https://doi.org/10.4081/ripppo.2020.461
DBT-informed treatment in a partial hospital and intensive outpatient program: the role of step-down care
Published: September 7, 2020
Abstract Views: 1380
PDF: 780
HTML: 78
HTML: 78
Publisher's note
All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.
All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.
Authors
Few studies to date have examined Partial Hospital (PH) and Intensive Outpatient (IOP) programs that utilize a Dialectical Behavior Therapy (DBT)-informed model. Preliminary findings suggest that DBT-informed PH programs are effective in reducing clinical symptoms; however, less is known about IOP programs as well as step-down care models. The present study utilized clinically relevant outcome indices and included a heterogeneous clinical sample. Specifically, the present study assessed pre-post data to examine changes in symptoms of depression, anxiety, hopelessness, and overall degree of suffering from intake to discharge in DBT-informed PH and IOP programs as well as a step-down condition (PH to IOP). Participants included 205 adults (ages M = 35.28, SD = 12.49). The sample was predominantly female (N = 139, 67.8%) and Caucasian (N = 181, 88.3%). The sample was divided into three distinct groups: PH program patients, PH to IOP program step-down patients, and IOP patients. Findings indicated significant symptom reduction from intake to discharge for all three conditions. There were no significant differences in mean change scores in symptom reduction between the three groups. Severity of depression symptoms at intake predicted program placement. However, type of program did not predict significant changes in symptoms from intake to discharge. This DBT-informed PH and IOP program was successful at reducing various psychiatric symptoms in the sample. Clinicians might consider the advantages of placing patients with higher symptoms of depression into PH programs with the intention of transitioning to step-down care through IOP programs that utilize DBT.
Antonsen, B. T., Klungsøyr, O., Kamps, A., Hummelen, B., Johansen, M. S., Pedersen, G., … Wilberg, T. (2014). Step-down versus outpatient psychotherapeutic treatment for personality disorders: 6-year follow-up of the Ullevål personality project. BMC Psychiatry, 14. https://doi.org/10.1186/1471-244X-14-119.
DOI: https://doi.org/10.1186/1471-244X-14-119
Beck, A. T., & Steer, R. A. (1988). BHS, Beck Hopelessness Scale: Manual. San Antonio, TX: Psychological corporation.
Ben-Porath, D. D., & Koons, C. R. (2005). Telephone coaching in dialectical behavior therapy: A decision-tree model for managing inter-session contact with clients. Cognitive and Behavioral Practice, 12(4), 448-460.
DOI: https://doi.org/10.1016/S1077-7229(05)80072-0
Bouvard, M., Charles, S., Guerin, J., Aimard, G., & Cottraux, J. (1992). Study of Beck's hopelessness scale. Validation and factor analysis. L'Encephale, 18(3), 237-240.
Chapman, A. (2019). Borderline personality disorder and emotion dysregulation. Development & Psychopathology, 31(3), 1143-1156. doi:10.1017/S0954579419000658.
DOI: https://doi.org/10.1017/S0954579419000658
Chapman, A. (2019). Phone Coaching in Dialectical Behavior Therapy. New York: Guilford Press.
Eisner, L., Eddie, D., Harley, R., Jacobo, M., Nierenberg, A. A., & Deckersbach, T. (2017). Dialectical behavior therapy group skills training for bipolar disorder. Behavior Therapy, 48(4), 557–566. https://doi-org.jproxy.lib.ecu.edu/10.1016/j.beth.2016.12.006.
Federici, A., & Wisniewski, L. (2013). An intensive DBT program for patients with multidiagnostic eating disorder presentations: A case series analysis. International Journal of Eating Disorders, 46(4), 322–331. https://doi org.jproxy.lib.ecu.edu/10.1002/eat.22112.
