Stand-alone dialectical behavior therapy skills training for borderline personality disorder: A systematic review and meta-analysis.

In 30 seconds

This systematic review and meta-analysis assessed stand-alone dialectical behavior therapy skills training (DBT-ST) for adults with standardized diagnoses of borderline personality disorder. Seven studies met eligibility criteria, and five contributed to the meta-analysis. Across study arms, BPD clinical severity improved substantially (standardized mean change d = -1.32, 95% CI [-1.99, -0.64]), although results were heterogeneous. Depression and global psychopathology also decreased. Pooled dropout was 29% (95% CI [23%, 36%]), corresponding to 71% retention. The findings provide symptom-change and retention benchmarks, but do not establish comparative efficacy.

Key findings

• BPD clinical severity showed a large within-arm improvement (d = -1.32, 95% CI [-1.99, -0.64]), with substantial heterogeneity.
• Depression decreased (k = 4; d = -1.04, 95% CI [-1.33, -0.75]).
• Global psychopathology decreased moderately (k = 2; d = -0.73, 95% CI [-1.39, -0.08]).
• Pooled dropout was 29% (95% CI [23%, 36%]), corresponding to 71% retention.

Why it matters

Stand-alone DBT skills groups are used for BPD, and these pooled estimates offer clinicians and service planners benchmarks for symptom change and retention. The results suggest potential benefit across several symptom domains, while substantial heterogeneity and the inclusion of non-comparative pre-post evidence mean that improvement cannot be attributed confidently to DBT-ST alone.

What to keep in mind

Only seven studies met criteria and five entered the meta-analysis. Substantial heterogeneity was reported for BPD severity, and the evidence included pre-post studies, limiting causal and comparative conclusions.