Dialectical Behavior Therapy Interventions Helpful In Preventing Suicide Attempts

New findings published in JAMA Psychiatry have shown that a variety of dialectical behavioral therapy (DBT) interventions have be found helpful in preventing suicide attempts and nonsuicidal self-injury acts when reviewed in a randomized clinical trial of women who were dealing with a borderline personality disorder (BPD).

Women who are suffering with BPD oftentimes have a heightened fear of abandonment, frequent mood swings, self-harming behaviors and chronic feelings of emptiness that may lead to suicidal tendencies.

Previous research has shown that DBT, a multicomponent therapy for individuals at high risk for suicide and with similar or multiple severe mental disorders, can particularly benefit from this kind of help as it works to regulate irrational thoughts and stabilize emotions.

The study notes that the components of DBT includes the following, courtesy of a news release: "individual therapy, group skills training, between-session telephone coaching and a therapist consultation team. The importance of DBT skills training compared with the other components has not been studied directly, according to study background."

Researcher from the University of Washington, Seattle, set out to evaluate the importance of skills training by comparing three treatment groups: skills training plus case management to replace individual therapy (DBT-S), DBT individual therapy plus activities group to replace skills training so therapists instead focused on the skills patients already had (DBT-I); and standard DBT, which included skills training and individual therapy. The DBT Suicide Risk Assessment and Management protocol was used with all patients in the study.

For the study, they worked with 99 women, all around the age of 30, who dealt with BPD and who had had at least two suicide attempts, an NSSI act or suicide attempt in the eight weeks before screening, and a suicide attempt in the past year. Of the women, 33 were randomized to each of the three treatment groups: standard DBT, DBT-S or DBT-I.

Findings revealed that all three of the treatments made a significant difference in these women's lives, reducing the severity of intentional self-injury, the number of suicide attempts and overall reason for living.

"Contrary to our expectations, standard DBT was not superior to either comparison condition for any suicide-related outcome, and no significant differences were detected between DBT-S and DBT-I," study authors concluded. "Thus, all three versions of DBT were comparably effective at reducing suicidality among individuals at high risk for suicide. ... More research is needed before strong conclusions can be made as to what is the best DBT intervention for highly suicidal individuals."