Dialectical Behavior Therapy Is Effective for the Treatment of Suicidal Behavior: A Meta-Analysis

Behav Ther. 2019 Jan;50(1):60-72. doi: 10.1016/j.beth.2018.03.009. Epub 2018 Mar 22.


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.

Keywords: dialectical behavior therapy (DBT); meta-analysis; self-directed violence; suicide; suididal ideation.

Publication types

  • Meta-Analysis
  • Review

MeSH terms

  • Adolescent
  • Clinical Trials as Topic / methods
  • Dialectical Behavior Therapy / methods*
  • Female
  • Humans
  • Male
  • Self-Injurious Behavior / diagnosis
  • Self-Injurious Behavior / prevention & control
  • Self-Injurious Behavior / psychology
  • Suicidal Ideation*
  • Suicide, Attempted / prevention & control*
  • Suicide, Attempted / psychology*
  • Treatment Outcome