Dialectical Behavior Therapy for Borderline Personality Disorder

Overseen By Shireen L Rizvi, PhD

Age: < 65

Sex: Any

Trial Phase: Academic

Sponsor: Rutgers, The State University of New Jersey

Disqualifiers: Schizophrenia, Anorexia, Non-English, others

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Compensation: Varies

Number of Visits: 3

Duration: 24 weeks

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial examines the effectiveness of a therapy called DBT-A (Dialectical Behavior Therapy for Adolescents) for young people showing signs of borderline personality disorder (BPD). The goal is to assist adolescents aged 13-20 who experience issues like impulsive behavior or frequent self-harm. Participants must exhibit at least three symptoms of BPD, including impulsivity or self-harm, and live close enough to the clinic to attend weekly sessions. The study includes individual therapy, family skills groups, and other supportive activities, aiming to enhance emotional regulation and overall well-being. As an unphased trial, this study provides a unique opportunity for participants to contribute to the understanding and improvement of mental health therapies for adolescents.

Will I have to stop taking my current medications?

The trial does not require you to stop taking your current medications. You only need to stop other forms of talk therapy during the program, but you can continue with medication management.

What prior data suggests that DBT-A is safe for adolescents with borderline personality disorder?

Research has shown that Dialectical Behavior Therapy for Adolescents (DBT-A) is generally safe and well-tolerated. In a small study, 12 teenagers showed significant improvements in their symptoms after receiving DBT-A treatment. Studies also report a clear reduction in self-harm behavior among participants following the therapy.

Additionally, research indicates that DBT, the therapy from which DBT-A is adapted, effectively and safely treats borderline personality disorder and related issues. These findings suggest that DBT-A can be safely used with teenagers facing emotional challenges and symptoms of borderline personality disorder. ^{1 2 3 4 5}

Why are researchers excited about this trial?

Dialectical Behavior Therapy for Adolescents (DBT-A) is unique because it specifically tailors the standard DBT model for adolescents struggling with Borderline Personality Disorder (BPD) features. Unlike typical treatments that may focus solely on individual therapy, DBT-A combines weekly individual sessions, multifamily skills groups, and phone coaching to involve the family in the therapeutic process. Researchers are excited about DBT-A because this comprehensive approach addresses emotional dysregulation in adolescents more holistically, potentially leading to better outcomes by engaging both the young person and their family in the healing process.

What evidence suggests that DBT-A might be an effective treatment for borderline personality disorder?

Research has shown that Dialectical Behavior Therapy for Adolescents (DBT-A), the treatment model delivered to all participants in this trial, effectively treats symptoms of borderline personality disorder (BPD) in young people. One study found that DBT-A greatly reduced BPD symptoms and improved emotional management, common issues for those with the disorder. Another study showed that DBT-A decreased self-harm and enhanced overall emotional health. Evidence also suggests that attending group-based DBT skills training can lead to positive changes. Overall, DBT-A effectively addresses key symptoms of BPD in adolescents. ^{1 6 7 8 9}

Are You a Good Fit for This Trial?

This trial is for adolescents aged 13-20 with borderline personality disorder, showing impulsive behavior or self-harm. They must live close to the clinic and have a caregiver join in treatment. Participants can't be in other talk therapies, must understand English, have an IQ above 70, and not require services for conditions like schizophrenia.

Inclusion Criteria

Agreement to take part in assessments, videotaping/audiotaping and coding of their sessions by research personnel.

I agree to stop other talk therapies while I'm in the DBT program.

You have certain additional traits that indicate you may have borderline personality disorder (BPD).

Exclusion Criteria

My IQ is below 70.

I need mental health services not offered here, like for schizophrenia or severe anorexia, or I'm already getting the best treatment elsewhere.

Court-ordered to participate in treatment

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Treatment

Participants receive Dialectical Behavior Therapy for Adolescents (DBT-A) over a six-month period, including weekly individual therapy, weekly multifamily skills group, phone coaching as needed, and therapist consultation

24 weeks

Weekly visits (in-person)

Mid-treatment Assessment

Participants are assessed at the three-month mark to evaluate progress and adjust treatment as necessary

1 week

1 visit (in-person)

Post-treatment Assessment

Participants are assessed at the end of the six-month treatment period to evaluate outcomes

1 week

1 visit (in-person)

Follow-up

Participants are monitored for safety and effectiveness three months after treatment completion

12 weeks

1 visit (in-person)

What Are the Treatments Tested in This Trial?

Interventions

• DBT-A

Trial Overview

The study tests Dialectical Behavior Therapy (DBT-A) specifically designed for teenagers at Rutgers University's DBT Clinic. It involves six months of therapy with assessments throughout the process to track progress and effectiveness.

How Is the Trial Designed?

Group I: DBT-A Experimental Treatment 1 Intervention

The standard treatment to be delivered to all participants is DBT-A, which is a treatment model adapted from DBT. DBT-A is an adaptation for adolescents with emotion dysregulation and BPD features (Miller, Rathus, \& Linehan, 2007; Rathus \& Miller, 2015). DBT-A involves weekly individual therapy with the adolescent, weekly multifamily skills group in which adolescents and family members participate, as needed phone coaching, and weekly consultation team for the therapists.

Who Is Running the Clinical Trial?

