1. Findings on DBT

2.  Meta-analyses of randomized clinical trials
• Effect sizes (how much of an effect does tx have?)
 Systematic reviews of randomized control
trials
 Randomized control trials
 Comparison group studies or case-control
studies
 Cohort or time series studies with repeated
measures
 Single case reviews such as case reports
 Qualitative studies
 Practice Wisdom and Expert opinion

3.  Where to find studies or evidence for treatments:
 Clearinghouses:
• SAMHSA http://nrepp.samhsa.gov/AdvancedSearch.aspx
• Cochrane Review www2.cochrane.org
 Practice guidelines
• www.guideline.gov
 Journal articles
 Books
 Conferences
 Treatment Manuals
• should have evidence noted in it
• Many based on practice wisdom only

4.  How likely is it that the outcome is the result
of the intervention and not related to other
things?
• Control or comparison group
 Therapy trials now require a treatment as usual or equivalent
treatment rather than a no treatment control
• Measurement
 Validated scales
 Pre/post testing or number of observations
• Replication
• Sample size
• Sampling procedures (convenience samples)
• Inclusion and exclusion criteria

5.  At the Meta-Analysis and Systematic review state
 Multiple studies, multiple replications, moderate effect sizes
 SAMHSA
 http://nrepp.samhsa.gov/ViewIntervention.aspx?id=36
 12 Unique Studies
 Overall quality of evidence by SAMHSA (ranging 0-4) = 3.2, with scores as high as 4.0
 Outcomes (what does DBT treat?)
 1: Suicide attempts
2: Nonsuicidal self-injury (parasuicidal history)
3: Psychosocial adjustment
4: Treatment retention
5: Drug use
6: Symptoms of eating disorders
 Highest treatment level for adult populations: Young Adult (18-25) through Older Adult (55+
 All ethnicities (though white predominant)
 Both genders (primarily female, fewer studies include men)
 Treatment Settings
• Inpatient
Outpatient
Other community settings

6.  Adolescent DBT:
• No randomized control trials
 Programs typically only approved as EBP with RCT
• Single case reviews with multiple participants
• Convenience samples
 Alec Miller book, “treatment of suicidal adolescents”
• Time series/cohort series
• Comparison and non-equivalent control groups
 Juvenile offenders

7.  DBT Graduate Groups
• Single case reviews with small sample sizes
• Qualitative studies
• Practice Wisdom/Expert Opinion
• No formalized treatment manual or process
 Stage II treatment: collaborations with Edna Foa and
exposure based treatments; no tx for non trauma based
clients
 DBT Special Populations (DBT-SP)
• Single case study
 22 participants, only 17 completed study (25% dropout)
 No formal outcomes
 Convenience sample