HUS". Participants were encouraged to view these videos by calls/messages. One month after the end of the confinement, an online questionnaire assessed satisfaction. Result(s): In total, 92% of patients responded. Of the 34 respondents, 28 (82%) had watched at least one video, and 32% had watched more than 6 videos. A very large majority of users were satisfied with the videos. Seventy-nine percent said they were very helpful in understanding the skills, and 77% thought they had used the DBT skills more frequently. All but one said that the skills helped them to overcome difficulties in times of confinement. Discussion(s): Our study is the first to interview patients directly regarding DBT YouTube videos. These videos were considered relevant by participants during the confinement period. Their use could compliment DBT skills training groups, and serve as a training support for therapists.Copyright © 2021 Elsevier Masson SAS

Psychological Treatment of Persistent Genital Arousal Disorder/Genitopelvic Dysesthesia Using an Integrative Approach.

Persistent genital arousal disorder/genitopelvic dysesthesia (PGAD/GPD) is characterized by persistent, unwanted physiological genital arousal (i.e., sensitivity, fullness, and/or swelling) in the absence of sexual excitement or desire which can persist for hours to days and causes significant impairment in psychosocial well-being (e.g., distress) and daily functioning. The etiology and course of PGAD/GPD is still relatively unknown and, unsurprisingly, there are not yet clear evidence-based treatment recommendations for those suffering from PGAD/GPD. We present the case of a 58-year-old woman with acquired persistent genital arousal disorder, which began in March 2020; she believed she developed PGAD/GPD due to a period of significant distress and anxiety related to the COVID-19 pandemic. After seeking medical diagnosis and treatment from multiple healthcare providers and trying a combination of pharmacological and medical treatment modalities, she presented for psychological treatment. An integrative therapy approach (3 assessment sessions, 11 treatment sessions), which included cognitive behavior therapy, distress tolerance and emotion regulation skills from dialectical behavior therapy, and mindfulness practice, was utilized. The patient reported improvements anecdotally (e.g., decreased impact on occupational and social functioning, greater self-compassion, less frequent and shorter duration of PGAD/GPD flare-ups, improved ability to cope with PGAD/GPD symptoms, and decreased need for sleeping medication) and on self-report measures (e.g., lower PGAD/GPD catastrophizing, lower anxiety and depression, and greater overall quality of life).We report the use of an integrative (i.e., psychoeducational, cognitive behavioral, dialectical behavioral, and mindfulness-based) intervention, which may be an effective psychological treatment for PGAD/GPD.

Making Lemonade out of Lemons: Dialectical Behavior Therapy via Telehealth During a Pandemic

The COVID-19 pandemic has created a burden on healthcare systems and increased demand for mental healthcare at a time when in-person services are limited. Many programs offering dialectical behavior therapy (DBT) for complex clients have pivoted to telehealth in order to increase access to critical mental healthcare. There is, however, limited research on the provision of telehealth treatment for clients with complex psychopathology more broadly, or the telehealth implementation of DBT more specifically. The aim of this study was to examine the use of telehealth services and related clinician attitudes and experiences in the context of DBT. We examined the degree of telehealth platform adoption among DBT clinicians, as well as changes in stress and self-care strategies. A supplemental aim was to gather clinicians' recommendations for providing DBT via telehealth. Participants included N=99 DBT practitioners (79.8% female;20.2% male). Qualitative and quantitative methods were used for data analysis. Findings show that telehealth DBT has been widely adopted among DBT clinicians, and that clinicians' attitudes to telehealth DBT are cautiously optimistic. Participants described three main areas of stress associated with DBT via telehealth provision, as well as lost and novel self-care strategies.

