Dialectical behavior therapy research and program evaluation in the Department of Veterans Affairs

Dialectical behavioral therapy (DBT) is a useful evidence-based psychotherapy for treatment of veterans with suicidality and emotion dysregulation. While DBT has not been systematically implemented across the Department of Veterans Affairs (VA), it has spread throughout the system by clinicians interested in treating suicidality and emotion dysregulation. Research and program evaluation of DBT has also occurred in the VA. Research has included examination of the efficacy of DBT for female veterans with borderline personality disorder and efficacy with male and female veterans at high risk of suicide. Program evaluation has included study of adaptations of DBT such as DBT skills group, DBT skills group for depression, modified DBT skills group for sexual minorities, and drop-in distress tolerance groups. In addition, providers in VA implemented an intensive outpatient program for treating borderline personality disorder (BPD) and posttraumatic stress disorder (PTSD) and found it helpful. Finally the implementation of DBT and cost of its use has also been evaluated. This chapter discusses this research and program evaluation in depth and concludes with future directions for DBT research in the VA.