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Lee S, Arora IS. The effectiveness, acceptability, and sustainability of a 4-week DBT-informed group therapy in increasing psychological resilience for college students with mental health issues. J Clin Psychol 2023. [PMID: 36920177 DOI: 10.1002/jclp.23509] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2022] [Revised: 01/08/2023] [Accepted: 03/01/2023] [Indexed: 03/16/2023]
Abstract
OBJECTIVE An adapted, time-limited dialectical behavior therapy (DBT) skills training group therapy can prove to be an evidence-based treatment that can easily fit the needs, demands, and limitations of University Counseling Centers to serve college students with mental disorders. The present naturalistic study investigated the effectiveness, acceptability, and sustainability of a 4-week DBT-informed group therapy in enhancing psychological resilience. METHODS Participants included 59 college students with heterogeneous mental health concerns. They attended weekly 1.5-hr DBT-informed, resilience-building group therapy for 4 weeks. Psychological resilience, mindfulness, emotional dysregulation, and overall distress were assessed at pretreatment and posttreatment, as well as at 1- and 3-month follow-ups. RESULTS Findings showed increased psychological resilience among the participants at posttreatment and follow-ups, and provided preliminary evidence for the role of mindfulness as an important contributor to enhancing psychological resilience even after controlling for risk factors, treatment dosage, pregroup psychological resilience, and changes in emotion dysregulation and overall distress. CONCLUSION A 4-week DBT-informed skills training group therapy can be utilized as a time-efficient, cost-effective, well-accepted preventative treatment with the potential longitudinal impact to boost psychological resilience for college students with mental health issues.
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Affiliation(s)
- Soonhee Lee
- Counseling Center, University of Maryland, Baltimore County (UMBC), Baltimore, Maryland, USA
| | - Ishita Sunita Arora
- Department of Human Services Psychology, University of Maryland, Baltimore County (UMBC), Baltimore, Maryland, USA
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Darrow SM, Maliken AC, Piatigorsky A, Stuart BK, Todd N, Yaeger AM, Londahl-Shaller EA. Effectiveness of the family-based model of dialectical behavior therapy for both suicidal adolescents and young adults in an academic medical center. J Clin Psychol 2022; 78:1422-1435. [PMID: 35080775 DOI: 10.1002/jclp.23317] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2021] [Revised: 11/21/2021] [Accepted: 01/06/2022] [Indexed: 11/09/2022]
Abstract
BACKGROUND Dialectical behavior therapy (DBT) is an effective approach to decreasing suicidal behaviors; the adapted, family-based model for adolescents (through 18 years old; DBT-A) also demonstrates efficacy. Data on higher dropout rates based on age, initial research on DBT with young adults in the community, and the theory that underlies DBT suggest that adaptations may also be appropriate for young adults. This study examines the effectiveness of DBT-A, presents preliminary data on delivering DBT-A to young adults (ages 18-26), and compares clinical characteristics, service utilization, and outcomes to adolescent clients (ages 13-17) to guide clinical considerations and future research on implementing DBT-A. METHODS Data were collected from a DBT-A clinic and included results from semi-structured diagnostic interviews, chart review, and scores on self-report measures. The Suicide Ideation Questionnaire and Beck Depression Inventory (BDI), given at program entry, after completion of one rotation through the skills modules, and at graduation, were used to evaluate outcomes. Outcomes were benchmarked against prior DBT-A trials. Adolescents' and young adults' clinical characteristics, service utilization, and outcomes were compared. RESULTS The effect size observed was smaller than in efficacy trials. Few differences were observed between teens (n = 87) and young adults (n = 45). Young adults were more likely to have participated in intensive services before DBT-A. They participated in fewer family sessions and graduated in fewer months compared to teens. CONCLUSION This study supports the use of the family-based model of DBT for suicidal teens and young adults although future research is needed to improve the effectiveness of this model when implemented in real-world settings.