Perceived Stress and Association with Sociodemographic, Interpersonal Relationship and COVID-19 Lockdown Related Stress in South Africa

Background: COVID-19 pandemic was declared a global public health emergency in March 2020. South Africa, like many countries, was not spared from this pandemic. In March 2020, the president announced a nationwide lockdown with social restrictions aimed to curb the spread of the virus. Such lockdown restrictions disrupted the normal day to day life for South Africans, leading to personal stress. Objective: The current study aimed to explore perceived stress and lockdown related stress among South African adults during the first wave of COVID 19. Methods: This study was cross-sectional in nature, using a sample of 203 adult males and females who were selected using a convenience sampling method on online social media platforms such as WhatsApp and Facebook. Participants completed an online survey that assessed socio-demographic information, perceived stress and lockdown related stress. Results and Discussion: A significant statical difference between males and females regarding their experience of lockdown related stress t (281) = 1.35, p < .004 was found. Relationship status was also significant for lockdown related stress t (281) =-2.02, p< .001 and perceived stress t= (281) =-.08, p< .000. No significant statistical difference between young and older adults in their experience of lockdown related stress and perceived stress was found. Conclusion: Male participants reported more lockdown related stress, while female participants reported more perceived stress. There were no age differences in lockdown related stress and perceived stress. People without intimate relationships reported more lockdown related stress and perceived stress than people with intimate relationships. © 2023 Maepa et al.

Reviewing the availability, efficacy and clinical utility of Telepsychology in dialectical behavior therapy (Tele-DBT).

BACKGROUND: Telepsychology is increasingly being implemented in mental health care. We conducted a scoping review on the best available research evidence regarding availability, efficacy and clinical utility of telepsychology in DBT. The review was performed using PRISMA-ScR guidelines. Our aim was to help DBT-therapists make empirically supported decisions about the use of telepsychology during and after the current pandemic and to anticipate the changing digital needs of patients and clinicians. METHODS: A search was conducted in PubMed, Embase, PsycARTICLES and Web of Science. Search terms for telepsychology were included and combined with search terms that relate to DBT. RESULTS: Our search and selection procedures resulted in 41 articles containing information on phone consultation, smartphone applications, internet delivered skills training, videoconferencing, virtual reality and computer- or video-assisted interventions in DBT. CONCLUSIONS: The majority of research about telepsychology in DBT has focused on the treatment mode of between-session contact. However, more trials using sophisticated empirical methodologies are needed. Quantitative data on the efficacy and utility of online and blended alternatives to standard (i.e. face-to-face) individual therapy, skills training and therapist consultation team were scarce. The studies that we found were designed to evaluate feasibility and usability. A permanent shift to videoconferencing or online training is therefore not warranted as long as face-to-face is an option. In all, there is an urgent need to compare standard DBT to online or blended DBT. Smartphone apps and virtual reality (VR) are experienced as an acceptable facilitator in access and implantation of DBT skills. In addition, we have to move forward on telepsychology applications by consulting our patients, younger peers and experts in adjacent fields if we want DBT to remain effective and relevant in the digital age.

Evaluating the feasibility, acceptability, and efficacy of a brief virtual dialectical behavioral therapy skills group for college students during COVID-19

College students have been facing a variety of challenges in the wake of the COVID-19 outbreak. The pandemic generated fear and led to a spectrum of psychological consequences (Liu et al., 2020) ranging from increased anxiety and depression to behavioral changes such as difficulty sleeping. The unprecedented COVID?19 crisis presents an imperative for telemental health interventions. Telemental health has been effective in treating anxiety and depressive symptoms (Brenes et al., 2015), and implementing telemental health can facilitate the delivery of counseling services to address students' pressing mental health concerns (Dorsey & Topol, 2020). Dialectical Behavioral Therapy (DBT;Linehan, 1993) skills training is one evidence-based treatment which effectively targets behaviors associated with difficulties regulating emotions. As DBT aims to teach individuals more adaptive coping skills so that reliance on ineffective coping mechanisms is reduced, DBT provides a fitting model amenable to telehealth. DBT skills training has been implemented in college settings, however, the available research evaluating DBT skills when delivered in an entirely virtual format is scant. This study aimed to evaluate the feasibility, acceptability, and preliminary efficacy of an 8-week virtually delivered DBT skills training program for college students during COVID-19. The intent-to-treat sample included 111 college students between the ages of 18 and 54 years (77% identified as cisgender women;83% identified as White). Participants were randomly assigned to virtual DBT (n = 57) or a waitlist control condition (n = 54). Assessments were conducted at pretreatment, 4-, 8- and 12-week follow up. Results of the study indicate that the intervention was feasible to implement in a virtual platform as evidenced by the retention of 71.9% of participants enrolled and was considered largely acceptable to participants as measured by both quantitative acceptability ratings and qualitative data. The intervention did not demonstrate efficacy in reducing symptoms of depression but demonstrated efficacy at reducing symptoms of anxiety. The intervention prevented participants from getting more distressed as the semester progressed. While the intervention did not demonstrate efficacy in increasing DBT skills use, it was effective in decreasing dysfunctional coping skills. Findings suggest that DBT skills training may serve as a preventative measure in the development or worsening of mental health problems, and that the virtual delivery of DBT skills can enhance mental health outcomes among college students. Recommendations as to how to improve the delivery of virtual DBT are provided. Clinical implications and future avenues of research are discussed. (PsycInfo Database Record (c) 2022 APA, all rights reserved)

