DBT in an outpatient forensic setting.

Area of Science:

• Forensic Psychiatry
• Clinical Psychology
• Mental Health Treatment

Background:

• Effective treatments for borderline personality disorder (BPD) exist but are often not applied in forensic settings.
• Forensic psychiatry prioritizes reducing criminal recidivism over addressing core BPD symptoms like self-harm.
• This gap limits access to evidence-based care for forensic BPD populations.

Purpose of the Study:

• To assess the feasibility of implementing a Dialectical Behavioral Treatment (DBT) program in an outpatient forensic clinic.
• To compare clinical and demographic characteristics of forensic BPD patients with non-forensic BPD patients.
• To evaluate the justification for excluding forensic patients from evidence-based BPD treatments.

Main Methods:

• A DBT program was implemented in a Dutch outpatient forensic clinic.
• Data collected included sociodemographic, clinical, and treatment information.
• Forensic BPD patient data (10 male, 19 female) were compared to non-forensic BPD patient data (n=58).

Main Results:

• DBT implementation was successful in the outpatient forensic clinic setting.
• Forensic BPD patients exhibited highly comparable clinical and etiological characteristics to non-forensic BPD patients.
• Female forensic BPD patients showed particular similarity to their non-forensic counterparts.

Conclusions:

• Evidence-based treatments, including DBT, can be successfully delivered in forensic mental health settings.
• Excluding forensic patients, especially females, from evidence-based BPD treatment is not supported by clinical data.
• Forensic BPD patients warrant access to the same effective treatments as general mental health populations.