(PS5-B41) Descriptive Exploration of DBT Treatment Outcomes Across White and Non-white Patients

Introduction: Dialectical Behavior Therapy (DBT) is the primary treatment provided for complex psychological disorders (Linehan, 1992). However, there is a lack of evidence relating to the efficacy of DBT when used with individuals belonging to diverse groups. Harned and colleagues (2022) suggest that existing randomized controlled trials of DBT research may adequately represent ethnoracial and sexual minority groups, but noted that improvements were needed in sample reporting and data analytic practices for these groups. In order to contribute to closing this gap in the literature, this study aims to examine differences in outpatient DBT treatment compliance and outcomes in non-White groups compared to White groups. 

Method: Participants (n = 165; 66% female; mean age 26.9) were patients completing comprehensive DBT treatment at an outpatient clinic and training center in California. Treatment outcome measures examined include the WSAS, MHC-SF, and BSL-23 (Mundt, 2002; Keyes, 2009; Bohus et al., 2009). Treatment compliance was measured by examining patient self-report of the number of times phone coaching was used, the proportion of assigned end of module assessments and diary cards completed, as well as the proportion of skills groups attended, graduation rates, and dropout rates. Participants completed outcome measures at intake and every two months throughout DBT treatment. 

Results: Of the 165 patients, 39 (24%) identified as non-White, and 126 (76%) identified as White. Descriptive analysis of treatment compliance did not suggest any major differences between White and non-White groups, respectively, on graduation rates (46% vs. 42%), dropout rates (27% vs. 32%), the proportion of end of module assessments completed (63% vs. 65%), the proportion of assigned diary cards completed (71% vs. 70%), the average number of phone coaching calls utilized per treatment module (1.7 vs. 1.9), or proportion of groups attended (79% vs. 77%). Regarding treatment outcomes, patients on average experienced significant improvement over the course of treatment on all outcomes (ps < .001), and there were no significant differences in the rate of improvement for White and non-White patients (ps < .05). 

Discussion: This study was among the first to specifically explore differences in DBT treatment outcomes by ethnoracial identity. We found no major differences in treatment compliance across multiple indicators between White and Non-white patients. Similarly, treatment outcomes improved on average over time for all patients, and the rate of these improvements was not significantly related to ethnoracial identity. Our findings should be caveated with several limitations, including the researcher-selected groupings for White (Caucasian) vs. non-White patients (Black or African American, Hispanic or Latino, Middle Eastern, Asian, Native Hawaiian or Pacific Islander, American Indian or Alaska Native), as well as the relatively small sample size. While these findings suggest that outpatient DBT may be an equally effective psychotherapy model for Non-white individuals, clinicians should nonetheless be aware of and develop cultural competence to support a diverse array of patients.