Pilot study of an undergraduate college course to support student mental health: Wellness and resilience for college and beyond

The purpose of this study was to investigate preliminary outcomes associated with an undergraduate course titled, "Wellness and Resilience for College and Beyond” (WRC), which teaches students evidence-based skills for emotional health. Three campuses in Southwestern Pennsylvania with no previous experience delivering this course implemented the one-semester WRC during the Fall 2019 semester;24 students completed a baseline survey and at least 1 follow-up survey. Participants completed electronic surveys at baseline, post-semester, and 3-month follow-up. Paired t-tests were used to compare baseline scores to scores at post-semester and 3-month follow-up. At post-semester, students reported significant improvements in psychological inflexibility, resilience, mindfulness, emotion dysregulation, distress tolerance, life satisfaction, dysfunctional coping, and adaptive skills use. With the exceptions of life satisfaction and emotion dysregulation, significant gains were maintained at 3-month follow-up. Notably, the follow-up assessment occurred at the beginning of the COVID-19 lockdown in the U.S. (March 2020), which may have affected life satisfaction and emotion dysregulation for participants. There was a nonsignificant decline in anxiety at post-semester which became statistically significant at 3-month follow-up. These preliminary data show proof of concept that WRC can be implemented successfully on new campuses with no previous expertise in this course and can achieve meaningful improvements on several emotional health outcomes with high relevance to collegiate mental health. In addition to these data, barriers to implementation and scale-up are discussed at length with "lessons learned” that may have broad relevance to the implementation of emotional wellbeing coursework in higher education and support such efforts to address student mental health at the population level.

Impact of dialectical behavior therapy on depression and anxiety in patients following COVID-19 discharge

Introduction: COVID-19 pandemic has a significant impact on mental health including anxiety and depression and can weaken the immune system and make a person more vulnerable to the disease. Psychotherapy techniques have been effective in reducing these disorders. Therefore, this study aimed to investigate the effect of dialectical behavior therapy on depression and anxiety in patients discharged from COVID-19. Methods: It was a randomized controlled trial (RCT). The statistical population consisted of 30 men who underwent COVID -19 disease quarantine. Convenience sampling was used and the patients were randomly assigned to experimental and control groups. In the experimental group, dialectical behavior therapy was performed in 10 sessions of 90 minutes. The Beck Depression Inventory (BDI) and the Beck Anxiety Inventory (BAI) were used. Data were analyzed using SPSS 21 software and multivariate analysis of variance. Results: There was a significant difference between the mean scores of depression and anxiety in the experimental and control groups (p < 0.001). The effect of this treatment on reducing the score of depression was 68% and on reducing the score of anxiety was 54%. Conclusion: Dialectical behavior therapy can reduce anxiety and depression in patients with COVID-19 disease. It is suggested that this intervention can be used in psychological treatment programs. (PsycInfo Database Record (c) 2023 APA, all rights reserved)

Evaluating the feasibility, acceptability, and efficacy of a brief virtual dialectical behavioral therapy skills group for college students during COVID-19

