(PS12-92) Digitally Delivered, Short-term Dialectical Behavior Therapy Groups: An Examination of Usability and Engagement Among Patients with Borderline Personality Disorder

Digital platforms have gained traction as alternative methods to deliver mental healthcare in recent years given their potential to circumvent common barriers to care (e.g. cost, provider location, time). Telehealth adaptations may be particularly vital for populations with severe symptoms, such as emotion regulation difficulties and non-suicidal self-injury. These symptoms are widely considered trademarks of borderline personality disorder (BPD), which effects an estimated 1-6% of the U.S. population. Dialectical behavior therapy (DBT) is a well-supported intervention for BPD and related high-risk behaviors; however, this treatment is both time and cost-intensive for clients and clinicians. Many studies examining how to deliver DBT virtually focus on the perspectives of providers, and as such, there is a dearth of research examining whether basic demographic characteristics of populations with emotion regulation difficulties or who engage in self-injury are associated with dropout rates or treatment attendance in virtual DBT interventions. Thus, the current study examined the relationship between demographic characteristics (e.g., age, race, sexual orientation) and treatment attendance, usability, and acceptance of a seven-week virtual DBT skills group. Participants were 55 adults recruited from the community who met at least 4 criteria for BPD and had engaged in recurrent self-injury within the previous year (89.1% assigned female at birth; M_age = 26.07, SD = 10.75; 70.9% White; 45.5% identified as straight). Participants were randomized into either DBT-Emotion Regulation or DBT-Interpersonal Effectiveness; demographic characteristics were collected at baseline and participants completed a telehealth usability and acceptability questionnaire at the end of treatment. Results from a series of ANOVAS indicate younger participants were significantly less likely to withdraw from treatment (F(1,53) = 4.30, p = .043), and therefore treatment completers were younger (M = 24.61, SD = 9.45) compared to participants that did not complete treatment (M = 31.91, SD = 13.91). Furthermore, treatment usability scores did significantly vary as a function of race, (F(1,34) = 5.52,  p = .026), such that on average, non-white participants reported the telehealth platform to be more favorable in terms of usability compared to white participants, evidenced by a large effect size (h_p² = 0.14). We found no significant association between sexual orientation and any treatment engagement outcomes examined, and none of the demographic characteristic were significantly correlated with the number of sessions attended. These findings are consistent with past literature indicating telehealth delivered treatments may be favorable to non-white populations, and significantly expands this research by including individuals who engage in self-harm. Future research should continue to explore if and how demographics characteristics influence engagement in telehealth treatments, particularly for individuals at risk for engaging in self-injurious behaviors. Limitations and clinical implications will be discussed.