Can trainees effectively deliver dialectical behavior therapy for individuals with borderline personality disorder? Outcomes from a training clinic
Abstract
OBJECTIVE: The aim of the current study was to evaluate the effectiveness of a 6-month course of comprehensive dialectical behavior therapy (DBT) provided in a training clinic with doctoral students as therapists and assessors. METHOD: = 29.52 [SD = 9.64]) are reported. Reliable change indices and clinical significance were calculated for measures. Finally, our results were benchmarked against a "gold standard" randomized clinical trial (RCT; McMain et al., 2009). RESULTS: Analyses with both the full sample and the treatment completers indicate significant reductions in mental health symptomatology that were reliable, clinically and statistically significant, and comparable in effect size to the benchmarked RCT. CONCLUSION: This DBT training clinic produced good outcomes, comparable to that of a large RCT. Results have implications for who can provide DBT treatment, as well as improving access to DBT in community settings where training clinics may be located.
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In a study at the Dialectical Behavior Therapy Clinic at Rutgers University, therapist trainees delivering DBT achieved similar outcomes to a benchmarked gold-standard RCT.
“Indeed, in a study conducted at the Dialectical Behavior Therapy Clinic at Rutgers University (DBT-RU), it was found that therapist trainees delivering DBT could achieve similar outcomes to a benchmarked gold-standard RCT (58).”
From The use of CAMS and DBT to effectively treat patients who are suicidal (2024) · cites this paper as [58]
Cites
Diagnostic and Statistical Manual of Mental Disorders
American Psychiatric Association (2013) · doi:10.1176/appi.books.9780890425596 · Cited by 116,369 · see citing works
Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision (DSM-IV-TR)
American Psychiatric Association (2000) · doi:10.1176/appi.books.9780890423349 · Cited by 11,069 · see citing works
Gratz, K. L., & Roemer, L. (2004) · Journal of Psychopathology and Behavioral Assessment · doi:10.1023/b:joba.0000007455.08539.94 · Cited by 8,942 · see citing works
The brief symptom inventory: an introductory report.
Derogatis, L. R., & Melisaratos, N. (1983) · Psychological Medicine · doi:10.1017/s0033291700048017 · Cited by 6,650 · see citing works
Comparison of Beck Depression Inventories -IA and -II in psychiatric outpatients
Beck, A. T., Steer, R. A., Ball, R., & Ranieri, W. F. (1996) · Journal of Personality Assessment · doi:10.1207/s15327752jpa6703_13 · Cited by 5,965 · see citing works
The Work and Social Adjustment Scale: a simple measure of impairment in functioning
Mundt, J. C., Marks, I. M., Shear, M. K., & Greist, J. M. (2002) · British Journal of Psychiatry · doi:10.1192/bjp.180.5.461 · Cited by 2,515 · see citing works
Nock, M. K., Holmberg, E. B., Photos, V. I., & Michel, B. D. (2007) · Psychological Assessment · doi:10.1037/1040-3590.19.3.309 · Cited by 1,352 · see citing works
Lobbestael, J., Leurgans, M., & Arntz, A. (2011) · Clinical Psychology & Psychotherapy · doi:10.1002/cpp.693 · Cited by 1,124 · see citing works
McHugh, R. K., & Barlow, D. H. (2010) · American Psychologist · doi:10.1037/a0018121 · Cited by 909 · see citing works
Bohus, M., Kleindienst, N., Limberger, M. F., Stieglitz, R., Domsalla, M., Chapman, A. L., Steil, R., Philipsen, A., & Wolf‐Arehult, M. (2008) · Psychopathology · doi:10.1159/000173701 · Cited by 738 · see citing works