College students have been facing a variety of challenges in the wake of the COVID-19 outbreak. The pandemic generated fear and led to a spectrum of psychological consequences (Liu et al., 2020) ranging from increased anxiety and depression to behavioral changes such as difficulty sleeping. The unprecedented COVID?19 crisis presents an imperative for telemental health interventions. Telemental health has been effective in treating anxiety and depressive symptoms (Brenes et al., 2015), and implementing telemental health can facilitate the delivery of counseling services to address students' pressing mental health concerns (Dorsey & Topol, 2020). Dialectical Behavioral Therapy (DBT;Linehan, 1993) skills training is one evidence-based treatment which effectively targets behaviors associated with difficulties regulating emotions. As DBT aims to teach individuals more adaptive coping skills so that reliance on ineffective coping mechanisms is reduced, DBT provides a fitting model amenable to telehealth. DBT skills training has been implemented in college settings, however, the available research evaluating DBT skills when delivered in an entirely virtual format is scant. This study aimed to evaluate the feasibility, acceptability, and preliminary efficacy of an 8-week virtually delivered DBT skills training program for college students during COVID-19. The intent-to-treat sample included 111 college students between the ages of 18 and 54 years (77% identified as cisgender women;83% identified as White). Participants were randomly assigned to virtual DBT (n = 57) or a waitlist control condition (n = 54). Assessments were conducted at pretreatment, 4-, 8- and 12-week follow up. Results of the study indicate that the intervention was feasible to implement in a virtual platform as evidenced by the retention of 71.9% of participants enrolled and was considered largely acceptable to participants as measured by both quantitative acceptability ratings and qualitative data. The intervention did not demonstrate efficacy in reducing symptoms of depression but demonstrated efficacy at reducing symptoms of anxiety. The intervention prevented participants from getting more distressed as the semester progressed. While the intervention did not demonstrate efficacy in increasing DBT skills use, it was effective in decreasing dysfunctional coping skills. Findings suggest that DBT skills training may serve as a preventative measure in the development or worsening of mental health problems, and that the virtual delivery of DBT skills can enhance mental health outcomes among college students. Recommendations as to how to improve the delivery of virtual DBT are provided. Clinical implications and future avenues of research are discussed. (PsycInfo Database Record (c) 2022 APA, all rights reserved)

Patients' Satisfaction with the quality of online versus in-person DBT skills group therapy: A pilot study

Introduction: Since the beginning of the COVID-19 era, there has been a major shift of psychiatry and psychotherapy practice to the online venues, or what has been broadly known as telepsychiatry. A practice that has been very practical since then. And yet, there has been a debate about the patients' degree of satisfaction with the therapeutic process, especially with a modality like group therapy, which has not been widely researched. Objective(s): The objective of this pilot is to assess the level of patients' satisfaction among both online and in-person participants of dialectical behavioral therapy (DBT) skills group as a part of comprehensive outpatient DBT program. Method(s): 27 DBT skills group participants completed an online form including demographic data, type and duration of group attended, in addition to the Arabic version of the Satisfaction with Therapy and Therapist Scale- Revised (STTS-R). Result(s): The majority of the 27 participants were females (88.9%), of which 81.4% were 18-34 years old and 77.4 % at least had a university degree. Among all the participants, 63% were online group attendants versus 37% in-person. The mean total of patient's satisfaction with the in-person group was 53.5 in comparison to 49.2 in online group participants. Also, 90% of in-person group participants reported that the group helped them in dealing with presenting problem to an extent in comparison to 82.2% of online participants. Conclusion(s): Although the COVID-19 pandemic mandated more use of telepsychiatry, in-person DBT skills group participants reported higher satisfaction of their therapy in comparison to online group participants.

