Dialectical behaviour therapy effective for post-traumatic stress disorder
Clinical studies confirm that dialectical behaviour therapy is effective for complex post-traumatic stress symptoms in female patients. Researchers from the Department of Clinical Psychology at the Karl Landsteiner University investigated data from a psychosomatic centre to analyse whether the method proves successful in a real-world clinical setting.
Laboratory situation versus clinical practiceControlled clinical studies provide reliable data to answer research questions. Nevertheless, the standardised "laboratory situation" differs from daily clinical practice. It is therefore even more important to further evaluate controlled clinical trials’ results and confirm them with data from real-world clinical settings. Originally, dialectical behaviour therapy is used for people with borderline personality disorder and those at high risk of suicide and self-harm. The researchers from the Department of Clinical Psychology, led by Dr Juliane Burghardt, aimed to evaluate the transferability of study results stating that dialectical behaviour therapy is also effective for complex post-traumatic disorders.
Therapy of complex trauma156 patients who showed symptoms after traumatisation and who were referred to the psychosomatic centre Eggenburg were allocated to different wards and treatment units for therapy after an initial examination by a psychiatrist. In the period from February 2020 to April 2021, an interdisciplinary team treated 111 patients following the routine method for post-traumatic stress disorders and 45 patients with dialectical behavioural therapy for posttraumatic stress disorder (DBT-PTSD). Standard trauma-specific therapy combines individual therapies, group settings, knowledge transfer, mindfulness and skills training whereas DBT-PTSD proceeds in seven treatment phases spread over 12 weeks and includes both compulsory and optional therapy modules. All therapists had either experience with trauma-specific therapy or had completed further training in DBT-PTSD. Previous clinical trials included only women with post-traumatic symptoms after sexual or physical violence in childhood while in the study group in the real-life setting, there were both male and female patients. Disease-specific symptoms were measured with clinical-psychological questionnaires from routine clinical practice.
Both forms of therapy improve symptomsAfter therapy, both treatment groups showed an improvement in post-traumatic symptoms; DBT-PTSD was partly even superior to trauma-specific therapy. Nevertheless, the efficacy of dialectical therapy in the real-life setting was significantly lower than in the clinical trials before. The researchers were able to identify treatment adherence as a main aspect of therapy success. In summary, the research confirms the results from the previous randomized clinical trials and highlights important aspects that should be implemented during therapy in inpatient centres. The research work was supported by the Gesellschaft für Forschungsförderung NÖ and the medical technology company VAMED. Results have been published open access in the European Journal of Psychotraumatology due to the funding of Karl Landsteiner University and are intended to support therapists in their daily routine work to improve treatment for people with complex post-traumatic stress disorders.