McMain, S. F., Links, P. S., Gnam, W. H., Guimond, T., Cardish, R. J., Korman, L., & Streiner, D. L. (2009) · American Journal of Psychiatry · doi:10.1176/appi.ajp.2009.09010039 · Cited by 729 · see citing works
Efficacy of dialectical behavior therapy in women veterans with borderline personality disorder
Koons, C. R., Robins, C. J., Lindsey Tweed, J., Lynch, T. R., Gonzalez, A. M., Morse, J. Q., Bishop, G. K., Butterfield, M. I., & Bastian, L. A. (2001) · Behavior Therapy · doi:10.1016/s0005-7894(01)80009-5 · Cited by 700 · see citing works
Trull, T. J., Jahng, S., Tomko, R. L., Wood, P. K., & Sher, K. J. (2010) · Journal of Personality Disorders · doi:10.1521/pedi.2010.24.4.412 · Cited by 651 · see citing works
Cognitive-behavioral treatment of borderline personality disorder
Brasfield, C. R. (1994) · Behaviour Research and Therapy · doi:10.1016/0005-7967(94)90183-x · Cited by 517 · see citing works
Linehan, M. M., Comtois, K. A., Brown, M. Z., Heard, H. L., & Wagner, A. (2006) · Psychological Assessment · doi:10.1037/1040-3590.18.3.303 · Cited by 486 · see citing works
Kliem, S., Kröger, C., & Kosfelder, J. (2010) · Journal of Consulting and Clinical Psychology · doi:10.1037/a0021015 · Cited by 474 · see citing works
Zanarini, M. C. (2003) · Journal of Personality Disorders · doi:10.1521/pedi.17.3.233.22147 · Cited by 413 · see citing works
Wise, E. A. (2004) · Journal of Personality Assessment · doi:10.1207/s15327752jpa8201_10 · Cited by 399 · see citing works
Borderline Personality Disorder and Suicidality
Oldham, J. M. (2006) · American Journal of Psychiatry · doi:10.1176/appi.ajp.163.1.20 · Cited by 374 · see citing works
Meta-Analysis and Systematic Review Assessing the Efficacy of Dialectical Behavior Therapy (DBT)
Panos, P. T., Jackson, J. W., Hasan, O., & Panos, A. (2014) · Research on Social Work Practice · doi:10.1177/1049731513503047 · Cited by 299 · see citing works
The dialectical behavior therapy ways of coping checklist: development and psychometric properties
Neacsiu, A. D., Rizvi, S. L., Vitaliano, P. P., Lynch, T. R., & Linehan, M. M. (2010) · Journal of Clinical Psychology · doi:10.1002/jclp.20685 · Cited by 200 · see citing works
The Encyclopedia of clinical psychology
(2015) · Choice Reviews Online · doi:10.5860/choice.190789 · Cited by 189 · see citing works
Carter, G. L., Willcox, C. H., Lewin, T. J., Conrad, A. M., & Bendit, N. (2010) · Australian & New Zealand Journal of Psychiatry · doi:10.3109/00048670903393621 · Cited by 180 · see citing works
The stress of patient suicidal behavior during clinical training: Incidence, impact, and recovery.
Kleespies, P. M., Penk, W. E., & Forsyth, J. P. (1993) · Professional Psychology Research and Practice · doi:10.1037/0735-7028.24.3.293 · Cited by 130 · see citing works
Rizvi, S. L., Hughes, C. D., & Thomas, M. C. (2016) · Psychological Services · doi:10.1037/ser0000100 · Cited by 96 · see citing works
Graduate Training and the Treatment of Suicidal Clients: The Students' Perspective
Dexter‐Mazza, E. T., & Freeman, K. A. (2003) · Suicide and Life-Threatening Behavior · doi:10.1521/suli.33.2.211.22769 · Cited by 92 · see citing works
Zanarini, M. C., Frankenburg, F. R., Reich, D. B., Conkey, L. C., & Fitzmaurice, G. M. (2015) · Psychiatric Services · doi:10.1176/appi.ps.201400055 · Cited by 77 · see citing works
Psychotherapy training: Suggestions for core ingredients and future research.
