Dialectical Behavior Therapy for Suicide Risk in Psychosis
Recruiting in Palo Alto (17 mi)
Age: 18+
Sex: Any
Travel: May Be Covered
Time Reimbursement: Varies
Trial Phase: Academic
Recruiting
Sponsor: University of Maryland, Baltimore
Disqualifiers: Intellectual disability, Traumatic brain injury, Deafness
No Placebo Group
Approved in 3 Jurisdictions
Trial Summary
What is the purpose of this trial?This trial aims to help people with psychotic disorders manage their emotions better, as they are at high risk of suicide. By improving emotional control, the treatment hopes to reduce suicidal thoughts and behaviors in this group.
Will I have to stop taking my current medications?
The trial information does not specify whether you need to stop taking your current medications. It's best to discuss this with the trial coordinators or your doctor.
What data supports the effectiveness of the treatment Dialectical Behavior Therapy Skills Training for suicide risk in psychosis?
Research shows that Dialectical Behavior Therapy (DBT) can help reduce suicide attempts and improve emotional regulation in patients with psychosis, as seen in a VA Health Care System program where patients showed improvements in suicidality and emotion regulation. Additionally, DBT has been effective in reducing self-harm behaviors in borderline personality disorder, suggesting its potential benefits for other mental health conditions.
12345Is Dialectical Behavior Therapy (DBT) safe for humans?
Dialectical Behavior Therapy (DBT) has been shown to be safe for humans, as it is an evidence-based treatment that helps reduce self-harm behaviors and suicidal actions, particularly in individuals with borderline personality disorder. It includes safety planning measures and risk management strategies to ensure the well-being of participants during treatment.
15678How is Dialectical Behavior Therapy Skills Training different from other treatments for suicide risk in psychosis?
Dialectical Behavior Therapy Skills Training is unique because it focuses on teaching practical skills to manage emotions and reduce suicidal thoughts, specifically tailored for individuals with psychosis, which is not commonly addressed by other treatments. It combines elements of cognitive-behavioral therapy with mindfulness and emotional regulation techniques, making it a comprehensive approach for those with complex mental health needs.
14579Eligibility Criteria
This trial is for adults with a psychosis spectrum disorder confirmed by an interview, who are already receiving outpatient mental health services. They must be able to read at a 6th-grade level and have a heightened risk of suicide as indicated by specific questionnaire scores. People with intellectual disabilities, traumatic brain injury, or deafness cannot participate.Inclusion Criteria
I am 18 years old or older.
I have been actively participating in outpatient mental health services.
6+ grade equivalent reading level as assessed by the Wide Range Achievement Test 4 (WRAT-4)
+2 more
Exclusion Criteria
Chart diagnosis of intellectual disability (DSM5 317, 318), traumatic brain injury, or deafness.
Trial Timeline
Screening
Participants are screened for eligibility to participate in the trial
2-4 weeks
Treatment
Participants receive Dialectical Behavior Therapy - Skill Training or Treatment As Usual
16 weeks
Follow-up
Participants are monitored for safety and effectiveness after treatment
4 weeks
Participant Groups
The study tests Dialectical Behavior Therapy Skills Training aimed at managing emotional turmoil in people with psychotic disorders to reduce their suicide risk. It includes advanced data collection methods like Ecological Momentary Assessment for real-time tracking of emotions and behaviors.
2Treatment groups
Experimental Treatment
Active Control
Group I: Dialectical Behavior Therapy - Skill TrainingExperimental Treatment1 Intervention
Group II: Treatment As UsualActive Control1 Intervention
Dialectical Behavior Therapy Skills Training is already approved in United States, European Union, Canada for the following indications:
🇺🇸 Approved in United States as DBT Skills Training for:
- Borderline Personality Disorder
- Emotion Dysregulation
- Suicidal Ideation
🇪🇺 Approved in European Union as Dialectical Behavior Therapy for:
- Borderline Personality Disorder
- Emotion Dysregulation
- Post-Traumatic Stress Disorder
🇨🇦 Approved in Canada as DBT Skills Training for:
- Borderline Personality Disorder
- Emotion Dysregulation
- Eating Disorders
Find a Clinic Near You
Research Locations NearbySelect from list below to view details:
University of MarylandBaltimore, MD
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Who Is Running the Clinical Trial?
University of Maryland, BaltimoreLead Sponsor
References
Teaching Dialectical Behavior Therapy to Psychiatry Residents: The Columbia Psychiatry Residency DBT Curriculum. [2022]Dialectical behavior therapy (DBT) is an evidence-based psychosocial treatment with efficacy in reducing self-harm behaviors in borderline personality disorder (BPD). This study describes and evaluates a clinical curriculum to teach DBT to psychiatry residents, developed at a large urban university hospital. The curriculum objectives are to (1) have psychiatry residents achieve basic understanding of DBT theory and clinical skill, (2) increase residents' ability and confidence in treating self-harm behaviors (both suicidal behavior and non-suicidal self-injury), and (3) enhance residents' willingness to treat individuals with BPD.
Dialectical behavior therapy group skills training in a community mental health setting: a pilot study. [2021]Effective and affordable therapies are needed for treating people with severe and persistent mental illness in a community mental health setting. In this pilot study, we evaluated the effectiveness of a modified dialectical behavior therapy (DBT) protocol for improving symptoms and functioning in a cohort of persons with severe and persistent mental illness. We provided six months of weekly DBT skills training in a group setting. Depression symptoms decreased significantly after treatment. There was a wide range of number of sessions attended, with a minority of the participants completing the full course of treatment. Increased attendance was correlated with improvements in depression symptoms, overall symptoms, quality of life, and community functioning. The study findings suggest that the group skills training component of DBT can be successfully implemented in a community mental health center and that further research to determine its efficacy in comparison to other treatments is warranted.