Clinical considerations for the delivery of virtual dialectical behavior therapy to high-risk patients

This article discusses the clinical considerations for the delivery of virtual dialectical behavior therapy to high-risk patients. The COVID-19 pandemic has required rapid recalibration of behavioral health services, which has been challenging across all sectors of healthcare, but particularly so for high-risk patients for whom the use of telehealth has raised concerns. The telehealth model for DBT can be successfully implemented, but requires careful planning to mitigate potential risks and the use of particular strategies to facilitate relationship building and communication. Furthermore, virtual Dialectical behavior therapy (vDBT) requires a specific technological infrastructure, as well as unique policies to govern patient behavior in the presence of increased distractions found in the home environment. The dropout rates were on the lower end for comprehensive DBT programs, suggesting that the virtual modality may improve convenience for patients, thus improving retention. Although vDBT presents some unique challenges, the authors were able to overcome many of these challenges by using them as opportunities for patients to practice DBT skills, emphasizing the dialectical perspective that challenging experiences and opportunities can co-exist. vDBT provides a promising model for improving access to appropriate, high-quality care while simultaneously reducing healthcare costs. However, the understanding of vDBT is still in its infancy and work is needed to optimize clinical processes for the virtual delivery of DBT as well as evaluate clinical outcomes among patients receiving vDBT, and determine the impact of vDBT on medical expenditure associated with comorbid chronic conditions. (PsycInfo Database Record (c) 2022 APA, all rights reserved)

A Case of Autosarcophagy in a Pediatric Patient With Depression

BACKGROUND: Self-mutilating behavior in the pediatric population is associated with psychiatric and psychosocial factors. Autosarcophagy, or self-cannibalism, is an extremely rare form of self-mutilation and is predominantly seen with psychosis or substance use.1 We report a case of oral autosarcophagy in a pediatric patient in the absence of substance use or psychosis. OBJECTIVE: To learn about autosarcophagy and its treatment in the pediatric population and to explore other neuropsychiatric disorders in which it is a predominant manifestation. METHODS: Review of a case using electronic medical records and relevant literature. Key terms: 'autosarcophagy,' 'body focused repetitive behavior,' 'oral self injury,' 'pediatric self-mutilation' using Medscape and Google Scholar. RESULTS: We present a 14-year-old female with history of seizure disorder in full remission, depression, self-cutting behavior, and suicidal ideation with 2 psychiatric hospitalizations, who presented to the pediatric emergency department with oral bleeding after eating one-third of her tongue over the course of a month. Evaluation was notable for poverty of speech and constricted affect. Patient stated she was 'trying to remove an infection' and alleviate discomfort. She denied that this behavior was an attempt to end her life but endorsed past suicidal ideations and cutting behavior. History revealed emergency room evaluation for aggressive behavior and episodes of volitional enuresis. We diagnosed major depressive disorder, recurrent episode in remission without psychosis. Drug screen, complete blood count, complete metabolic panel, COVID-19, urinalysis, thyroid-stimulating hormone, head computed tomography, and beta-human chorionic gonadotropin were negative. Patient continued home oral medications aripiprazole 10 mg daily, fluoxetine 30 mg daily, and levetiracetam 500 mg twice daily and was discharged the next day. CONCLUSIONS: Self-harm is observed in 17.2% of adolescents, 13.4% of young adults, and 5.5% of older adults.2 Cases of self-mutilation in pediatric patients typically present as cutting, burning, or head banging.3 Our differential diagnoses include borderline personality disorder due to repeated impulsivity and self-harm, and body focused repetitive behavior disorder (obsessive-compulsive disorder-related disorder), which presents with repetitive strain injuries and dental malocclusions. Treatment of self-mutilation involves treating the underlying psychiatric condition with psychotropic medications.4,5 In pediatric patients, dialectical behavioral therapy has been shown to reduce parasuicidal behaviors after 1 year of therapy.6 Our patient, under constant 24-hour observation, was cleared by medical, psychiatric, and dental teams. The patient followed up with outpatient psychotherapy and psychiatry. We are presenting this rare case for clinicians to identify and manage pediatric patients presenting with unique forms of self-harm tendencies.