Harned, M. S., Chapman, A. L., Dexter-Mazza, E. T., Murray, A., Comtois, K. A., & Linehan, M. M. (2008). Treating co-occurring Axis I disorders in recurrently suicidal women with borderline personality disorder: A 2-year randomized trial of dialectical behavior therapy versus community treatment by experts. Journal of Consulting and Clinical Psychology, 76(6), 1068–1075. https://doi-org.liblink.uncw.edu/10.1037/a0014044.
Harned, M. S., Wilks, C. R., Schmidt, S. C., & Coyle, T. N. (2018). Improving functional outcomes in women with borderline personality disorder and PTSD by changing PTSD severity and post-traumatic cognitions. Behavior Research and Therapy, 103, 53–61. https://doi-org.jproxy.lib.ecu.edu/10.1016/j.brat.2018.02.002.
Jeon, S. W., Han, C., Ko, Y.-H., Yoon, S., Pae, C.-U., Choi, J., Zimmerman, M. (2017). A Korean validation study of the Clinically Useful Anxiety Outcome Scale: Comorbidity and differentiation of anxiety and depressive disorders. PLoS ONE, 12(6).
DOI: https://doi.org/10.1371/journal.pone.0179247
Kliem, S., Kröger, C., & Kosfelder, J. (2010). Dialectical behavior therapy for borderline personality disorder: a meta-analysis using mixed-effects modeling. Journal of Consulting and Clinical Psychology, 78(6), 936.
DOI: https://doi.org/10.1037/a0021015
Koerner, K. (2012). Guides to individualized evidence-based treatment. Doing dialectical behavior therapy: A practical guide. New York, NY, US: Guilford Press.
Kröger, C., Harbeck, S., Armbrust, M., & Kliem, S. (2013). Effectiveness, response, and dropout of dialectical behavior therapy for borderline personality disorder in an inpatient setting. Behaviour Research and Therapy, 51(8), 411–416. https://doi. org.jproxy.lib.ecu.edu/10.1016/j.brat.2013.04.008.
Lenz, A. S., & Del Conte, G. (2018). Efficacy of dialectical behavior therapy for adolescents in a partial hospitalization program. Journal of Counseling & Development, 96(1), 15-26.
DOI: https://doi.org/10.1002/jcad.12174
Linehan, M. (1993). Cognitive-behavioral treatment of borderline personality disorder. New York, NY: Guilford Press.
Linehan, M. (2014). DBT Skills Training Manual, Second Edition. New York: Guilford Press.
Linehan, M. M., & Chen, E. Y. (2005). Dialectical behavior therapy for eating disorders. In Encyclopedia of cognitive behavior therapy (pp. 168-171). Springer, Boston, MA.
DOI: https://doi.org/10.1007/0-306-48581-8_50
Linehan, M. M., & Wilks, C. R. (2015). The course and evolution of dialectical behavior therapy. American Journal of Psychotherapy, 69(2), 97-110.
DOI: https://doi.org/10.1176/appi.psychotherapy.2015.69.2.97
Lothes, J. E., Mochrie, K. D., & St. John, J. (2014). The effects of a DBT informed partial hospital program on: depression, anxiety, hopelessness, and degree of suffering. Journal of Psychology and Psychotherapy, 4, 144. doi: 10.4172/2161-0487.1000144.
DOI: https://doi.org/10.4172/2161-0487.1000144
Lothes, J. E., Mochrie, K. D., Quickel, E. J. W., & St. John, J. (2016). Evaluation of a Dialectical Behavior Therapy-informed partial hospital program: Outcome data and exploratory analyses. Research in Psychotherapy: Psychopathology, Process and Outcome. 19(2). doi: 10.4081/ripppo.2016.219.
DOI: https://doi.org/10.4081/ripppo.2016.219
Maffei, C., Cavicchioli, M., Movalli, M., Cavallaro, R., & Fossati, A. (2018). Dialectical behavior therapy skills training in alcohol dependence treatment: Findings based on an open trial. Substance Use & Misuse, 53(14), 2368–2385. https://doi-org.jproxy.lib.ecu.edu/10.1080/10826084.2018.1480035.000000000.
