20 Weeks DBT Group Skills Training Study
Condition: Borderline Personality Disorder
MeSH terms: Personality Disorders; Borderline Personality Disorder
Study type: Interventional
Phase: Phase 1

Summary: 
      The aim of this study is to evaluate the effectiveness of a 20-week Dialectical Behaviour
      Therapy (DBT) skills training group for the treatment of chronic suicidal and non-suicidal
      self-injurious (NSSI) behaviours in individuals diagnosed with borderline personality
      disorder (BPD). Previous research has established the effectiveness of a one year
      comprehensive, combined individual and group DBT treatment. However, in practice, DBT is
      often offered in a skills only group format. This study will consist of a randomized,
      controlled trial designed to evaluate the effectiveness of DBT compared to a wait list
      control. 84 participants will be randomized to the 20-week DBT group or the wait-list and the
      following outcomes will be assessed:

        1. frequency of suicidal and NSSI behaviours

        2. symptom distress

        3. impulsivity

        4. treatment retention

        5. skill acquisition and

        6. social functioning

      Assessments will occur at pre-treatment, 10 weeks, 20 weeks and 3 months post treatment. The
      following main hypotheses will be examined: (1) Patients in the DBT skills group condition
      will have superior outcomes to patients on the treatment as usual wait list control in areas
      targeted by the treatment: frequency of suicidal and NSSI behaviours, emergency room visits,
      psychiatric hospital admissions, impulsivity, and knowledge and use of behavioral skills,
      general symptoms. The group receiving DBT will have superior outcomes at post treatment and
      these outcomes will be maintained during the three month post-treatment follow-up.
    

Detailed description: 
      The study will consist of a single-blind, two-arm randomized controlled trial designed to
      evaluate the effectiveness of DBT skills group offered as an adjunct to treatment as usual
      compared to a wait list control plus treatment as usual. The continuation of treatment as
      usual in both arms is permitted for two reasons. First, it would be unethical to assign
      suicidal patients to a wait list condition that prohibited involvement in ongoing treatment.
      Second, the proposed design enables us to address the question of the additive effect of the
      DBT skills group intervention. Subjects will be randomized to receive 20 weeks of DBT group
      skills training plus treatment as usual, or to a wait list control plus treatment as usual.
      Clinical effectiveness outcomes will be assessed at baseline, at 10 weeks, at 20 weeks and at
      8 months follow-up. DBT skills training is a manualized intervention developed by Linehan
      (1993). Key skills from the modules described in Miller, Rathus, and Linehan (2006) will
      serve as the basis of the DBT skills group, delivered in a psychoeducational format over the
      course of weekly two-hour sessions. The skills group covers five modules: mindfulness,
      emotion regulation, distress tolerance, interpersonal effectiveness, and dialectics.
    

Intervention name(s): Skills Training
Intervention type(s): Behavioral
Intervention description(s): 20 weeks of Dialectical Behaviour Therapy Skills Training
Allocation: Randomized
Intervention model: Single Group Assignment
Masking: None (Open Label)
Primary purpose: Treatment
Keywords: Borderline Personality Disorder; Skills Training; Dialectical Behavior Therapy; Suicidal and parasuicidal behavior