In August, Linda Dimeff took a look at this question. She started with a thorough look at research over the past 20 years, including findings by Linehan’s landmark study comparing comprehensive DBT to DBT Skills only. What implications can we derive from available research? How do we place these findings into a broader framework for best practice? What are the implications for implementing DBT going forward? Is it “good enough” to streamline DBT to the skills alone? Linda’s one-hour talk provides a helpful framework for thinking though these important questions.
Just for ease, here are a few highlights:
In “Study 2″ cited in Linehan’s original treatment manual (Linehan, Heard, & Armstrong, 1993; in M.M. Linehan, 1993a) Linehan asked the question: If a person with BPD is in individual, non-DBT psychotherapy, will treatment effectiveness be improved if DBT group skills training is added to therapy? She randomized clients to one of two conditions: DBT skills training; (n=11) vs. no-skills training control condition. She noted: “With the exception of the fact that we retained subjects in skills training reasonably well over the year (73%), the results suggested that DBT group skills training may have little if anything to recommend it as an additive treatment to ongoing individual (non-DBT) psychotherapy” (Linehan, 1993).
Since that seminal study, a number of studies have examined the efficacy of a skills training only approach for individuals with BPD, painting a picture that may on the surface appear at odds with Linehan’s original 1993 “Study 2” findings. Specifically, these more recent studies by other BPD/DBT researchers illustrate how DBT skills or behavioral skills can in fact be helpful. Without careful scrutiny, it’s easy to falsely conclude that DBT skills alone is sufficient.
The DBT/BPD world waited to learn of findings from Linehan’s recently published component analysis study where she rigorously compared standard DBT to DBT-Skills Training Only and DBT-Individual Therapy Only in a sample of highly suicidal individuals with BPD. The bottom line is this: standard comprehensive DBT still wins the day. However, the benefits of skills to overall improvement may be greater than you think!
We warmly invite you to check out this really fun new format in our DBT Skillz course created by Linda Dimeff and Kelly Koerner to help skills trainers re-energize! Note that registration for the course closes September 30th!