Boswell, J. F., & Castonguay, L. G. (2007) · Psychotherapy · doi:10.1037/0033-3204.44.4.378 · Cited by 57 · see citing works
Borkovec, T. D. (2004) · Clinical Psychology Science and Practice · doi:10.1093/clipsy/bph073 · Cited by 48 · see citing works
Cukrowicz, K. C., White, B. A., Reitzel, L. R., Burns, A. B., Driscoll, K. A., Kemper, T. S., & Joiner, T. E. (2005) · Professional Psychology Research and Practice · doi:10.1037/0735-7028.36.3.330 · Cited by 48 · see citing works
Chapman, A. L., Derbidge, C. M., Cooney, E., Hong, P. Y., & Linehan, M. M. (2009) · Journal of Personality Disorders · doi:10.1521/pedi.2009.23.2.122 · Cited by 47 · see citing works
Callahan, J. L., Gustafson, S. A., Misner, J. B., Paprocki, C. M., Sauer, E. M., Saules, K. K., Schwartz, J. L., Swift, J. K., Whiteside, D. M., Wierda, K., et al. (2014) · Training and Education in Professional Psychology · doi:10.1037/tep0000047 · Cited by 29 · see citing works
Borkovec, T. D. (2004) · Clinical Psychology Science and Practice · doi:10.1093/clipsy.bph073 · Cited by 29 · see citing works
Treatment Failure in Dialectical Behavior Therapy
Rizvi, S. L. (2010) · Cognitive and Behavioral Practice · doi:10.1016/j.cbpra.2010.05.003 · Cited by 17 · see citing works
Implementation of DBT-Informed Therapy at a Rural University Training Clinic: A Case Study
Kerr, P. L., Muehlenkamp, J. J., & Larsen, M. A. (2008) · Cognitive and Behavioral Practice · doi:10.1016/j.cbpra.2008.09.003 · Cited by 10 · see citing works
Implementing a dialectical behavior therapy training program for graduate students.
Lungu, A., Gonzalez, M. R., & Linehan, M. M. (2012) · Behavior Therapy · Cited by 7 · see citing works
Treatment for borderline personality disorder: perils of the randomized controlled trial paradigm
Bender, D. (2011) · Acta Psychiatrica Scandinavica · doi:10.1111/j.1600-0447.2010.01661.x · Cited by 3 · see citing works
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Woodbridge, J., Townsend, M. L., Reis, S. L., Singh, S., & Grenyer, B. F. S. (2021) · Australian & New Zealand Journal of Psychiatry · doi:10.1177/00048674211046893 · Cited by 69 · see citing works
Southward, M. W., & Cheavens, J. S. (2018) · Clinical Psychological Science · doi:10.1177/2167702618769560 · Cited by 68 · see citing works
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Zalewski, M., Maliken, A. C., Lengua, L. J., Martin, C. G., Roos, L. E., & Everett, Y. (2020) · Clinical Psychology Science and Practice · doi:10.1111/cpsp.12363 · Cited by 32 · see citing works
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Edwards, E. R., Sissoko, D. R. G., Abrams, D., Samost, D., Gamma, S. L., & Geraci, J. C. (2020) · Psychology Public Policy and Law · doi:10.1037/law0000236 · Cited by 23 · see citing works
Rizvi, S. L., & Fitzpatrick, S. (2020) · Suicide and Life-Threatening Behavior · doi:10.1111/sltb.12691 · Cited by 23 · see citing works
Ledden, S., Rains, L. S., Schlief, M., Barnett, P., Ching, B. C. F., Hallam, B., Günak, M. M., Steare, T., Parker, J., Labovitch, S., et al. (2021) · BMC Psychiatry · doi:10.1186/s12888-022-04171-z · Cited by 17 · see citing works
Brown, T. A., Cusack, A., Anderson, L. K., Reilly, E. E., Berner, L. A., Wierenga, C. E., Lavender, J. M., & Kaye, W. H. (2019) · Cognitive Therapy and Research · doi:10.1007/s10608-019-10006-1 · Cited by 23 · see citing works
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Southward, M. W., Howard, K. P., & Cheavens, J. S. (2023) · doi:10.1016/j.brat.2023.104288 · Cited by 20 · see citing works
Woodbridge, J., Reis, S. L., Townsend, M. L., Hobby, L., & Grenyer, B. F. S. (2021) · PLoS ONE · doi:10.1371/journal.pone.0255055 · Cited by 20 · see citing works
