Brief Dialectical Behavior Therapy in a Community Mental Health Agency: A Pilot Outcome Study

The effectiveness of a 4-month dialectical behavior therapy (DBT) program for individuals with borderline personality disorder (BPD) was evaluated in a naturalistic pilot study. 53 participants (48 women, 5 men) who met diagnostic criteria for BPD participated in one of 4 courses of treatment in a community mental health agency between 1996 and 1997. Subjects were assessed using the Brief Symptom Inventory (BSI) and a behavioral questionnaire. After 4 months of treatment, subjects showed statistically significant declines in global severity of psychiatric symptoms and psychological distress as assessed by the Global Severity Index (GSI) of the BSI. Subjects also showed substantial declines in self -reported incidents of self-harm behavior, .psychiatric hospitalizations, self-harm related emergency department visits, and calls to telephone crisis services. 48% of subjects showed statistically reliable change on the GSI, and effect sizes ranged from medium to large. The overall attrition rate for this program was 42%. None of the BSI indices or the age of subjects differentiated treatment completers from non-completers