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Feasibility and preliminary efficacy of dialectical behaviour therapy skills groups for Veterans with suicidal ideation: pilot

Published online by Cambridge University Press:  21 March 2019

Suzanne E. Decker ,
Lynette Adams ,
Laura E. Watkins ,
Lauren M. Sippel ,
Jennifer Presnall-Shvorin ,
Mehmet Sofuoglu  and
Steve Martino
Suzanne E. Decker*
Affiliation:
New England Mental Illness Research, Education, and Clinical Center, West Haven, CT 06516, USA Department of Psychiatry, Yale University School of Medicine, New Haven, CT 06511, USA
Lynette Adams
Affiliation:
Department of Psychiatry, Yale University School of Medicine, New Haven, CT 06511, USA Mental Health Service Line, Psychology Section, VA Connecticut Health Care System, West Haven, CT 06516, USA
Laura E. Watkins
Affiliation:
Department of Psychiatry, Yale University School of Medicine, New Haven, CT 06511, USA National Center for PTSD Clinical Neurosciences Division, West Haven, CT 06516, USA
Lauren M. Sippel
Affiliation:
Department of Psychiatry, Yale University School of Medicine, New Haven, CT 06511, USA National Center for PTSD Clinical Neurosciences Division, West Haven, CT 06516, USA
Jennifer Presnall-Shvorin
Affiliation:
Mental Health Service Line, Psychology Section, VA Connecticut Health Care System, West Haven, CT 06516, USA
Mehmet Sofuoglu
Affiliation:
New England Mental Illness Research, Education, and Clinical Center, West Haven, CT 06516, USA Department of Psychiatry, Yale University School of Medicine, New Haven, CT 06511, USA
Steve Martino
Affiliation:
New England Mental Illness Research, Education, and Clinical Center, West Haven, CT 06516, USA Department of Psychiatry, Yale University School of Medicine, New Haven, CT 06511, USA
*
*Corresponding author. Email: suzanne.decker@yale.edu; suzanne.e.decker@gmail.com; suzanne.decker@va.gov
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Abstract

Background:

Veterans are at high risk for suicide; emotion dysregulation may confer additional risk. Dialectical behaviour therapy (DBT) is a well-supported intervention for suicide attempt reduction in individuals with emotion dysregulation, but is complex and multi-component. The skills group component of DBT (DBT-SG) has been associated with reduced suicidal ideation and emotion dysregulation. DBT-SG for Veterans at risk for suicide has not been studied.

Aims:

This study sought to evaluate the feasibility and acceptability of DBT-SG in Veterans and to gather preliminary evidence for its efficacy in reducing suicidal ideation and emotion dysregulation and increasing coping skills.

Method:

Veterans with suicidal ideation and emotion dysregulation (N = 17) enrolled in an uncontrolled pilot study of a 26-week DBT-SG as an adjunct to mental health care-as-usual.

Results:

Veterans attended an average 66% of DBT-SG sessions. Both Veterans and their primary mental health providers believed DBT-SG promoted Veterans’ use of coping skills to reduce suicide risk, and they were satisfied with the treatment. Paired sample t-tests comparing baseline scores with later scores indicated suicidal ideation and emotion dysregulation decreased at post-treatment (d = 1.88, 2.75, respectively) and stayed reduced at 3-month follow-up (d = 2.08, 2.59, respectively). Likewise, skillful coping increased at post-treatment (d = 0.85) and was maintained at follow-up (d = 0.91).

Conclusions:

An uncontrolled pilot study indicated DBT-SG was feasible, acceptable, and demonstrated potential efficacy in reducing suicidal ideation and emotion dysregulation among Veterans. A randomized controlled study of DBT-SG with Veterans at risk for suicide is warranted.

Keywords

dialectical behaviour therapyemotion dysregulationskills trainingsuicidal ideationVeterans
Type
Brief Clinical Report
Information
Behavioural and Cognitive Psychotherapy , Volume 47 , Issue 5 , September 2019 , pp. 616 - 621
Creative Commons
This is a work of the U.S. Government and is not subject to copyright protection in the United States.
Copyright
© British Association for Behavioural and Cognitive Psychotherapies 2019

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Footnotes

§

Authors’ present addresses: Dr Watkins is now at Department of Psychiatry, Emory University Medical Center, Atlanta, GA, USA; Dr Sippel is now at National Center for PTSD, White River Junction, VT, USA; Dr. Presnall-Shvorin is now at the War Related Illness and Injury Study Center (WRIISC) of VA New Jersey Health Care System, East Orange, NJ, USA.

References

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