Implementing a dialectical behavior therapy group intervention in a primary care setting: a feasibility and acceptability study.

Research shows that people in the United States are more likely to seek mental health treatment from primary care providers than mental health specialists. Incorporating effective transdiagnostic psychological interventions in integrated behavioral health settings that can address a variety of presenting problems across clinical severity can reduce burden on primary care clinics and increase the accessibility of evidence-based treatments. Dialectical Behavior Therapy (DBT) is a comprehensive treatment originally developed to treat borderline personality disorder and suicidality whose skills teachings have been adapted to meet the needs of various clinical populations. Research shows that DBT skills-only interventions have been effectively delivered in diverse settings within transdiagnostic populations, but have never directly been researched in primary care settings. This year-long pilot study aimed to test the feasibility and acceptability of a modified DBT skills-only group intervention in an integrated behavioral health setting. DBT skills groups were open enrollment and rolling admissions, and ran continuously for 50 weeks. Results showed that the intervention was feasible and acceptable, with high ratings of enjoyment, skill helpfulness, and skills practice across weekly and post-treatment measures. Mindfulness skills were indicated by both quantitative and qualitative measures to be the most helpful and frequently used skills by participants. Paired t-tests showed clinically significant reductions in participant somatization, depression, rumination and emotion dysregulation and significant increases in participant skills use, with small – medium effect sizes in the intent-to-treat sample (N=35) and medium – large effect sizes in the subset of the sample that received an adequate dose of the intervention (N=16). HLM demonstrated a clinically significant effect of time on decreases in weekly somatization, depression, and anxiety symptoms. Data indicate the clinical utility of using DBT skills as a transdiagnostic group intervention in primary care settings. Psy.D.Includes bibliographical reference