Neacsiu, A. D., Eberle, J. W., Kramer, R., Wiesmann, T., & Linehan, M. M. (2014). Dialectical behavior therapy skills for transdiagnostic emotion dysregulation: A pilot randomized controlled trial. Behavior Research and Therapy, 59, 40-51. doi:10.1016/j.brat.2014.05.005.
DOI: https://doi.org/10.1016/j.brat.2014.05.005
Neuhaus, E. C. (2006). Fixed values and a flexible partial hospital program model. President and Fellows of Harvard College, 14, 1-14. doi: 10.1080/10673220500519706.
DOI: https://doi.org/10.1080/10673220500519706
Öst, LG. (2008). Efficacy of the third wave of behavioral therapies: A systematic review and meta-analysis. Behaviour Research and Therapy, 46, 296-321.
DOI: https://doi.org/10.1016/j.brat.2007.12.005
Panos, P. T., Jackson, J. W., Hasan, O., & Panos, A. (2014). Meta-analysis and systematic review assessing the efficacy of dialectical behavior therapy (DBT). Research on Social Work Practice, 24(2), 213-223.
DOI: https://doi.org/10.1177/1049731513503047
Ritschel, L. A., Cheavens, J. S., & Nelson, J. (2012). Dialectical behavior therapy in an intensive outpatient program with a mixed‐diagnostic sample. Journal of Clinical Psychology, 68(3), 221-235. doi:10.1002/jclp.20863.
DOI: https://doi.org/10.1002/jclp.20863
Swenson, C. R. (2016). DBT® Principles in Action: Acceptance, Change, and Dialectics. Guilford Publications.
Stoffers, JM, Vollm, BA, Rucker, G., Timmer, A, Huband, N, Lieb, K (2012). Psychological therapies for borderline personality disorder. Cochrane Database Systematic Review, August 15;8:CD005652.
Tarrier, N., Taylor, K., & Gooding, P. (2008). Cognitive-behavioral interventions to reduce suicide behavior a systematic review and meta-analysis. Behavior Modification, 32, 77-108.
DOI: https://doi.org/10.1177/0145445507304728
Telch, C. F., Agras, W. S., & Linehan, M. M. (2001). Dialectical behavior therapy for binge eating disorder. Journal of Consulting and Clinical Psychology, 69(6), 1061.
DOI: https://doi.org/10.1037/0022-006X.69.6.1061
Valentine, S. E., Bankoff, S. M., Poulin, R. M., Reidler, E. B., & Pantalone, D. W. (2015). The use of dialectical behavior therapy skills training as stand‐alone treatment: A systematic review of the treatment outcome literature. Journal of Clinical Psychology, 71(1), 1-20. doi:10.1002/jclp.22114.
DOI: https://doi.org/10.1002/jclp.22114
West, S. G., & Thoemmes, F. (2010). Campbell’s and Rubin’s perspectives on causal inference. Psychological Methods, 15(1), 18-37. http://dx.doi.org/10.1037/a0015917.
DOI: https://doi.org/10.1037/a0015917
Zimmerman, M., Chelminski, I., McGlinchey, J. B., & Posternak, M. A. (2008). A clinically useful depression outcome scale. Comprehensive Psychiatry, 49(2), 131-140.
DOI: https://doi.org/10.1016/j.comppsych.2007.10.006
Zimmerman, M., Chelminski, I., Young, D., & Dalrymple, K. (2010). A clinically useful anxiety outcome scale. Journal of Clinical Psychiatry, 71(5), 534-42. doi: 10.4088/JCP.09m05264blu.
DOI: https://doi.org/10.4088/JCP.09m05264blu
Zimmerman, M., & McGlinchey, J.B. (2008) Patient acceptability of the use of scales to monitor the outcome of depression in clinical practice. Annals of Clinical Psychiatry, 20, 125-129.