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Affiliation(s)
- Sabrina M Darrow
- Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, San Francisco, California, USA
| | - Ashley C Maliken
- Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, San Francisco, California, USA
| | - Auran Piatigorsky
- Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, San Francisco, California, USA
| | - Barbara K Stuart
- Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, San Francisco, California, USA
| | - Natalie Todd
- Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, San Francisco, California, USA
| | - Alison M Yaeger
- McLean Hospital & Department of Psychiatry, Harvard Medical School, Cambridge, Massachusetts, USA
| | - Esme A Londahl-Shaller
- Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, San Francisco, California, USA
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Tobon JI, Zipursky RB, Streiner DL, Colvin E, Bahl N, Ouimet AJ, Burckell L, Jeffs L, Bieling PJ. Motivational Enhancement as a Pretreatment to a Transdiagnostic Intervention for Emerging Adults with Emotion Dysregulation: A Pilot Randomized Controlled Trial. JOURNAL OF THE CANADIAN ACADEMY OF CHILD AND ADOLESCENT PSYCHIATRY = JOURNAL DE L'ACADEMIE CANADIENNE DE PSYCHIATRIE DE L'ENFANT ET DE L'ADOLESCENT 2020; 29:132-148. [PMID: 32774397 PMCID: PMC7391867] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 07/02/2019] [Accepted: 02/07/2020] [Indexed: 06/11/2023]
Abstract
OBJECTIVE New approaches are needed to help the large number of emerging adults (EA) presenting with early-stage mental health problems. The goal of this pilot study was to carry out a randomized controlled trial to investigate whether motivational enhancement therapy (MET) improved the treatment effects of a 12-week psychological intervention, Dialectical Behaviour Therapy Skills Training (DBT-ST), for EA presenting in the early stages of mental health difficulties. Participants were recruited from the Youth Wellness Centre at St. Joseph's Healthcare Hamilton and McMaster University's Student Wellness Centre in Hamilton, Canada. METHODS Seventy-five participants were randomized to receive MET followed by DBT-ST or to DBT-ST alone. We assessed psychological distress, emotion dysregulation, and depression and anxiety symptoms as outcomes. RESULTS We found that both treatment groups had significant reductions in emotional dysregulation, psychological distress, depression, and anxiety at post-treatment and at the three-month follow-up. Participants assigned to MET pre-treatment experienced greater improvement in psychological distress at the end of treatment. CONCLUSION This pilot study provides preliminary evidence of the potential augmentation of DBT-ST using MET in a real-world setting. Future studies should examine whether MET uniquely augments DBT-ST through the use of a comparable pre-treatment control group.
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Affiliation(s)
- Juliana I Tobon
- Youth Wellness Centre, St. Joseph's Healthcare Hamilton, Hamilton, Ontario
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, St. Joseph's Healthcare Hamilton, Hamilton, Ontario
| | - Robert B Zipursky
- Youth Wellness Centre, St. Joseph's Healthcare Hamilton, Hamilton, Ontario
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, St. Joseph's Healthcare Hamilton, Hamilton, Ontario
- Department of Psychiatry, University of Toronto, Toronto, Ontario
- Centre for Addiction and Mental Health, Toronto, Ontario
| | - David L Streiner
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, St. Joseph's Healthcare Hamilton, Hamilton, Ontario
- Department of Psychiatry, University of Toronto, Toronto, Ontario
- Centre for Addiction and Mental Health, Toronto, Ontario
| | - Eamon Colvin
- School of Psychology, University of Ottawa, Ottawa, Ontario
| | - Nancy Bahl
- School of Psychology, University of Ottawa, Ottawa, Ontario
| | | | - Lisa Burckell
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, St. Joseph's Healthcare Hamilton, Hamilton, Ontario
- Borderline Personality Disorder Service, St. Joseph's Healthcare Hamilton, Hamilton, Ontario
| | - Lisa Jeffs
- Youth Wellness Centre, St. Joseph's Healthcare Hamilton, Hamilton, Ontario
| | - Peter J Bieling
- Youth Wellness Centre, St. Joseph's Healthcare Hamilton, Hamilton, Ontario
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, St. Joseph's Healthcare Hamilton, Hamilton, Ontario
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Chugani CD, Fuhrman B, Abebe KZ, Talis J, Miller E, Coulter RWS. Wellness and resilience for college and beyond: protocol for a quasi-experimental pilot study investigating a dialectical behaviour therapy skill-infused college course. BMJ Open 2020; 10:e036833. [PMID: 32565475 PMCID: PMC7311003 DOI: 10.1136/bmjopen-2020-036833] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
