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Standalone DBT Group Skills Training Versus Standard (i.e. All Modes) DBT for Borderline Personality Disorder: A Natural Quasi-experiment in Routine Clinical Practice

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Abstract

We describe a naturally occurring, real-world comparison of outcomes following 6 months in standalone DBT skills training group for adults with Borderline Personality Disorder (BPD) without recent suicidal or severe self-harming behaviours and standard (i.e. all modes) DBT for BPD including patients with recent high-risk behaviours. 34 patients chose standalone skills over waiting for standard DBT and 54 were offered standard DBT. Dropout was higher for standalone skills than standard DBT (38.2% vs. 16.7%). No statistically or clinically significant differences were found among completers between conditions on borderline symptoms, general psychopathology, and suicide ideation. There was a moderate effect for standalone skills on hopelessness and emotion regulation difficulties which may have reflected non-equivalence of treatment groups. Significant methodological factors limit generalisability of findings which offer support for feasibility of standalone DBT skills as an effective alternative to waitlist for standard DBT for at least some patients with BPD in the community.

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Authors and Affiliations

  1. Department of Psychology, Cluain Mhuire Community Mental Health Services, Blackrock, Co. Dublin, Ireland

    Jim Lyng & Daniel J. Duffy

  2. School of Psychology, Bangor University, Adeilad Brigantia, Bangor, Gwynedd, LL57 2AS, UK

    Jim Lyng & Michaela A. Swales

  3. Centre for Educational Development, Appraisal and Research, University of Warwick, Coventry, West Midlands, CV4 7AL, UK

    Richard P. Hastings

  4. South Eastern Health and Social Care Trust, Dundonald, BT16 1RH, UK

    Tracy Millar

  5. Department of Psychology, St Patrick’s University Hospital, Dublin, D08 K7YW, Ireland

    Richard Booth

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  1. Jim Lyng
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  2. Michaela A. Swales
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Correspondence to Jim Lyng.

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Conflict of interest

The first and second authors (JL and MS) receive consultancy fees for the delivery of training in dialectical behaviour therapy (DBT) through British Isles DBT Training Ltd. (www.dbt-training.co.uk). The second author (MS) receives royalties for books authored on the subject of DBT and is an owner of British Isles DBT Training Ltd. There are no further conflicts of interests. No other authors receive fees for training in DBT. With the exception of the second author, there is no ownership of public or private firms with relevance to the study, no authors receive commercial sponsorships, and besides the book royalties of the second author there are no other patents or royalties due to any authors in relation to the subject matter. We, the authors, certify full responsibility for the manuscript. In so doing, we certify that we accept responsibility for the conduct of the study and for the analysis and interpretation of the data, that we helped write the manuscript and agree with the decisions about it, that we each meet the definition of an author as stated by the International Committee of Medical Journal Editors, and we have seen and approved the final manuscript. In certifying responsibility for the manuscript, we, the authors, also certify that neither the article nor any essential part of it, including tables and figures, will be published or submitted elsewhere before appearing in the Journal.

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Lyng, J., Swales, M., Hastings, R.P. et al. Standalone DBT Group Skills Training Versus Standard (i.e. All Modes) DBT for Borderline Personality Disorder: A Natural Quasi-experiment in Routine Clinical Practice. Community Ment Health J 56, 238–250 (2020). https://doi.org/10.1007/s10597-019-00485-7

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