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

Stand-alone dialectical behavior therapy skills training groups (DBT-ST) are widely used for borderline personality disorder (BPD), yet skills-specific benchmarks for symptom change and tolerability are unclear. Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, we searched PubMed, APA PsycARTICLES, APA PsycINFO, Psicodoc, and Psyke (English/Spanish) for adult stand-alone DBT-ST covering the four standard modules. Eligible designs were randomized clinical trials, controlled trials, and pre-post studies with standardized BPD diagnoses. Continuous outcomes were synthesized as standardized mean differences (Hedges-corrected d); within-arm pre-post effects used standardized mean change (assumed r = .50 when missing). Dropout was pooled on the logit scale and back transformed to retention. Random-effects model with Hartung-Knapp adjustments quantified heterogeneity and ran sensitivity/bias diagnostics. Seven studies met criteria; five entered meta-analysis. BPD clinical severity showed large within-arm improvement (d = -1.32, 95% confidence interval [CI; -1.99, -0.64]) with substantial heterogeneity. Depression decreased largely (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%]), implying 71% retention. Stand-alone DBT-ST is associated with large symptom reductions and acceptable retention, providing skills-specific benchmarks to inform implementation, whereas heterogeneity indicates the need for more robust comparative trials. (PsycInfo Database Record (c) 2026 APA, all rights reserved).