About this course
DBT has been found effective in reducing suicide attempts and other life-threatening behavior. Evaluating suicide-related outcomes in DBT clinical programs, implementation projects, and clinical trials is critically important and can pose methodological and practical challenges. As DBT research moves from its original efficacy trials to evaluations of various DBT adaptations and in different effectiveness, implementation, and program contexts, clinicians and clinical researchers have an increasing number of decisions to make about how to evaluate DBT to balance rigor, ethical principles, and practical concerns.
Methodological challenges commonly include operationalizing outcomes, powering to detect changes in a low base rate behavior like suicide attempt, monitoring treatment fidelity, managing missing data, and designing control conditions. Practical challenges can include difficulty recruiting large samples, managing participant and system concerns about randomization, working effectively with regulatory and administrative systems (e.g., institutional review boards), and recruiting, training, and retaining therapists and other staff.
This clinical workshop will discuss these challenges and solutions based on panelists’ experiences conducting DBT program evaluations, assessing the outcomes of DBT implementation projects, and conducting DBT clinical trials using efficacy, effectiveness, and hybrid effectiveness-implementation designs. Panelists will discuss the above methodological challenges and potential solutions such as pragmatic fidelity monitoring, selection of transdiagnostic outcome measures, and suicide risk management strategies for control conditions. Panelists will then discuss practical challenges and solutions, including strategies to boost recruitment, address participant and systems concerns about randomization, and work effectively with institutional review boards. Recommendations for conducting program evaluation, implementation, and clinical trials will be provided to enhance and facilitate ongoing and future DBT efforts.
