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

56 Participants Needed

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial uses Dialectical Behavior Therapy (DBT) to help adolescents aged 13-20 with borderline personality disorder symptoms. The therapy teaches them skills to manage emotions, cope with stress, and improve relationships. DBT has been adapted and studied for adolescents with various psychiatric disorders, including borderline personality disorder, and has shown promise in reducing problematic behaviors.

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.

How is Dialectical Behavior Therapy (DBT) different from other treatments for Borderline Personality Disorder?

Dialectical Behavior Therapy (DBT) is unique because it combines cognitive-behavioral techniques with mindfulness and acceptance strategies, focusing on balancing acceptance and change. It is based on a biosocial theory that views Borderline Personality Disorder as a dysfunction of the emotion regulation system, and it has been shown to reduce suicidal behavior and improve social adjustment. ^{1 2 3 4 5}

What data supports the effectiveness of the treatment DBT-A for Borderline Personality Disorder?

Research shows that dialectical behavior therapy (DBT) significantly reduces symptoms of borderline personality disorder (BPD) and related issues like depression and disability. Studies found that DBT is effective in both inpatient and real-world settings, with improvements maintained over time. ^{3 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

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) 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]

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]

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]

Citations

1. England pubmed.ncbi.nlm.nih.gov

Effectiveness of dialectical behaviour therapy for borderline personality disorder in an inpatient setting. [2022]

2. United States pubmed.ncbi.nlm.nih.gov

Naturalistic follow-up of a behavioral treatment for chronically parasuicidal borderline patients. [2022]

3. United States pubmed.ncbi.nlm.nih.gov

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

4. England pubmed.ncbi.nlm.nih.gov

Service user experience of adapted dialectical behaviour therapy in a community adult mental health setting. [2012]

5. England 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. [2022]

6. Denmark pubmed.ncbi.nlm.nih.gov

Dialectical behavior therapy for borderline personality disorder: theoretical and empirical foundations. [2022]

7. United States pubmed.ncbi.nlm.nih.gov

Use of dialectical behavior therapy in inpatient treatment of borderline personality disorder: a systematic review. [2022]

8. United States pubmed.ncbi.nlm.nih.gov

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

9. United States pubmed.ncbi.nlm.nih.gov

Borderline personality disorder (BPD) Compass is a promising complementary intervention to dialectical behavior therapy: Comment on Sauer-Zavala (2022). [2023]