Effectiveness of Dialectical Behavior Therapy in a Community Mental Health Center

Dialectical behavior therapy (DBT) has been shown to be effective in randomized controlled trials with women with borderline personality disorder and histories of chronic self-inflicted injury including suicide attempts. The present study is a pre-post replication of a comprehensive DBT program in a community mental health center for individuals who chronically injure themselves and/or have experienced multiple treatment failures. Twenty-four subjects were given the Treatment History Interview to obtain information regarding medically treated self-inflicted injuries and the use of crisis services. After 1 year of treatment, DBT showed a significant reduction in the number and severity of self-inflicted injuries, psychiatric-related emergency room visits, psychiatric inpatient admissions and days, and the number of crisis treatment systems engaged. Results are compared to benchmarks from 3 other clinical trials of DBT. While this pre-post comparison has threats to internal validity, it supports the feasibility of DBT when fully implemented in a community mental health clinic.