DOI: https://doi.org/10.1080/10401230802177680
How to Cite
Mochrie, K. D., Lothes II, J., Guendner, E., & St. John, J. (2020). DBT-informed treatment in a partial hospital and intensive outpatient program: the role of step-down care. Research in Psychotherapy: Psychopathology, Process and Outcome, 23(2). https://doi.org/10.4081/ripppo.2020.461
PAGEPress has chosen to apply the Creative Commons Attribution NonCommercial 4.0 International License (CC BY-NC 4.0) to all manuscripts to be published.
Similar Articles
- Rachele Mariani, Alessandra De Coro, Study of a Short-term Treatment by Referential Activity Linguistic Measures , Research in Psychotherapy: Psychopathology, Process and Outcome: Vol. 16 No. 1 (2013)
- Paolo Migone, The influence of pharmaceutical companies , Research in Psychotherapy: Psychopathology, Process and Outcome: Vol. 20 No. 2 (2017)
- Giovanna Esposito, Anna Sara Cutolo, Raffaella Passeggia, Silvia Formentin, Miguel Mario Gonçalves, Tracking change in group interventions: a further adaptation of the innovative moments coding system for groups , Research in Psychotherapy: Psychopathology, Process and Outcome: Vol. 25 No. 3 (2022): SPECIAL ISSUE: "Group psychotherapy: between settled benchmarks and new horizons"
- Nicola Carone, Ilaria Maria Antonietta Benzi, Laura Muzi, Laura Antonia Lucia Parolin, Andrea Fontana, Problematic internet use in emerging adulthood to escape from maternal helicopter parenting: defensive functioning as a mediating mechanism , Research in Psychotherapy: Psychopathology, Process and Outcome: Vol. 26 No. 3 (2023)
- Alice Fiorini Bincoletto, Ludovica Zanini, Grazia Fernanda Spitoni, Vittorio Lingiardi, Negative and positive ageism in an Italian sample: how ageist beliefs relate to epistemic trust, psychological distress, and well-being , Research in Psychotherapy: Psychopathology, Process and Outcome: Vol. 26 No. 2 (2023)
- Benedetto Farina, Marianna Liotti, Claudio Imperatori, Lucia Tombolini, Elena Gasperini, Paola Mallozzi, Marianna Russo, Giorgia Simoncini Malucelli, Fabio Monticelli, Cooperation within the therapeutic relationship improves metacognitive functioning: preliminary findings , Research in Psychotherapy: Psychopathology, Process and Outcome: Vol. 26 No. 3 (2023)
- Laura Bonalume, Laura Corbelli, Mattia Ferro, Anna Lisa Mazzoleni, Maria Pia Roggero , Developing a prototype for relationship therapy psychoanalysis: an empirical study with the Psychotherapy Process Q-set , Research in Psychotherapy: Psychopathology, Process and Outcome: Vol. 26 No. 1 (2023)
- Annalisa Tanzilli, Antonello Colli, Laura Muzi, Vittorio Lingiardi, Clinician Emotional Response Toward Narcissistic Patients: A Preliminary Report , Research in Psychotherapy: Psychopathology, Process and Outcome: Vol. 18 No. 1 (2015)
- Raffaella Perrella, Nadia Del Villano, Giorgio Caviglia, Referential activity, dissociation, psychopathology and psychotherapy , Research in Psychotherapy: Psychopathology, Process and Outcome: Vol. 19 No. 2 (2016)
- Marcia Olhaberry, Marìa José Leòn, Magdalena Seguel, Constanza Mena, Video-feedback intervention in mother-baby dyads with depressive symptomatology and relationship difficulties , Research in Psychotherapy: Psychopathology, Process and Outcome: Vol. 18 No. 2 (2015): Special issue on Qualitative and Quantitative Research in Child and Adolescent Psychotherapy: part 1
<< < 9 10 11 12 13 14 15 16 17 18 > >>
You may also start an advanced similarity search for this article.