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Noll, L. K., Lewis, J., Zalewski, M., Martin, C. G., Roos, L. E., Musser, N., & Reinhardt, K. M. (2019) · Training and Education in Professional Psychology · doi:10.1037/tep0000252 · Cited by 12 · see citing works
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Miga, E. M., LoTempio, E. R., Michonski, J. D., & Hunter, D. A. (2020) · Elsevier eBooks · doi:10.1016/b978-0-12-816384-9.00004-x · Cited by 1 · see citing works
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Dixon–Gordon, K. L., Conkey, L. C., & Woods, S. E. (2020) · Cambridge University Press eBooks · doi:10.1017/9781108333931.086
Guimarães, L. D. C., Simões, J. N., & Santos, L. A. (2021)
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Rosenthal, M. Z., Wyatt, K. P., & McMahon, K. (2020) · Cambridge University Press eBooks · doi:10.1017/9781108333931.071
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Washburn, J. J. (2021) · Comprehensive Clinical Psychology · doi:10.1016/b978-0-12-818697-8.00099-6
Woodbridge, J., Townsend, M. L., Reis, S. L., & Grenyer, B. F. S. (2022) · Research Square · doi:10.21203/rs.3.rs-1699762/v1
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Fitzpatrick, S., & Rizvi, S. L. (2022) · Springer eBooks · doi:10.1007/978-3-031-11677-3_8
Ledden, S., Rains, L. S., Schlief, M., Barnett, P., Ching, B. C. F., Hallam, B., Günak, M. M., Steare, T., Parker, J., Labovitch, S., et al. (2022) · Figshare · doi:10.6084/m9.figshare.20962345
Woodbridge, J., Townsend, M. L., Reis, S. L., & Grenyer, B. F. S. (2024) · Figshare · doi:10.6084/m9.figshare.26583207
Zeligman, M. R., Hasan, S., Rickman, L., & Hatchwell, E. (2026) · Counseling Outcome Research and Evaluation · doi:10.1080/21501378.2026.2707924
Fergusson, L., Hepworth, C., Jolley, S., & Lawlor, C. (2026) · Journal of Behavior Therapy and Experimental Psychiatry · doi:10.1016/j.jbtep.2026.102127
Stock, M., Proctor, K., Lea, J., & Camp, J. (2026) · The Cognitive Behaviour Therapist · doi:10.1017/s1754470x26100774
Maxwell, C. A., Holland, K. E., Young, L., Chen, E. Y., Olino, T. M., & Kendall, P. C. (2026) · Journal of Clinical Psychology · doi:10.1002/jclp.70195
- Authors
- Rizvi, S. L., Hughes, C. D., Hittman, A. D., & Vieira Oliveira, P.
- Affiliations
- Rutgers, The State University of New Jersey (US)
- Rutgers University
- Corresponding author
- Rizvi, Shireen L.
- Venue
- Journal of Clinical Psychology
- Publisher
- Wiley
- Published
- 2017-02-21
- Volume
- 73
- Issue
- 12
- Pages
- 1599-1611
- ISSN
- 0021-9762 (ISSN-L)
- 1097-4679
- OpenAlex
- W2589693427
- Cited by
- 50
- References
- 36
- Citations by year
- 2026: 4 · 2025: 1 · 2024: 7 · 2023: 4 · 2022: 10 · 2021: 7 · 2020: 8 · 2019: 6 · 2018: 3
- FWCI
- 5.77
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Journal of Clinical Psychology (publishedVersion)
- PubMed (publishedVersion)
- Funders
- American Foundation for Suicide Prevention (SRG‐0‐126‐11)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Personality Disorders and Psychopathology
- Social Sciences › Psychology › Clinical Psychology › Psychotherapy Techniques and Applications
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Keywords
- dialectical behavior therapy, borderline personality disorder, trainee therapists, doctoral students, treatment effectiveness, reliable change index, clinical significance, access to psychotherapy, community mental health services
- MeSH terms
- Suicide Prevention, Adult, Behavior Therapy, Borderline Personality Disorder, Female, Humans, Male, Outcome Assessment, Health Care, Benchmarking, Young Adult
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