Dialectical behavior therapy (DBT) applied to college students: a randomized clinical trial

Area of Science:

• Psychiatry and Mental Health
• Clinical Psychology
• Adolescent and Young Adult Health

Background:

• College counseling centers (CCCs) face increasing demand for treating complex student mental health issues.
• Suicidal ideation and self-harm are significant concerns among college student populations.
• Dialectical Behavior Therapy (DBT) is a recognized treatment for individuals with emotion dysregulation and suicidality.

Purpose of the Study:

• To compare the effectiveness of DBT against an optimized treatment-as-usual (O-TAU) control for suicidal college students.
• To investigate baseline global functioning as a moderator of treatment outcomes in this population.

Main Methods:

• A randomized controlled trial involving 63 suicidal college students (ages 18-25) meeting criteria for borderline personality disorder.
• Participants were assigned to either DBT or O-TAU, both involving individual and group components over 7-12 months.
• Assessments were conducted at multiple time points, including pretreatment, during treatment, and at an 18-month follow-up.

Main Results:

• DBT significantly reduced suicidality, depression, nonsuicidal self-injurious (NSSI) events, borderline personality disorder (BPD) criteria, and psychotropic medication use compared to O-TAU.
• Greater improvements in social adjustment were observed in the DBT group.
• DBT demonstrated particular efficacy for students with lower global functioning at baseline; no significant differences in dropout rates were found.

Conclusions:

• DBT is an effective intervention for suicidal college students with complex clinical presentations, including those with BPD criteria.
• The findings support the use of DBT in college counseling settings for this vulnerable population.
• Future research should explore implementing DBT within a stepped care model in CCCs.