Effectiveness of Enhanced Dialectical Behavior Therapy Skills Training Group for Borderline Personality Disorder

Description

Dialectical Behavior Therapy (DBT) holds the strongest empirical support for the treatment of Borderline Personality Disorder (BPD). However, in Chile-as in much of Latin America-the availability of DBT falls significantly short of meeting patient demand. Despite its demonstrated efficacy, the duration of DBT and its multicomponent structure pose challenges for implementation and dissemination, particularly within public healthcare settings. This study aims to compare the clinical effectiveness of a 12-week DBT skills training group (12w-DBT-ST) with a quasi-standard 6-month DBT program (24w-DBT) and treatment as usual (TAU) for individuals with BPD in routine public mental health services. The primary hypothesis is that 12w-DBT-ST will be equivalent to the quasi-standard 24w-DBT and superior to TAU in reducing suicidal and self-harming behaviors.

Interventions

• Enhanced Dialectical Behavior Therapy Skills Training (Behavioral)
  The intervention lasts 13 weeks and includes the following components: 1) Introductory Group for Orientation and Distress Tolerance DBT skills (2 hours per week during the first 4 weeks), Since week 2, weekly DBT skills-training group (2.5 hours; 12 weeks), 3) Weekly "check-in" phone calls throughout the 13 weeks, 4) Phone coaching for emergencies during business hours, 5) Weekly consultation team meeting (60.90 minutes)
• Dialectical Behavior Therapy (Behavioral)
  The intervention begins with a "pretreatment" phase consisting of three to four preparatory individual psychotherapy sessions in which the therapeutic goals are defined, commitment is established, and the patient is oriented to the rules and procedures of therapy. Pretreatment is followed by standard Dialectical Behavior Therapy over 24 weeks, comprising: 1) a weekly DBT skills-training group (2.5 hrs.); 2) weekly individual DBT psychotherapy (45 min.); 3) Access to phone coaching during business hours (although standard DBT considers 24/7 access, this study arm involves only office-hour access plus orientation to using National Hotline); 4) weekly consultation team meeting (60 min.).
• Treatment as Usual (TAU) (Behavioral)
  It corresponds to the standard treatment currently provided at any community mental health center in Chile, which consists of monthly or fortnightly individual standard psychotherapy sessions.

Eligibility criteria

Conditions

Locations

• CECOSAM Padre Las Casas — Padre Las Casas, Araucania, Chile
• Hospital Provincial del Huasco — Vallenar, Atacama, Chile
• COSAM Puerto Montt — Port Montt, Los Lagos Region, Chile
• COSAM Reloncaví — Port Montt, Los Lagos Region, Chile
• CECOSAM Temuco — Temuco, Región Del La Araucanía, Chile
• COSAM La Pintana — Santiago, Santiago Metropolitan, Chile
• Hospital Dr. Sótero del Río — Santiago, Santiago Metropolitan, Chile