INTRODUCTION College students' mental health problems and suicidal behaviour are serious, persistent and prevalent public health issues. With the need for mental health support greatly exceeding the availability of on-campus treatment, a recent trend on college campuses is to offer courses designed to teach students strategies for developing mental health or resilience. While these courses are exceptionally popular among students, a paucity of research investigates the health outcomes associated with participation. The purpose of this study is to investigate the acceptability, appropriateness, feasibility and preliminary effectiveness of a college course grounded in skills from dialectical behaviour therapy (DBT) titled, 'Wellness and Resilience for College and Beyond'. METHODS AND ANALYSIS During the spring and fall 2020 semesters, the course will be offered on five campuses in Southwestern Pennsylvania and West Virginia. The course consists of 15 weekly 2.5-hour lessons, weekly homework assignments and a final examination with content drawn from DBT, acceptance and commitment therapy and positive psychology. Undergraduate students aged 18-24 will self-select into the course and control subjects receiving 'university as usual' will be recruited to serve as a comparison group. Students who receive the course will complete measures of course acceptability, appropriateness and feasibility. All study participants will complete measures of adaptive coping skills use, emotion dysregulation and suicidality. ETHICS AND DISSEMINATION All of the study procedures were approved as an exempt protocol for evaluation of educational curricula by the University of Pittsburgh Human Research Protections Office (HRPO); the study was approved as a research study by the institutional review board (IRB) of the fifth study site. The University of Pittsburgh HRPO served as the IRB of record for all except one study site, which required standard IRB review. Data from this study will be disseminated via conference presentations, peer-reviewed publications and via our online stakeholder learning collaborative. TRIAL REGISTRATION NUMBER NCT04338256.
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Affiliation(s)
- Carla D Chugani
- School of Medicine, Department of Pediatrics, University of Pittsburgh, Pittsburgh, Pennsylvania, United States
| | - Barbara Fuhrman
- School of Medicine, Department of Pediatrics, University of Pittsburgh, Pittsburgh, Pennsylvania, United States
| | - Kaleab Z Abebe
- School of Medicine, Division of General Internal Medicine, University of Pittsburgh, Pittsburgh, PA, United States
| | - Janine Talis
- School of Medicine, Department of Pediatrics, University of Pittsburgh, Pittsburgh, Pennsylvania, United States
| | - Elizabeth Miller
- School of Medicine, Department of Pediatrics, University of Pittsburgh, Pittsburgh, Pennsylvania, United States
| | - Robert W S Coulter
- School of Public Health, University of Pittsburgh, Pittsburgh, PA, United States
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Üstündağ-Budak AM, Özeke-Kocabaş E, Ivanoff A. Dialectical Behaviour Therapy Skills Training to Improve Turkish College Students’ Psychological Well-Being: A Pilot Feasibility Study. INTERNATIONAL JOURNAL FOR THE ADVANCEMENT OF COUNSELLING 2019. [DOI: 10.1007/s10447-019-09379-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Toms G, Williams L, Rycroft-Malone J, Swales M, Feigenbaum J. The development and theoretical application of an implementation framework for dialectical behaviour therapy: a critical literature review. Borderline Personal Disord Emot Dysregul 2019; 6:2. [PMID: 30805193 PMCID: PMC6373034 DOI: 10.1186/s40479-019-0102-7] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/07/2018] [Accepted: 02/05/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Dialectical behaviour therapy (DBT) is a third wave behaviour therapy combining behaviour based components with elements of mindfulness. Although DBT effectiveness has been explored, relatively little attention has been given to its implementation. Frameworks are often the basis for gathering information about implementation and can also direct how the implementation of an intervention is conducted. Using existing implementation frameworks, this critical literature review scoped the DBT implementation literature to develop and refine a bespoke DBT implementation framework. METHOD AND RESULTS The initial framework was developed by consolidating existing implementation frameworks and published guidance on DBT implementation. The critical literature review retrieved papers from Medline, CINAHL, PsycInfo, PubMed, and the reference lists of included papers. Framework elements were used as codes which were applied to the literature and guided the synthesis. Findings from the synthesis refined the framework.The critical literature review retrieved 60 papers but only 14 of these explicitly focused on implementation. The DBT implementation framework captured all the execution barriers and facilitators described in the literature. However, the evidence synthesis led to a more parsimonious framework as some elements (e.g., research and published guidance) were seldom discussed in DBT implementation. CONCLUSION To our knowledge this is the first published review exploring DBT implementation. The literature synthesis suggests some tentative recommendations which warrant further exploration. For instance, if DBT implementation is not pre-planned, having someone in the organisation who champions DBT can be advantageous. However, as the literature is limited and has methodological limitations, further prospective studies of DBT implementation are needed.
