DBT Skills Group for Suicide Risk
Recruiting in Palo Alto (17 mi)
+4 other locations
Age: 18+
Sex: Any
Travel: May Be Covered
Time Reimbursement: Varies
Trial Phase: Academic
Recruiting
Sponsor: VA Office of Research and Development
Disqualifiers: Cognitive impairment, English language, others
No Placebo Group
Approved in 2 Jurisdictions
Trial Summary
What is the purpose of this trial?This trial tests if adding a group therapy that teaches emotion management skills (DBT-SG) to usual care can reduce suicide attempts among Veterans. The therapy aims to help Veterans better control their emotions, which may lower their risk of suicide. Dialectical Behavior Therapy (DBT) is a well-supported intervention for reducing suicide attempts in individuals with emotion dysregulation.
Do I have to stop taking my current medications for the trial?
The trial protocol does not specify whether you need to stop taking your current medications. It seems likely that you can continue your usual treatment, as the trial involves DBT Skills Group in addition to VHA treatment-as-usual.
What data supports the effectiveness of the treatment DBT Skills Group for reducing suicide risk?
Research shows that Dialectical Behavior Therapy (DBT) skills training can help reduce suicidal thoughts, especially when patients use the skills effectively. Studies also suggest that DBT skills training can improve mental health in people with various mental disorders and reduce the need for psychiatric inpatient care.
12345Is DBT Skills Group safe for humans?
DBT Skills Group has been used safely in various studies for people with conditions like borderline personality disorder and self-harm tendencies. It includes safety planning measures and strategies to manage risks, which suggests it is generally safe for humans.
16789What makes the DBT Skills Group treatment unique for reducing suicide risk?
The DBT Skills Group treatment is unique because it focuses on teaching practical skills to manage emotions and reduce suicidal thoughts, specifically targeting emotion dysregulation, which is a key risk factor for suicide. Unlike other treatments, it is a component of the broader Dialectical Behavior Therapy, making it more focused and potentially more accessible for those at high risk.
12678Eligibility Criteria
This trial is for Veterans with current suicidal thoughts or past suicide attempts, who can attend group sessions and are eligible for VHA care. They must have had at least two suicide attempts, one recently, struggle with managing emotions (score of 110+ on DERS), and be able to communicate in English. Those with significant cognitive issues or plans to move within 18 months cannot join.Inclusion Criteria
History of two or more suicide attempts in lifetime, with one in past 6 months, on Columbia-Suicide Severity Rating Scale (C-SSRS)
I can attend group sessions.
Emotion dysregulation (score 110 on DERS)
+4 more
Exclusion Criteria
Significant cognitive impairment (score < 28 on modified Telephone Interview for Cognitive Status (mTICS))
Plan to move away or be unavailable in the next 18 months
I cannot read or communicate in English.
Trial Timeline
Screening
Participants are screened for eligibility to participate in the trial
2-4 weeks
Treatment
Participants receive Dialectical Behavior Therapy Skills Group (DBT-SG) in addition to VHA treatment as usual, consisting of 24 weekly sessions
24 weeks
24 visits (in-person)
Follow-up
Participants are monitored for safety and effectiveness after treatment, including assessment of suicide risk and coping skills
18 months
Participant Groups
The study is testing if a DBT Skills Group (DBT-SG) alongside usual VHA treatments helps reduce suicide attempts more than just the usual treatment alone. It's a randomized controlled trial where participants are randomly placed into either the test group receiving DBT-SG plus standard care or a control group getting only standard care.
2Treatment groups
Experimental Treatment
Active Control
Group I: DBT-SG plus VHA treatment as usualExperimental Treatment2 Interventions
Dialectical Behavior Therapy Skills Group (DBT-SG) in addition to VHA treatment as usual. Group is 24 weekly sessions teaching skills in emotion regulation, distress tolerance, interpersonal effectiveness, and mindfulness.
Group II: VHA treatment as usualActive Control1 Intervention
VHA treatment as usual for Veterans at risk for suicide attempt
DBT Skills Group is already approved in United States, European Union for the following indications:
🇺🇸 Approved in United States as DBT Skills Group for:
- Suicidal ideation
- Emotion dysregulation
- Borderline personality disorder
🇪🇺 Approved in European Union as DBT Skills Group for:
- Emotion dysregulation
- Borderline personality disorder
- Suicidal behavior
Find a Clinic Near You
Research Locations NearbySelect from list below to view details:
Louis Stokes VA Medical Center, Cleveland, OHCleveland, OH
VA San Diego Healthcare System, San Diego, CASan Diego, CA
New Mexico VA Health Care System, Albuquerque, NMAlbuquerque, NM
James A. Haley Veterans' Hospital, Tampa, FLTampa, FL
More Trial Locations
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Who Is Running the Clinical Trial?
