Evidence-Based Analysis of Dialectical Behavior Therapy Components and Outcomes for Borderline Personality Disorder: Skills Training, Cultural Considerations, and Healthcare Utilization

Abstract

Background:
Borderline Personality Disorder (BPD) affects approximately 1.4% of adults in the United States, presenting significant challenges in emotion regulation, interpersonal relationships, and distress tolerance. Dialectical Behavior Therapy (DBT), developed by Marsha Linehan, has emerged as the gold standard treatment for BPD, combining individual therapy with skills training groups.
Objective:
This comprehensive review examines the effectiveness of DBT skills groups and individual therapy components for individuals diagnosed with BPD, with particular focus on emotion regulation, distress tolerance, and interpersonal effectiveness. We analyze treatment completion rates, comparative effectiveness of different DBT components, cultural adaptations, and integration with pharmacological treatments.
Methods:
A systematic analysis of randomized controlled trials, longitudinal studies, and clinical outcomes data from 2015-2024 was conducted, incorporating findings from major academic medical centers across the United States.
Results:
DBT demonstrates significant efficacy in reducing suicidal behaviors (Cohen's d = 0.65), improving emotion regulation (d = 0.72), and enhancing interpersonal functioning (d = 0.58). Treatment completion rates average 68% for full DBT programs, with retention significantly influenced by therapeutic alliance, cultural adaptation, and integrated care approaches.
Conclusions:
DBT skills training represents an evidence-based intervention for BPD with robust empirical support. Cultural adaptations and integrated treatment models show promise for improving outcomes across diverse populations.