Symptom reduction in DBT-informed partial hospital, intensive outpatient, and step-down programs: Mindfulness matters
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Sustainable Development Goals
SDG 04: Quality Education
Abstract
Preliminary evidence suggests the efficacy of Dialectical Behavior Therapy (DBT) to reduce clinical symptoms in Partial Hospital (PH) programs. However, less is known about the impact of stand-alone DBT treatment in Intensive Outpatient (IOP) programs, or in PH to IOP step-down care models. The current study examined changes in depression, anxiety, stress, and hopelessness, as well as mindfulness skills acquisition, from intake and discharge data of clients at a southeastern behavioral health clinic in the United States. The sample included 146 clients 65.75% female (ages M = 33.88, SD = 12.34), who attended either a DBT PH, IOP, or PH to IOP step-down program. Participants completed the Depression, Anxiety, Stress Scale (DASS-21), Beck Hopelessness Scale (BHS), and Five Facets of Mindfulness Questionnaire Short Form (FFMQ‐SF) during intake and discharge from program. Depression, anxiety, and hopelessness decreased from intake to discharge in the PH program, while all symptoms decreased in the IOP and step-down programs. There was no difference in symptom reduction between programs. Greater overall hours in treatment was associated with less change in depression and anxiety in the step-down program. Mindfulness total scores increased in each program, as well as most subscales. Mindfulness skills acquisition predicted decreases in depression and stress in the IOP group, and decreases in depression and hopelessness in the step-down group. Overall, stand-alone DBT was successful at reducing clinical symptoms for clients placed in these programs. Additionally, regularly practiced mindfulness skills as part of DBT treatment appears to play an integral role in symptom reduction.