VA Office of Research and DevelopmentLead Sponsor
References
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.
Feasibility and Efficacy of Intensive Dialectical Behavior Therapy Skills Training in An Outpatient Setting for A Group of Patients with Extensive Care Needs - A Transdiagnostic Approach. [2023]Dialectical behavior therapy (DBT) is a treatment originally developed för chronically suicidal adults. It is common to adapt it by using one specific component, the DBT skills training (DBT-ST) and apply it in a group therapy setting for a variety of mental disorders. The primary aim of the study was to explore whether patients with extended care needs would report improved mental health after participating in an intensive form of DBT-ST. The secondary aim was to explore whether the use of psychiatric inpatient care for the group would decrease.
Dialectical behavior therapy-based skills training for family members of suicide attempters. [2022]This pilot study evaluated the effect of Family Connections (FC), a Dialectical Behavior Therapy-based manualized skills training program, for family members of suicide attempters. The DBT-based skills training program aims to enhance the knowledge of wide range research based aspects of suicidal behavior and treatment recommendations. Furthermore it includes skills training for interpersonal relationships and also offers family members an opportunity to share their experiences. Thirteen participants completed the 9-week program with pre- and post self-report questionnaires. The results showed significant reduction in burden, improved psychic health and an increase in well-being regarding the relation with the patient. These results provide support for the need and importance of a DBT-based skills training program addressed specifically to family members of suicide attempters.
Effectiveness of dialectical behavior therapy skills training group for adults with borderline personality disorder. [2021]This study evaluated the effectiveness of the Dialectical Behavior Therapy Skills Training Group (DBT-ST) component of DBT.
Suicidal Ideation and Skill Use During In-patient Dialectical Behavior Therapy for Borderline Personality Disorder. A Diary Card Study. [2020]Associations between suicidal ideation and skill use were investigated during in-patient dialectical behavior therapy (DBT) for borderline personality disorder (BPD). Participants were N = 44 patients with BPD undergoing a 5-week in-patient DBT program in a psychiatric clinic. They filled in a diary card each treatment day resulting in 1,334 skill use ratings and 1,364 suicidal ideation ratings. Treatment days were categorized as days with successful skill use (using skills and perceiving them as effective), days with no skill use, days with unsuccessful skill use (using skills but perceiving them as ineffective). Multilevel models were performed to account for the nested data structure. The results showed that suicidal ideation improved more for patients who applied skills successfully more often during treatment (p < 0.05). Moreover, suicidal ideation was lower on treatment days with successful skill use compared to treatment days with no skill use and compared to treatment days with unsuccessful skill use (p < 0.05). When treatment days with no skill use were compared to treatment days with unsuccessful skill use, suicidal ideation was higher on treatment days with unsuccessful skill use (p < 0.05). To conclude, using skills successfully on as many treatment days as possible is associated with lower suicidal ideation.
[Dialectical Behaviour Therapy for adolescents (DBT-A)--a pilot study on the therapy of suicidal, parasuicidal, and self-injurious behaviour in female patients with a borderline disorder]. [2022]In Germany suicide ranks as the second leading cause of death in adolescents. Risk factors for suicide are impulsive and self-injurious behaviour, depression, and conduct disorder. The main hypothesis of our study is that Dialectical Behavior Therapy (DBT) for adolescents is an effective method of treatment for these patients.
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).
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.
Dialectical behavior therapy-skills system for cognitively challenged individuals with self-harm: a Swedish pilot study. [2023]Background: Dialectical behavior therapy (DBT) is an evidence-based treatment for self-harm and emotion regulation difficulties. A modified version, DBT-Skills System (DBT-SS), has been developed in the USA for individuals with cognitive difficulties. The present study is a pilot study, testing the DBT-SS in a Swedish context. Methods: Six participants were treated with individual therapy and group skills training for 48 sessions each. A case series design was used to follow individual development over time. The primary outcome measure was reduction in challenging behaviors. Secondary outcomes were level of functioning in daily life, hospital admissions, and resilience and vulnerabilities in different risk domains. Data was analyzed using time-series diagrams. Effect sizes of changes were calculated using Cohen's d. Results: Challenging behaviors decreased over time and participants' global level of functioning increased. There was a reduction in number of hospital admissions over time. As for resilience and vulnerabilities, participants' overall level of risk in various areas remained unchanged or decreased after treatment. Conclusions: The results indicate that DBT-SS might be a promising treatment for cognitively challenged individuals with emotion regulation difficulties and challenging behaviors in a Swedish context. The study provides suggestions for a future randomized controlled trial. Supplemental data for this article is available online at here.