Meta-Analysis and Systematic Review Assessing the Efficacy of Dialectical Behavior Therapy (DBT)

Res Soc Work Pract. 2014 Mar;24(2):213-223. doi: 10.1177/1049731513503047. Epub 2013 Sep 19.


Objective: The objective was to quantitatively and qualitatively examine the efficacy of DBT (e.g., decreasing life-threatening suicidal and parasuicidal acts, attrition, and depression) explicitly with borderline personality disorder (BPD) and using conservative assumptions and criteria, across treatment providers and settings.

Method: Five randomized controlled trials (RCTs) were identified in a systematic search that examined the efficacy of DBT in reducing suicide attempts, parasuicidal behavior, attrition during treatment, or symptoms of depression, in adult patients with BPD.

Results: Combining effect measures for suicide and parasuicidal behavior (five studies total) revealed a net benefit in favor of DBT (pooled Hedges' g -0.622). DBT was only marginally better than treatment as usual (TAU) in reducing attrition during treatment in five RCTs (pooled risk difference -0.168). DBT was not significantly different from TAU in reducing depression symptoms in three RCTs (pooled Hedges' g -0.896).

Discussion: DBT demonstrates efficacy in stabilizing and controlling self-destructive behavior and improving patient compliance.

Keywords: TAU; adults; attrition; borderline personality disorder (BPD); dialectical behavioral therapy (DBT); evidence-based practice; field of practice; mental health; meta-analysis; methodological article; outcome study; population; randomized controlled trial (RCT); suicide prevention.