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Affiliation(s)
- Gill Toms
- Gill Toms, School of Healthcare Sciences, Bangor University, Fron Heulog, Bangor, Gwynedd LL57 2EF UK
| | - Lynne Williams
- Gill Toms, School of Healthcare Sciences, Bangor University, Fron Heulog, Bangor, Gwynedd LL57 2EF UK
| | - Jo Rycroft-Malone
- Gill Toms, School of Healthcare Sciences, Bangor University, Fron Heulog, Bangor, Gwynedd LL57 2EF UK
| | - Michaela Swales
- North Wales Clinical Psychology Programme, School of Psychology, Brigantia Building, Bangor University, Bangor, Gwynedd LL57 2DG UK
| | - Janet Feigenbaum
- Research Department of Clinical, Education and Health Psychology, University College London, Gower Street, London, WC1E 6BT UK
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Lin TJ, Ko HC, Wu JYW, Oei TP, Lane HY, Chen CH. The Effectiveness of Dialectical Behavior Therapy Skills Training Group vs. Cognitive Therapy Group on Reducing Depression and Suicide Attempts for Borderline Personality Disorder in Taiwan. Arch Suicide Res 2019. [PMID: 29528807 DOI: 10.1080/13811118.2018.1436104] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
In this study the effectiveness of the condensed Dialectical Behavior Therapy Skills Training Group (DBTSTG) was compared to the Cognitive Therapy Group (CTG) in reducing depression and suicide reattempt and modifying emotion regulation strategies among those with borderline personality disorder (BPD). A total of 82 depressed BPD college students with a suicidal history within the past 6-months were randomly allocated to DBTSTG or CTG. Both groups had similar reductions in suicide reattempts and depression after the intervention and 6-month follow-ups. However, the CTG showed improvements in cognitive errors, but the DBTSTG revealed increases in acceptance and decreases in suppression scores. Both groups were effective in decreasing depression and suicide reattempt in BPD college students, probably through increasing adaptive antecedent-focused or response-focused strategies of emotion regulation, respectively.
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Cannon JL, Umstead LK. Applying Dialectical Behavior Therapy to Self-Harm in College-Age Men: A Case Study. JOURNAL OF COLLEGE COUNSELING 2018. [DOI: 10.1002/jocc.12089] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Affiliation(s)
- Jennifer L. Cannon
- Department of Counseling and Educational Development; University of North Carolina at Greensboro
| | - Lindsey K. Umstead
- Department of Counseling and Educational Development; University of North Carolina at Greensboro
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Lee S, Mason M. Effectiveness of Brief DBT-informed Group Therapy on Psychological Resilience: A Preliminary Naturalistic Study. JOURNAL OF COLLEGE STUDENT PSYCHOTHERAPY 2018. [DOI: 10.1080/87568225.2018.1425646] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Soonhee Lee
- University of Maryland, Baltimore County (UMBC), Baltimore, Maryland, USA
| | - Mark Mason
- University of Delaware, Newark, Delaware, USA
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Pistorello J, Coyle TN, Locey NS, Walloch JC. Treating Suicidality in College Counseling Centers: A Response to Polychronis. JOURNAL OF COLLEGE STUDENT PSYCHOTHERAPY 2016; 31:30-42. [PMID: 28752155 PMCID: PMC5526647 DOI: 10.1080/87568225.2016.1251829] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
This is a commentary on the article by Paul D. Polychronis, "Changes Across Three Editions of The Suicidal Patient: Clinical and Legal Standards of Care: Relevance to Counseling Centers," published in this issue of the Journal of College Student Psychotherapy.
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Affiliation(s)
| | - Trevor N. Coyle
- Department of Psychology, University of Washington, Seattle, Washington, USA
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