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DOI: 10.1055/a-2294-2330
Effekte des Skills-Trainings der Dialektisch-Behavioralen Therapie (DBT) bei Depressionen und Angststörungen – Eine praxisorientierte Pilotstudie
Effects of Dialectical Behavior Therapy (DBT) Skills Training on Depression and Anxiety Disorders – A Pilot Study under Routine Care ConditionsZusammenfassung
Ziel der Studie Das Skills-Training als integraler Bestandteil der Dialektisch Behavioralen Therapie (DBT) weist eine hohe Effektivität in der Behandlung der Borderline-Persönlichkeitsstörung auf. Zunehmend richtet sich das Forschungsinteresse auf die transdiagnostische Wirkung des Trainings bei Depression und Angststörungen. In der vorliegenden Pilotstudie wurde untersucht, inwiefern sich die Befunde qualitativ hochwertiger randomisiert-kontrollierter Studien auf den klinischen Alltag übertragen lassen.
Methodik N=26 Patient*innen ohne Achse II Persönlichkeitsstörungen wurden teilstationär über einen Zeitraum von acht Wochen behandelt. In der Kontrollgruppe (KG) erhielten 11 Patient*innen eine multimodale Verhaltenstherapie und in der Experimentalgruppe (EG) erhielten 15 Patient*innen zusätzlich zur multimodalen Verhaltenstherapie ein wöchentliches Skills-Training. Längsschnittlich zu drei Messzeitpunkten wurde die Symptombelastung, sowie Fertigkeiten der Emotionsregulation und Achtsamkeit erfasst. Mit Hilfe von Mehrebenenanalysen wurde untersucht, ob sich additive Effekte durch das Skills-Training identifizieren lassen.
Ergebnisse Die EG war der KG deskriptiv in allen Endpunkten überlegen. Die Effektstärken waren vergleichbar mit jenen aus der experimentellen Forschung. Eine Verbesserung der Achtsamkeit korrelierte signifikant mit einer Verringerung der Symptombelastung.
Diskussion Die Befunde ordnen sich in vorangegangene Forschungsbemühungen ein und ergänzen diese um eine praxisorientierte Forschungsperspektive. Vor- und Nachteil der experiementellen und naturalistischen Forschung werden diskutiert und relevante Limitationen der vorliegenden Studie herausgestellt.
Schlussfolgerung Das Skills-Training als etabliertes, flexibel einsetzbares, modulares Therapieprogramm eignet sich hervorragend, um transdiagnostisch die Anpassungsfähigkeit von Patient*innen zu verbessern.
Abstract
Objective Skills training as an integral part of dialectical behavioral therapy (DBT) is highly effective in the treatment of borderline personality disorder. Research interest is increasingly focused on the transdiagnostic effects of the skills training on depression and anxiety disorders. The present study examined the extent to which the findings of high-quality randomized controlled studies can be transferred to everyday treatment under routine care conditions.
Methods N=26 patients without personality disorders were treated in a day clinic over a period of eight weeks. In the control group, 11 patients received routine care treatment and in the experimental group 15 patients additionally received weekly skills training. Symptom distress, as well as emotion regulation and mindfulness were assessed longitudinally at three time points. Multilevel analyzes were used to examine whether there was an additive effect of the skills training.
Results The experimental group was superior to the control group in all endpoints. The effect sizes were comparable to those from experimental research. Improvements in mindfulness were significantly correlated with reductions in symptom distress.
Discussion The findings fit into previous research efforts and complement them with a naturalistic research perspective. The advantages and disadvantages of an experimental and naturalistic research perspective are discussed, and relevant limitations of the present study are highlighted.
Conclusion Skills training is an established, flexible, modular therapy program that is ideal for improving the adaptability of patients with different psychological diagnoses.
Schlüsselwörter
Skills-Training - transdiagnostische Wirksamkeit - praxisorientierte Psychotherapieforschung - Dialektisch Behaviorale Therapie (DBT)Keywords
dialectical behavioral therapy (DBT) - skills training - transdiagnostic effects - effectivenessPublication History
Received: 12 February 2024
Accepted: 24 March 2024
Article published online:
19 April 2024
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