Predicting dropout in outpatient dialectical behavior therapy with patients with borderline personality disorder receiving psychiatric disability
Open accessAbstract
BACKGROUND: Rates of treatment dropout in outpatient Dialectical Behavior Therapy (DBT) in the community can be as high as 24 % to 58 %, making dropout a great concern. The primary purpose of this article was to examine predictors of dropout from DBT in a community mental health setting. METHODS: Participants were 56 consumers with borderline personality disorder (BPD) who were psychiatrically disabled participating in a larger feasibility trial of Dialectical Behavior Therapy- Accepting the Challenges of Exiting the System. The following variables were examined to see whether they predicted dropout in DBT: age, education level, baseline level of distress, baseline level of non-acceptance of emotional responses, and skills module in which a consumer started DBT skills group. These variables were chosen based on known predictors of dropout in consumers with BPD and in DBT, as well as an interest in what naturally occurring variables might impact dropout. RESULTS: The dropout rate in this sample was 51.8 %. Results of the logistic regression show that younger age, higher levels of baseline distress, and a higher level of baseline non-acceptance of emotional responses were significantly associated with dropout. The DBT skills module in which an individual started group did not predict dropout. CONCLUSIONS: The implications of these findings are that knowledge of consumer age and pretreatment levels of distress and non-acceptance of emotional responses can impact providers' choice of commitment and treatment strategies to reduce dropout. Future research should examine these strategies, as well as the impact of predictor variables on outcome and reasons for dropout.
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The dropout rates observed in the sample were at the lower end of rates reported in other studies.
“The dropout rates we observed in our sample were at the lower end of rates reported in other studies (28, 29).”
From Radical Acceptance of Reality: Putting DBT®-A Skill Groups Online During the COVID-19 Pandemic: A Qualitative Study (2022) · cites this paper as [28]
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Wenn Leitlinien enden und Gefährdung beginnt
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Walton, C. J., Skerven, K., White, A., & Davine, T. P. (2026) · Behavioural and Cognitive Psychotherapy · doi:10.1017/s1352465826101337
- Authors
- Landes, S. J., Chalker, S. A., & Comtois, K. A.
- Affiliations
- University of Washington (US)
- Corresponding author
- Landes, Sara J.
- Venue
- Borderline Personality Disorder and Emotion Dysregulation
- Published
- 2016-09-01
- Volume
- 3
- Issue
- 1
- Pages
- 9-9
- ISSN
- 2051-6673 (ISSN-L)
- PMC
- PMC5007727
- OpenAlex
- W2503727958
- Cited by
- 48
- References
- 49
- Citations by year
- 2026: 5 · 2025: 5 · 2024: 3 · 2023: 4 · 2022: 9 · 2021: 4 · 2020: 4 · 2019: 5 · 2018: 6 · 2017: 3
- FWCI
- 6.25
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- cc-by
- Locations
- Borderline Personality Disorder and Emotion Dysregulation (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- Funders
- National Institute of Mental Health (5R34MH079923-02, 1F32MH084788-01A1)
- 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
- treatment discontinuation, dialectical behavior therapy, borderline personality disorder, psychiatric disability, community mental health services, predictors of dropout, age, outpatient psychotherapy
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