Dialectical behavior therapy skills utilization: a three-month follow-up study on clinical outcomes

Ample research supports skills training of Dialectical Behavior Therapy (DBT) to be a critical mode of treatment, though gaps remain in our understanding of the effects of actual skills utilization outside of treatment at longer-term follow-ups. The current study involved 60 adults from around the U.S. receiving comprehensive DBT in-person or via telehealth. Participants completed an online registration survey assessing their mental health, daily reports of DBT skills use for three weeks, and a follow-up survey reassessing mental health three months later. The objectives were to examine if frequency of DBT skills use by comprehensive DBT clients predicts improvements in their mental health at follow-up and whether the four different DBT skills modules differentially impact these outcomes. Results suggested that greater number of days of skills use per week was associated with fewer difficulties in work and social adjustment at follow-up, while accounting for baseline functioning. Number of days of overall skills use per week was not associated with other outcomes, such as borderline personality disorder (BPD) symptom, anxiety, or depression severity, or adaptive or maladaptive ways of coping. Controlling for all other modules, clients who used Interpersonal Effectiveness (IE) skills on more days per week reported fewer difficulties in work and social functioning, and lower BPD and depression symptom severity and anger. No significant associations were found between the three other modules and any outcomes. These findings highlighted improvements in social-related functioning among DBT clients who endorsed greater overall skills use, and the potentially unique effects of IE skills on treatment outcomes.M.S.Includes bibliographical reference