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The effectiveness of dialectical behaviour therapy in routine public mental health settings: An Australian controlled trial
Abstract
Randomised controlled studies in research environments have demonstrated dialectical behaviour therapy (DBT) to be more efficacious than treatment as usual in reducing suicidal behaviour in patients with borderline personality disorder (BPD). Limited evidence exists for the effectiveness of DBT in the treatment of BPD within routine clinical settings. This study examines the clinical and cost effectiveness of providing DBT over treatment as usual in a routine Australian public mental health service. Forty-three adult patients with BPD were provided with outpatient DBT for six months with patient outcomes compared to those obtained from patients in a wait list group receiving treatment as usual (TAU) from the same service. After six months of treatment the DBT group showed significantly greater reductions in suicidal/non-suicidal self-injury, emergency department visits, psychiatric admissions and bed days. Self-report measures were administered to a reduced sample of patients. With this group, DBT patients demonstrated significantly improved depression, anxiety and general symptom severity scores compared to TAU at six months. Average treatment costs were significantly lower for those patients in DBT than those receiving TAU. Therapists who received intensive DBT training were shown to produce significantly greater improvements in patients' suicidal and non-suicidal self-injury than therapists who received only 4 day basic training. Further clinical improvements were achieved in patients offered an additional six months of DBT. This study demonstrates that providing DBT to patients within routine public mental health settings can be both clinically effective and cost effective.
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“However, it has not been evaluated outside a research setting.”
From Emotion regulation group therapy for deliberate self-harm: A multi-site evaluation in routine care using an uncontrolled open trial design (2017) · cites this paper as [15]
In the citing paper
“The optimal duration of DBT has been understudied, but some findings indicate that brief formats (e.g. 6-month, 16-week) are effective in treating ED (e.g. Koons et al., 2001; Stanley et al., 2007; Pasieczny & Connor, 2011; Neacsiu et al., 2014; Delparte et al., 2019).”
From Feasibility, Acceptability and Preliminary Efficacy of Dialectical Behavior Therapy for Autistic Adults without Intellectual Disability: A Mixed Methods Study (2022) · cites this paper as Pasieczny & Connor, 2011
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Bamelis, L. L. M., Evers, S. M. A. A., Spinhoven, P., & Arntz, A. (2014) · American Journal of Psychiatry · doi:10.1176/appi.ajp.2013.12040518 · Cited by 497
“, personality disorders [33] and mood disorders [34]).”
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Metadata
- Authors
- Pasieczny, N., & Connor, J.
- Affiliations
- Queensland Health (AU)
- The University of Queensland (AU)
- Corresponding author
- Pasieczny, Nathan
- Venue
- Behaviour Research and Therapy
- Publisher
- Elsevier BV
- Published
- 2011-01
- Volume
- 49
- Issue
- 1
- Pages
- 4-10
- ISSN
- 0005-7967 (ISSN-L)
- OpenAlex
- W2090458554
- Cited by
- 116
- References
- 49
- Citations by year
- 2026: 9 · 2025: 1 · 2024: 3 · 2023: 3 · 2022: 8 · 2021: 10 · 2020: 12 · 2019: 4 · 2018: 13 · 2017: 9 · 2016: 7 · 2015: 7 · 2014: 7 · 2013: 10 · 2012: 12
- FWCI
- 8.06
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Behaviour Research and Therapy (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Queensland Health
- Newcastle University
- Department of Biotechnology, Ministry of Science and Technology, India
- University of Queensland
- Topics
- Social Sciences › Psychology › Clinical Psychology › Personality Disorders and Psychopathology
- Social Sciences › Psychology › Clinical Psychology › Psychotherapy Techniques and Applications
- Health Sciences › Medicine › Psychiatry and Mental health › Bipolar Disorder and Treatment
- Keywords
- dialectical behavior therapy, borderline personality disorder, suicidal behavior, non-suicidal self-injury, public mental health services, outpatient care, cost-effectiveness, therapist training, waitlist control, anxiety and depression, emergency department visits, psychiatric hospital admissions
- MeSH terms
- Adolescent, Adult, Australia, Mental Disorders, Borderline Personality Disorder, Female, Humans, Male, Mental Health Services, Middle Aged, Psychiatric Status Rating Scales, Severity of Illness Index, Cognitive Behavioral Therapy, Self-Injurious Behavior, Health Care Costs, Self Report
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