Dialectical Behavior Therapy Skills and Urges to Use Alcohol and Substances: An Examination of Diary Cards.

Background: Skills learned in Dialectical Behavior Therapy (DBT) are a proposed mechanism that prompts behavior change. Few studies have examined the effects of DBT skills on treatment outcomes. No published studies have examined the effects of DBT skills on alcohol and substance use outcomes. Objectives: This study examined 48 individuals in a community mental health facility that delivers DBT-adherent treatment. Utilizing intake data and diary cards, multilevel model analyses were conducted to examine the effects each DBT skills domain had on urges for participants that entered treatment with varying frequencies of alcohol and substance use. Results: Emotion regulation and mindfulness skills domains were related to decreased urges for individuals that entered treatment with high frequencies of alcohol and substance use. Previous-day distress tolerance skills were associated with decreased urges and previous-day interpersonal effectiveness skills were associated with decreased urges for individuals that entered treatment with high frequencies of substance use. Conclusions: DBT skills may be a helpful mechanism to decrease urges for individuals that use alcohol and other substances. However, more research on why certain skills domains may be more effective is needed.

Applying adherent DBT Principles to treatment in a partial hospital setting: An analysis over 5-years of outcomes from intake to discharge.

OBJECTIVES: A small number of studies to date have examined Partial Hospital (PH) that utilize a Dialectical Behavior Therapy (DBT) model. Preliminary findings suggest DBT PH programs can be effective in various symptom reduction. METHODS: This study examined clinically relevant outcomes and included a heterogeneous clinical sample over a five-year period. Specifically, the present study assessed pre-post data to examine changes in symptoms of depression, anxiety, hopelessness, and overall degree of suffering from intake to discharge in a DBT PH. RESULTS: Findings showed symptom reduction from intake to discharge for depression, anxiety, hopelessness, and suffering for all 5 years. This DBT PH program was successful at reducing various symptoms in a sample of psychiatric patients. CONCLUSION: Clinicians might consider the advantages of placing patients in PH programs versus an inpatient stay or consider utilizing DBT-informed PH programs after an inpatient hospitalization as a form of step-down care.

DBT-informed treatment in a partial hospital and intensive outpatient program: the role of step-down care.

Few studies to date have examined Partial Hospital (PH) and Intensive Outpatient (IOP) programs that utilize a Dialectical Behavior Therapy (DBT)-informed model. Preliminary findings suggest that DBT-informed PH programs are effective in reducing clinical symptoms; however, less is known about IOP programs as well as step-down care models. The present study utilized clinically relevant outcome indices and included a heterogeneous clinical sample. Specifically, the present study assessed pre-post data to examine changes in symptoms of depression, anxiety, hopelessness, and overall degree of suffering from intake to discharge in DBT-informed PH and IOP programs as well as a step-down condition (PH to IOP). Participants included 205 adults (ages M = 35.28, SD = 12.49). The sample was predominantly female (N = 139, 67.8%) and Caucasian (N = 181, 88.3%). The sample was divided into three distinct groups: PH program patients, PH to IOP program step-down patients, and IOP patients. Findings indicated significant symptom reduction from intake to discharge for all three conditions. There were no significant differences in mean change scores in symptom reduction between the three groups. Severity of depression symptoms at intake predicted program placement. However, type of program did not predict significant changes in symptoms from intake to discharge. This DBT-informed PH and IOP program was successful at reducing various psychiatric symptoms in the sample. Clinicians might consider the advantages of placing patients with higher symptoms of depression into PH programs with the intention of transitioning to step-down care through IOP programs that utilize DBT.

From the hospital to the clinic: The impact of mindfulness on symptom reduction in a DBT partial hospital program.

OBJECTIVE: Preliminarily findings suggest dialectical behavior therapy (DBT)-informed partial hospital (PH) programs can reduce patient symptoms. The present study assessed changes in various mental health symptoms as well as mindfulness skill acquisition in relation to these outcomes in a DBT-informed PH program. METHOD: Participants included 212 adults, ages 18-66 (Mean = 35.63, Standard Deviation = 12.39). The sample was predominantly female (N = 140, 66.00%) and Caucasian (N = 185, 87.30%). RESULTS: Findings showed significant symptom reduction (i.e., depression, anxiety, hopelessness, and degree of suffering) from intake to discharge. Overall mindfulness skill acquisition significantly increased from intake to discharge, and specific scales of mindfulness acquisition accounted for significant proportions of the variance in symptom reduction for depression and anxiety. CONCLUSIONS: Mindfulness skill acquisition may be a mechanism by which DBT impacts symptom reduction in PH settings. Future studies might examine mindfulness practice to determine optimum doses.