Rutgers, The State University of New Jersey

Lead Sponsor

Trials

471

Recruited

81,700+

Published Research Related to This Trial

Dialectical behavior therapy (DBT) has been proven effective in reducing parasuicidal behaviors and improving social adjustment in patients with borderline personality disorder, as shown in two randomized trials.

The therapy's unique approach, which balances acceptance and change, was found to be more effective in reducing suicidal behavior compared to techniques focused solely on either acceptance or change.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Dialectical behavior therapy for borderline personality disorder: theoretical and empirical foundations. Shearin, EN., Linehan, MM.[2022]

In a study of 68 clients with borderline personality disorder, both Dialectical Behavior Therapy (DBT) and Dynamic Deconstructive Psychotherapy (DDP) significantly reduced symptoms of BPD, depression, and disability after 12 months, showing effectiveness similar to controlled trials.

DDP outperformed DBT in terms of treatment outcomes, while DBT had a high dropout rate, suggesting that DDP may be a more effective option in real-world settings for treating BPD.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Naturalistic Outcomes of Evidence-Based Therapies for Borderline Personality Disorder at a Medical University Clinic. Gregory, RJ., Sachdeva, S.[2019]

Both Dialectical Behaviour Therapy (DBT) and Mentalization-Based Therapy (MBT) help reduce self-harm in patients with borderline personality disorder by teaching skills like impulse control, questioning thoughts, and effective communication, as shown in a study of 73 patients over 12 months.

Patients in MBT reported more difficulties with group interactions compared to those in DBT, highlighting the importance of managing therapeutic relationships to prevent negative effects on treatment outcomes.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Patient experiences of therapy for borderline personality disorder: Commonalities and differences between dialectical behaviour therapy and mentalization-based therapy and relation to outcomes. Barnicot, K., Redknap, C., Coath, F., et al.[2022]

Dialectical Behavior Therapy (DBT) is highly effective for treating complex mental health issues, particularly for individuals with borderline personality disorder (BPD), focusing on chronic suicidality and emotion dysregulation.

The authors discuss the strengths and limitations of the BPD Compass intervention, which is a promising approach in the context of DBT, indicating ongoing developments in effective therapies for BPD.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Borderline personality disorder (BPD) Compass is a promising complementary intervention to dialectical behavior therapy: Comment on Sauer-Zavala (2022). Crowell, SE., Kaliush, PR., Vlisides-Henry, RD.[2023]

Dialectical behavior therapy (DBT) is an effective, evidence-based treatment specifically designed for borderline personality disorder (BPD), particularly benefiting parasuicidal women, but also showing promise for those with substance use disorders and binge-eating disorder.

DBT incorporates unique elements such as a focus on emotions, a dialectical philosophy, and mindfulness techniques, which differentiate it from other cognitive-behavioral therapies and are essential for its effectiveness.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Dialectical behavior therapy: current indications and unique elements. Chapman, AL.[2021]

Citations

1.

pmc.ncbi.nlm.nih.gov

pmc.ncbi.nlm.nih.gov/articles/PMC3037874/

Dialectical Behavioral Therapy for Adolescents (DBT-A)

In the pilot study, 12 adolescents were treated. At the beginning of therapy, 83% of patients fulfilled five or more DSM-IV criteria for borderline personality ...

2.

tandfonline.com

tandfonline.com/doi/abs/10.1080/23794925.2022.2056929

Dialectical Behavior Therapy for Adolescents: Treatment ...

The goal of this study was to evaluate the effectiveness of dialectical behavior therapy for adolescents (DBT-A) with borderline personality ...

3.

pubmed.ncbi.nlm.nih.gov

pubmed.ncbi.nlm.nih.gov/38874116

Randomized effectiveness-implementation trial of ...

Emerging evidence suggests that group-based DBT skills training alone can lead to promising outcomes.

4.

onlinelibrary.wiley.com

onlinelibrary.wiley.com/doi/10.1002/jclp.23725

Randomized effectiveness‐implementation trial of ...

Primary outcomes were emotion dysregulation and BPD symptoms. Secondary outcomes were suicidality, coping, depression, anxiety, and stress.

5.

sciencedirect.com

sciencedirect.com/science/article/pii/S2352250X21000038

Implementation of an evidence-based intervention for ...

A recently updated systematic review of psychological therapies for BPD found DBT to be more effective at reducing BPD severity and self-harm and improving ...

6.

bmcpsychiatry.biomedcentral.com

bmcpsychiatry.biomedcentral.com/articles/10.1186/s12888-024-05876-z

Evaluation of dialectical behavior therapy for adolescents in ...

The findings of the current study are promising as the participants reported considerably reduced self-harm behavior after DBT-A treatment.

7.

formative.jmir.org

formative.jmir.org/2025/1/e66181

Acceptance, Safety, and Effect Sizes in Online Dialectical ...

Objective: This study aims to provide initial effect size estimates of symptom change from pre- to post treatment, and the acceptance and safety ...

8.

behavioraltech.org

behavioraltech.org/wp-content/uploads/2023/07/Research-Update-2016.All_.pdf

DBT Treatment Research

Dialectical behavior therapy (DBT) has been shown effective for the treatment of borderline personality disorder (BPD) and other high-risk, suicidal, and ...

9.

jamanetwork.com

jamanetwork.com/journals/jamapsychiatry/fullarticle/2685324

Efficacy of Dialectical Behavior Therapy for Adolescents at ...

This randomized clinical trial evaluates the efficacy of dialectical behavior therapy compared with individual and group supportive therapy ...