Shame, suicidal ideation, and urges for non-suicidal self-injury among individuals with borderline personality disorder receiving dialectical behavior therapy: The mediating role of anger

Introduction Borderline personality disorder (BPD) is a disorder of pervasive emotion dysregulation associated with high rates of self-injurious thoughts and behaviors (SITB). Understanding specific emotion states in relation to SITB is important for effective intervention. Methods The current study examined whether, and how, the specific emotion of shame contributes to suicide ideation and urges to […]

Paved with good intentions: How our systems intersect to create health disparities for multiply marginalized youth

Background Youth who hold multiply marginalized identities often experience barriers in accessing care following psychiatric hospitalization Methodology The following commentary piece shares a case amalgamation from a multidisciplinary gender clinic in a tertiary care children’s hospital which illustrates the myriad of ways that our current mental healthcare systems fail to connect youth efficiently and effectively […]

Safety planning in context: A case study integrating DBT techniques and ACT for overlapping suicide and psychosis risk

Suicide risk is markedly higher for clients at clinical high risk for psychosis (CHR-p) compared to the general population. Dialectical behavior therapy (DBT) has a strong evidence base supporting its utility for managing suicide risk. Meanwhile, acceptance and commitment therapy (ACT) has been shown to effectively treat individuals with psychosis symptoms, as well as comorbid […]

Cessation of deliberate self-harm behavior in patients with borderline personality traits treated with outpatient dialectical behavior therapy

The first aim of the study was to identify when deliberate self-harm (DSH) behavior ceased in patients with borderline symptoms undergoing dialectical behavioral treatment (DBT). The second aim was to compare patients who ceased their self-harm behavior early or late in the course of treatment, with regard to demographics, comorbidity, and symptom severity. The study […]

Adapted dialectical behavior therapy for adolescents with a high risk of suicide in a community clinic: A pragmatic randomized controlled trial

Objective This study is a pragmatic randomized controlled trial, which compares the effectiveness of an adapted form of Dialectical Behavior Therapy for Adolescents (DBT-A) and treatment as usual plus group sessions (TAU + GS) to reduce suicidal risk for adolescents in a community health mental clinic. Method Thirty-five adolescents from a community outpatient clinic, with repetitive NSSI […]

Changes in suicide and non-suicidal self-injury ideation and the moderating role of specific emotions over the course of dialectical behavior therapy

Objective Dialectical behavior therapy (DBT) targets suicidal behavior and non-suicidal self-injury (NSSI) as well as urges/ideation to engage in these behaviors. However, it remains unclear which specific suicidal ideation (SI) and NSSI ideation domains (i.e., frequency, worst intensity, average intensity, perceived likelihood of future ideation, and duration of ideation), if any, are impacted, and whether […]

Dialectical behavior therapy for adolescents (DBT-A): Outcomes among sexual minorities at high risk for suicide

The alarming rates and pervasiveness of suicidal and self-destructive behaviors (e.g., non-suicidal self-injury) among young sexual minorities represent a major public health concern. We set out to examine whether an empirically driven treatment for suicide and self-harm, dialectical behavior therapy for adolescents (DBT-A), provides benefits for adolescents who identify as gay, lesbian, bisexual, or questioning […]

Psychological approaches to suicide treatment and prevention

In recent decades, the sub-specialization of “clinical suicidology” emphasizing suicide risk assessment, treatment, training, and the management of suicide-related liability has grown exponentially. This line of thinking had led to the development of suicide-specific treatments that target suicide as the focus of care (vs. a primary focus on treating mental disorders). These treatments are being extensively investigated […]

Dialectical behaviour therapy (DBT) for high-risk transgender and gender diverse (TGD) youth: A qualitative study of youth and mental health providers’ perspectives on intervention relevance

Objectives Despite the significant mental health challenges and unique treatment needs of transgender and gender diverse (TGD) youth, research on the acceptability of evidence-based treatments for these youth is limited. To address this gap, the current study explored the perceived relevance of dialectical behaviour therapy (DBT) for high-risk TGD youth. Methods Qualitative data were collected […]

Stepped care for suicide prevention in teens and young adults: Design and methods of a randomized controlled trial

Background Suicide is the second‑leading cause of death among adolescents and young adults in the United States, with rates rising over much of the last decade. The design, testing, and implementation of interventions to prevent suicide in this population is a public health priority. This manuscript outlines the design and methods for a research study […]

CALMA, a mobile health application, as an accessory to therapy for reduction of suicidal and non-suicidal self-injured behaviors: A pilot cluster randomized controlled trial

The present study was aim to evaluate the acceptability and preliminary effectiveness of a mobile-health application, CALMA, based on dialectical behavioral therapy skills. CALMA was proposed as an adjunct to therapy for the reduction of non-suicidal and suicidal self-injury behaviors. A parallel design was used to compare the intervention group (DBT + CALMA) and the comparison group […]

Brief internet-delivered skills training based on DBT for adults with borderline personality disorder: A feasibility study

Objective Borderline personality disorder (BPD) is characterized by instability in emotions, relationships, and behaviors, such as self-injury and suicidal behavior. Dialectical Behavioral Therapy (DBT) is an established intervention for BPD, but there are long waiting times for treatment. This study aimed to explore if a brief internet-delivered DBT skills training program with minimal therapist support […]