Mindful attention for reading and class (MARC): A DBT-informed group intervention for college students with attention-deficit/hyperactivity disorder

Up to 80% of children diagnosed with ADHD have symptoms that persist into adulthood (Barkley et al., 2007), and up to 8% of college students report having the disorder (DuPaul et al., 2009). COVID-19 has exacerbated ADHD-related difficulties with concentration, academic performance, and emotional distress (Breaux et al., 2021;Pollak et al., 2021). Dialectical Behavior Therapy (DBT) skills training has shown promise as an effective intervention for ADHD in college students (Fleming et al., 2015) although DBT has typically been delivered face to face over a number of months. The current study was designed to assess the effectiveness of a brief (2-session) DBT-informed group intervention delivered via telehealth. Thirty-three students with at least five DSM-5 symptoms of ADHD were randomized to either a DBT skills group or a Brain Training group which consisted of online puzzle and attention games. Students in both groups received validation, discussion with peers, and psychoeducation. Students completed several measures related to number of ADHD symptoms, quality of life, mindfulness, and visual and auditory attention across three time points (pre, post, and one month follow-up). Statistical analyses revealed no differences based on treatment condition. However, regardless of group intervention, students did report improvements in quality of life, use of mindful nonjudgement skills, and number of ADHD symptoms. The results of this study suggest that providing an open and supportive environment for students with ADHD to meet and discuss their symptoms, learn about their disorder, and provide support to one another, may be beneficial. (PsycInfo Database Record (c) 2022 APA, all rights reserved)

The Effects of Educational Intervention based on Dialectical Behavior Therapy on Emotional Regulation and Self-control after Discharge in Patients with Covid-19

Aims: One of the important causes of anxiety in COVID-19 is the inability to regulate emotion and lack of self-control during threatening conditions. Psychotherapy techniques have been effective in reducing psychological disorders. This study aimed at evaluating the effectiveness of dialectical behavior therapy on emotional regulation and self-control of these patients. Materials & Methods: It was a quasi-experimental pretest-posttest study with a control group. The statistical population included 30 men who were undergoing COVID-19 quarantine. Available sampling was used and individuals were randomly assigned to experimental and control groups. In the experimental group, the dialectical behavior therapy was performed in 10 sessions of 90 minutes. Tangi self-control and Garnofsky emotion regulation questionnaires were used. Data were analyzed using SPSS 21 software and multivariate analysis of covariance. Findings: There was a significant difference between the mean scores of emotional regulation and self-control variables in the experimental and control groups (p< 0.05) The effect of this treatment on increasing the emotional regulation score was 27% and on increasing the self-control score was 15%. Conclusion: Dialectical behavior therapy can increase cognitive regulation and improve self-control in patients with COVID-19. It is suggested that this intervention be used in psychological treatment programs. © 2022, Tarbiat Modares University. All rights reserved.

Dialectical behavior therapy and the COVID-19 pandemic: Building a life worth living in the face of an unrelenting crisis

The COVID-19 global pandemic has drastically altered the way in which the world operates and human beings interact. The COVID-19 pandemic has affected the bodies, finances, minds, and souls of every individual in more ways than one. People all over the world are feeling the impact of the increase of these stressors, with the psychological impact being potentially as great as the physical. Prior to the onset of this global pandemic, suicide was already considered a major public health problem (World Health Organization, Suicide. Retrieved from https://www.who.int/newsroom/fact-sheets/detail/suicide, 2018). This chapter will offer a reflection on the experience of providing dialectical behavior therapy (DBT) during the ongoing COVID-19 pandemic. An overview of DBT will be provided in order to highlight the impact of the pandemic on the provider, the patient, and implementation of the treatment itself. Obstacles and adaptations to treatment will be presented through the lens of the four components of DBT by way of narrative and clinical case examples. (PsycInfo Database Record (c) 2022 APA, all rights reserved)

A comparison of telehealth versus in-person group therapy: Results from a DBT-based dual diagnosis IOP.

