Current research in Dialectical Behaviour Therapy

Abstract – Julieta Azevedo

DBT Today: State-of-the-Art and Future Directions.

Introduction:
Dialectical Behaviour Therapy (DBT) is a structured cognitive-behavioural intervention originally developed for individuals with borderline personality disorder (BPD). Over the past two decades, DBT has demonstrated robust efficacy in addressing self-harm, emotion dysregulation, and interpersonal dysfunction. More recently, its application has broadened to include diverse clinical populations such as people with autistic features, post-traumatic stress disorder (PTSD), bipolar disorder, eating disorders, and substance use disorders, amongst others. Alongside this clinical expansion, DBT is increasingly being adapted to a wide array of settings, including forensic services, inpatient units, school-based environments, and with various minoritised groups. This presentation provides a critical overview of how DBT is evolving across these domains and explores the implications for clinical practice and research.

Method:
This presentation synthesises findings from recent systematic reviews, implementation studies, and randomised controlled trials (RCTs) investigating DBT across a range of populations and service settings. A particular focus is given to methodological rigor and the challenges associated with using heterogeneous measures and methods and on the need for consistent and robust designs.

Results:
Findings suggest increasing evidence for the generalisability of DBT principles across diagnostic groups and demographic categories. However, implementation studies consistently reveal common barriers, such as resource constraints and insufficient infrastructure for sustaining high-fidelity delivery. Moreover, significant variability in study designs, outcome measures, and follow-up durations presents challenges for drawing robust conclusions about effectiveness and comparative impact across contexts.

Discussion:
The ongoing expansion of DBT reflects its broad clinical utility and responsiveness to diverse population needs. However, as adaptations proliferate, it is essential to ensure that core features of DBT are preserved to maintain treatment integrity. Future research should prioritise the development of consensus on core outcome sets and benchmarking of routine outcomes to improve consistency across studies. Additionally, there is a need for high-quality methodological work that can guide adaptations while supporting generalisability, scalability, and cultural sensitivity. This presentation aims to foster dialogue around how DBT can evolve with scientific rigor and practical relevance in increasingly complex clinical landscapes.