Effect of offering care management or online dialectical behavior therapy skills training vs usual care on self-harm among adult outpatients with suicidal ideation: A randomized clinical trial

OBJECTIVE To compare 2 low-intensity outreach programs with usual care for prevention of suicidal behavior among outpatients who report recent frequent suicidal thoughts. DESIGN, SETTING, AND PARTICIPANTS Pragmatic randomized clinical trial including outpatients reporting frequent suicidal thoughts identified using routine Patient Health Questionnaire depression screening at 4 US integrated health systems. A total of 18 […]

A critical, relational approach for working with suicide in family therapy

Suicidality is a major global public health issue that couple and family therapists will inevitably encounter in their clinical work. While relational therapies for addressing suicidality are growing, few specifically outline ways to address the influence of systemic oppression on suicidality, reflecting the push to de-politicise suicide research. To address this issue, scholars have proposed […]

Function and psychotherapy of chronic suicidality in borderline personality disorder: Using the reinforcement model of suicidality

Although great advancements in evidence-based therapies, chronic suicidal patients with borderline personality disorder (BPD) still challenge our mental health system. While BPD patients continue suffering from distress and aversive emotions, therapists and relatives feel often stunned and helpless when confronted with suicidality resulting in interruption of therapies, repeated presentations to emergency rooms and referrals to […]

Implementation of dialectical behavior therapy with suicidal and self-harming adolescents in a community clinic

The object of this research was to examine the feasibility and effectiveness of Dialectical Behavior Therapy (DBT) with suicidal and self-harming adolescents treated in a community clinic. A group of 24 adolescents at high risk for suicide were enrolled in 6 months of comprehensive DBT, provided by therapists and trainees at a county-run outpatient mental […]

Dialectical behavior therapy compared with enhanced usual care for adolescents with repeated suicidal and self-harming behavior: Outcomes over a one-year follow-up

OBJECTIVE: We conducted a 1-year prospective follow-up study of posttreatment clinical outcomes in adolescents with recent and repetitive self-harm who had been randomly allocated to receive 19 weeks of either dialectical behavior therapy adapted for adolescents (DBT-A) or enhanced usual care (EUC) at community child and adolescent psychiatric outpatient clinics. METHOD: Assessments of self-harm, suicidal […]

Dialectical behavior therapy for high suicide risk in individuals with borderline personality disorder: A randomized clinical trial and component analysis

OBJECTIVE: To evaluate the importance of the skills training component of DBT by comparing skills training plus case management (DBT-S), DBT individual therapy plus activities group (DBT-I), and standard DBT which includes skills training and individual therapy. DESIGN, SETTING, AND PARTICIPANTS: We performed a single-blind randomized clinical trial from April 24, 2004, through January 26, […]

Efficacy of dialectical behavior therapy for adolescents at high risk for suicide: A randomized clinical trial

Objective  To evaluate the efficacy of dialectical behavior therapy (DBT) compared with individual and group supportive therapy (IGST) for reducing suicide attempts, nonsuicidal self-injury, and overall self-harm among high-risk youths. Design, Setting, and Participants  This randomized clinical trial was conducted from January 1, 2012, through August 31, 2014, at 4 academic medical centers. A total of 173 […]

Long term effectiveness of dialectical behavior therapy versus enhanced usual care for adolescents with self-harming and suicidal behavior

BACKGROUND: Knowledge is lacking on the long-term outcomes of treatment for adolescents with repetitive suicidal and self-harming behavior. Furthermore, the pathways through which treatment effects may operate are poorly understood. Our aims were to investigate enduring treatment effects of dialectical behavior therapy adapted for adolescents (DBT-A) compared to enhanced usual care (EUC) through a prospective […]

The effectiveness of dialectical behavior therapy skills training group vs. cognitive therapy group on reducing depression and suicide attempts for borderline personality disorder in Taiwan

In this study the effectiveness of the condensed Dialectical Behavior Therapy Skills Training Group (DBTSTG) was compared to the Cognitive Therapy Group (CTG) in reducing depression and suicide reattempt and modifying emotion regulation strategies among those with borderline personality disorder (BPD). A total of 82 depressed BPD college students with a suicidal history within the […]

Developing adaptive treatment strategies to address suicidal risk in college students: A pilot sequential, multiple assignment, randomized trial (SMART)

This pilot study investigated the potential to utilize adaptive treatment strategies for treating moderate to severe suicidal risk among college students. This article will describe the unique study design and report on feasibility and acceptability findings. A 2-stage Sequential Multiple Assignment Randomized Trial (SMART) was conducted: In Stage 1, 62 suicidal college students were randomized […]

Efficacy of dialectical behavior therapy for adolescents at high risk for suicide: A randomized clinical trial.

Objective  To evaluate the efficacy of dialectical behavior therapy (DBT) compared with individual and group supportive therapy (IGST) for reducing suicide attempts, nonsuicidal self-injury, and overall self-harm among high-risk youths. Design, Setting, and Participants  This randomized clinical trial was conducted from January 1, 2012, through August 31, 2014, at 4 academic medical centers. A total of 173 […]