Tele-DBT: reviewing the efficacy and clinical utility of telehealth for borderline personality disorder
Dialectical Behaviour Therapy (DBT) is the gold-standard treatment for borderline personality disorder, but access is limited. This review examines what is known about delivering DBT via telehealth – what the evidence says about its efficacy, and what the practical implications are for services. Important reading for clinicians and service managers considering how to expand access to evidence-based treatment for this population.
Abstract
Telepsychology is increasingly being implemented in mental health care.
We conducted a scoping review on the best available research evidence regarding availability, efficacy and clinical utility of telepsychology in DBT. The review was performed using PRISMA-ScR guidelines. Our aim was to help DBT-therapists make empirically supported decisions about the use of telepsychology during and after the current pandemic and to anticipate the changing digital needs of patients and clinicians. A search was conducted in PubMed, Embase, PsycARTICLES and Web of Science. Search terms for telepsychology were included and combined with search terms that relate to DBT. Our search and selection procedures resulted in 41 articles containing information on phone consultation, smartphone applications, internet delivered skills training, videoconferencing, virtual reality and computer- or video-assisted interventions in DBT. The majority of research about telepsychology in DBT has focused on the treatment mode of between-session contact. However, more trials using sophisticated empirical methodologies are needed. Quantitative data on the efficacy and utility of online and blended alternatives to standard (i. e. face-to-face) individual therapy, skills training and therapist consultation team were scarce. The studies that we found were designed to evaluate feasibility and usability. A permanent shift to videoconferencing or online training is therefore not warranted as long as face-to-face is an option. In all, there is an urgent need to compare standard DBT to online or blended DBT. Smartphone apps and virtual reality (VR) are experienced as an acceptable facilitator in access and implantation of DBT skills. In addition, we have to move forward on telepsychology applications by consulting our patients, younger peers and experts in adjacent fields if we want DBT to remain effective and relevant in the digital age.
Keywords: dialectical behaviour therapy, DBT, borderline personality disorder, telehealth, emotion regulation
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Reference
van Leeuwen, H., Sinnaeve, R., Witteveen, U., Van Daele, T., Ossewaarde, L., Egger, J. I. M., & van den Bosch, L. M. C. (2021). Reviewing the efficacy and clinical utility of telecommunication in treatment of people with severe emotion regulation disorders: tele-dialectical behavior therapy (Tele-DBT) in borderline personality disorder. Borderline Personality Disorder and Emotion Dysregulation, 8, 26. https://doi.org/10.1186/s40479-021-00165-7