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Home arrow Health arrow Dialectical Behaviour Therapy: Distinctive Features
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Effectiveness of DBT

Knowing that DBT is an efficacious treatment is essential when deciding whether to implement it. Whether DBT proves an effective treatment option for any given organization or client, however, requires attention to outcome measurement in routine clinical practice. DBT treatment programmes collect data on client outcomes to assess effectiveness in treatment delivery and to provide information to the hosting healthcare organization. The focus of DBT on life-threatening and seriously destabilizing behaviours proves helpful in this regard. Just as therapists wish to ensure that the risk and severity of their clients’ problems are decreasing, organizations want to reduce the frequency and severity of suicidal behaviours and to reduce the number of hospital days. Collecting data on these behavioural outcomes, therefore, benefits therapists and organizations alike. In addition to evaluating behaviourally specific outcomes targeted by the treatment (i.e. variables that the programme anticipates will change), DBT teams keep the evaluation task manageable and choose outcomes that link to stakeholder (client, family, therapist, and organization) goals (Rizvi et al., 2007). Outcomes from these evaluations can only deliver a verdict on the effectiveness of DBT if measures of both programmatic and therapist adherences to DBT principles are taken.

In addition to the programmatic level, DBT therapists evaluate the impact of the treatment on individual clients’ identified targets (Chapter 16). In most cases, outcome on these variables relates directly to the programme evaluation (e.g. suicide attempts, nonsuicidal self-injurious behaviour, in-patient days) but will also likely include outcomes on idiographic variables (e.g. bingeing and vomiting episodes, frequency of stealing). Tracking outcomes for individual clients frequently proves helpful in treating clients with multiple comorbid conditions. At any one time, the size and number of tasks still to achieve in therapy may overwhelm therapists and clients alike, leading them to forget progress on previous targets. Outcome information can counteract this cognitive bias and provide more realistic assessments of treatment effectiveness. Such an objective evaluation of progress on target behaviours also assists the therapist and client to decide whether to continue therapy at the end of the treatment contract.

 
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