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Treatment - CBT

(PS3-62) A Meta-analytic Examination of the Effectiveness of Dialectical Behavior Therapy in Reducing Self-directed Violence and Suicidality in Usual Care

Friday, November 15, 2024
11:30 AM – 12:30 PM EST
Location: Franklin Hall, Level 4, Marriott Downtown
Abstract Text: Dialectical behavior therapy (DBT), an outpatient intervention, has shown efficacy in reducing suicidality. Less is known about its effectiveness when delivered in usual care (UC) settings, where the resource-intensive nature of the program often results in modifications during implementation. A systematic search yielded 83 empirical evaluations of DBT that include at least one of three suicidality-related outcomes: (a) self-directed violence (SDV), (b) crisis service use (CSU), and (c) suicidal ideation (SI). Using meta-analysis, the current study estimated pooled effect of DBT in UC, compared effects in UC and non-UC settings, and examined predictors of differential outcomes. DBT demonstrated a large effect (g=.81) in reducing SDV and a medium effect in reducing SI (g=.68). The estimated effect on CSU (g=.60) was non-significant after adjusting for publication bias (g=.29). DBT was more effective than control conditions in reducing SDV (g=.50), even after adjusting for publication bias (g=1.63). No differences between UC and non-UC effects were detected. In uncontrolled studies, positive associations emerged between therapist training and SDV reduction, adherence-reporting and CSU reduction, and outpatient and SI reduction. Results support DBT’s effectiveness in reducing suicidality-related outcomes in UC but should be interpreted with caution given the heterogeneity among studies.
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