OBJECTIVE: The effectiveness of remotely delivered group interventions and treatments for individuals with more complex psychiatric presentations is understudied. Nevertheless, the emergence of the COVID-19 pandemic shifted such treatments from in-person to remote service delivery without the establishment of comparable effectiveness between in-person and remote delivery. The current study presents the results of a private practice's transition from in-person treatment delivery to a videoconference-delivered Dialectical Behavior Therapy (DBT)-based intensive outpatient program (IOP) for individuals with comorbid mental health and substance use disorder diagnoses in response to the pandemic. METHODS: Change in symptoms of depression, anxiety, and stress following completion of the IOP was compared between the in-person and videoconference groups. RESULTS: Large reductions in symptoms were found following completion of the IOP for both the in-person and videoconference groups. Furthermore, no significant differences in symptom reduction were found between the groups. CONCLUSION: Although large-scale replication is needed, these results suggest that IOPs and other intensive group therapies delivered via videoconference may be as effective as in-person therapies, even among individuals with more complex psychiatric presentations. Providers who have transitioned group therapies to videoconference formats or are considering creating remote groups can be more confident that they are not sacrificing treatment efficacy.

Effectiveness of family connections intervention for family members of persons with personality disorders in two different formats: Online vs face-to-face.

Introduction: Personality disorders (PD) have a serious impact on the lives of individuals who suffer from them and those around them. It is common for family members to experience high levels of burden, anxiety, and depression, and deterioration in their quality of life. It is curious that few interventions have been developed for family members of people with PD. However, Family Connections (FC) (Hoffman and Fruzzetti, 2005) is the most empirically supported intervention for family members of people with Borderline Personality Disorder (BPD). Aim: The aim of this study is to explore the effectiveness of online vs face-to-face FC. Given the current social constraints resulting from SARS-CoV-2, interventions have been delivered online and modified. Method: This was a non-randomized pilot study with a pre-post evaluation and two conditions: The sample consisted of 45 family members distributed in two conditions: FC face-to-face (20) performed by groups before the pandemic, and FC online (25), performed by groups during the pandemic. All participants completed the evaluation protocol before and after the intervention. Results: There is a statistically significant improvement in levels of burden (η 2 = 0.471), depression, anxiety, and stress (η 2 = 0.279), family empowerment (η 2 = 0.243), family functioning (η 2 = 0.345), and quality of life (µ2 η 2 = 0.237). There were no differences based on the application format burden (η 2 = 0.134); depression, anxiety, and stress (η 2 = 0.087); family empowerment (η 2 = 0,27), family functioning (η 2 = 0.219); and quality of life (η 2 = 0.006), respectively). Conclusions: This study provides relevant data about the possibility of implementing an intervention in a sample of family members of people with PD in an online format without losing its effectiveness. During the pandemic, and despite the initial reluctance of family members and the therapists to carry out the interventions online, this work shows the effectiveness of the results and the satisfaction of the family members. These results are particularly relevant in a pandemic context, where there was no possibility of providing help in other ways. All of this represents a great step forward in terms of providing psychological treatment.

Implementation of a Mobile DBT App and Its Impact on Suicidality in Transitional Age Youth with Borderline Personality Disorder: A Qualitative Study.

Contemporary performance and accessibility are features that enable mobile devices to be increasingly beneficial in the context of optimizing the treatment of psychiatric disorders. Smartphones have the potential to effectively support psychotherapeutic interventions among adolescents and young adults who require them. In the present study, the use and subjective influence of a smartphone app with content from dialectical behavior therapy (DBT) was investigated among transitional age youth (TAY) with borderline personality disorder, focusing on suicidality and non-suicidal self-injury (NSSI), in a natural setting. A longitudinal qualitative approach was used by means of individual semi-structured interviews, where participants were asked about their experiences and associated emotions before and after a testing period of 30 days. A total of 13 TAY with a diagnosed borderline personality disorder between the ages of 18 and 23 were included. Six overarching themes were identified through qualitative text analysis: (1) experiences with DBT skills, (2) phenomenon of self-harm, (3) feelings connected with self-harm, (4) dealing with disorder-specific symptoms, (5) prevention of self-harm, and (6) attitude toward skills apps. In general, the provision of an app with DBT content achieved a positive response among participants. Despite a small change in the perception of suicidality and NSSI, participants could imagine its benefits by integrating their use of the app as a supportive measure for personal psychotherapy sessions.