Exploring follow-up outcomes and experiences of dialectical behaviour therapy

Abstract

Systematic Review: Dialectical behaviour therapy (DBT) has a growing evidence base for treating individuals with a diagnosis of borderline personality disorder (BPD). Less is known about the long-term effects of the treatment, which is an important consideration when treating a chronic disorder such as BPD. The current systematic review explores reported outcomes after one year of follow-up for individuals who engaged in the treatment. A systematic search of four databases (PsycInfo, PubMed, Scopus, CINAHL) was performed. Controlled and uncontrolled studies were included. A total of ten articles were included pertaining to seven studies. Overall, improvements following treatment with DBT extended over the follow-up period. These findings suggest the effects of DBT in treating BPD are maintained, at least one to two years post-intervention. Given a lack of long-term follow-up in randomised controlled trials, evidence for the efficacy of the treatment at follow-up is unclear.

Empirical Paper: Qualitative research in the area of DBT is limited, particularly at follow-up. The current study explored the follow-up experiences of individuals who previously received a diagnosis of borderline personality disorder and self-report having benefitted from DBT at the time of treatment. Individuals who completed 12 months of standard DBT and were a minimum of two years post-completion were recruited. Semi-structured interviews were completed with a total of twelve participants. A thematic analysis generated three main themes which indicated that participants found DBT had a positive impact on their lives in the years after the programme and enabled further development; gave them control over their lives and the ability to manage setbacks and difficult situations; and contributed to healthier and more meaningful relationships with others. Despite the positive impact of DBT, participants required further support in the years after completing the programme. Clinical and research implications of these findings are discussed.