Predictors of Adoption and Reach Following Dialectical Behavior Therapy Intensive Training™. [2020]Dialectical behavior therapy (DBT) is an evidence-based treatment for borderline personality disorder. The DBT Intensive Training™ is widely used to train community clinicians to deliver DBT, but little is known about its effectiveness. This study prospectively evaluated predictors of adoption and reach of DBT among 52 community teams (212 clinicians) after DBT Intensive Training™. Pre-post training questionnaires were completed by trainees and a follow-up survey by team leaders approximately 8 months later. Overall, 75% of teams adopted all DBT modes and delivered DBT to an average of 118 clients. Lower training and program needs, fewer bachelor's-level clinicians, and greater prior DBT experience predicted adoption of more DBT modes. More prior DBT experience, smaller team size, more negative team functioning, and staff with lower job satisfaction, growth, efficacy, and influence predicted greater DBT reach. DBT Intensive Training™ appears effective in promoting DBT adoption and reach in routine clinical practice settings.
Description of a Dialectical Behavior Therapy program in a Veterans Affairs Health Care System. [2022]A comprehensive Dialectical Behavior Therapy (DBT) program was created within a VA Health Care System for patients with recent psychiatric hospitalization, suicidality and/or significant emotion dysregulation. The program was notable for being one of a relatively small number of comprehensive DBT programs in the VA system, and for including patients with psychosis and psychotic disorder, with a majority of patients (58%) having a documented history of psychosis or endorsing psychotic symptoms in assessments. We describe the process of creating this program at a VA medical center and present preliminary program evaluation data. All patients completed assessments of suicidality (C-SSRS), emotion dysregulation (DERS), skills use and dysfunctional coping (DBT-WCCL), borderline symptomatology (BSL-23), and depression (PHQ-9) at program entry and subsequently every 6-8 weeks through program completion. Suicide attempts and hospitalizations were also tracked. Twelve patients completed multiple (up to six) assessment timepoints, allowing for evaluation of change during treatment. Patients demonstrated improvements on most measures and no hospitalizations or suicide attempts during active treatment, and the subsample with psychosis showed average improvements on every outcome measure. Eleven of 12 patients completed a full six-month rotation.
A randomized trial of brief dialectical behaviour therapy skills training in suicidal patients suffering from borderline disorder. [2022]Evidence-based therapies for borderline personality disorder (BPD) are lengthy and scarce. Data on brief interventions are limited, and their role in the treatment of BPD is unclear. Our aim was therefore to evaluate the clinical effectiveness of brief dialectical behaviour therapy (DBT) skills training as an adjunctive intervention for high suicide risk in patients with BPD.
Dialectical Behavior Therapy Is Effective for the Treatment of Suicidal Behavior: A Meta-Analysis. [2019]Dialectical Behavior Therapy (DBT) prioritizes suicidal behavior and other self-directed violence as the primary treatment targets, and has been demonstrated to reduce self-directed violence in clinical trials. This paper synthesizes findings from controlled trials that assessed self-directed violence and suicidality, including suicide attempts, non-suicidal self-injury (NSSI), suicidal ideation, and accessing psychiatric crisis services. Eighteen controlled trials of DBT were identified. Random effects meta-analyses demonstrated that DBT reduced self-directed violence (d = -.324, 95% CI = -.471 to -.176), and reduced frequency of psychiatric crisis services (d = -.379, 95% CI = -.581 to -.176). There was not a significant pooled effect of DBT with regard to suicidal ideation (d = -.229, 95% CI = -.473 to .016). Our findings may reflect the prioritization of behavior over thoughts within DBT, and offer implications for clinical practice and future research concerning the implementation of DBT for acute suicidality.
Risk management in dialectical behavior therapy: Treating life-threatening behaviors as problems to be solved. [2022]Dialectical behavior therapy (DBT) is an empirically supported behavioral treatment for individuals with borderline personality disorder who frequently exhibit life-threatening behavior, such as suicide attempts, nonsuicidal self-injury urges and actions, and suicidal ideation. We provide an overview of the theoretical framework by which DBT conceptualizes these life-threatening behaviors and the principles by which safety planning measures are implemented and maintained throughout treatment. The importance of orienting clients to treatment and obtaining their commitment to decrease life-threatening behavior is reviewed. Relevant strategies associated with risk management and assessment, such as the diary card, chain analysis, solution analysis, phone coaching, and consultation team, are described. The overview concludes with a case example to illustrate the application of these techniques with a DBT client with a long-standing history of engaging in life-threatening behaviors. (PsycInfo Database Record (c) 2022 APA, all rights reserved).
Factors predicting early dropout from dialectical behaviour therapy in individuals with borderline personality disorder. [2019]Dialectical behaviour therapy skills training (DBT-ST) has proven effective to treat individuals with borderline personality disorder (BPD). However, therapy still faces the problem of early dropout. The aim of the present study is to examine which factors are associated with early dropout from DBT-ST in a sample of subjects with BPD.
Feasibility and preliminary efficacy of dialectical behaviour therapy skills groups for Veterans with suicidal ideation: pilot. [2022]Veterans are at high risk for suicide; emotion dysregulation may confer additional risk. Dialectical behaviour therapy (DBT) is a well-supported intervention for suicide attempt reduction in individuals with emotion dysregulation, but is complex and multi-component. The skills group component of DBT (DBT-SG) has been associated with reduced suicidal ideation and emotion dysregulation. DBT-SG for Veterans at risk for suicide has not been studied.