Dialectical behaviour therapy skills training for individuals with substance use disorder: A systematic review

Issues: Dialectical behaviour therapy skills training (DBT-ST) is currently being implemented as a standalone intervention for substance use disorders (SUD), despite limited empirical evidence to support its efficacy in this context. This review aimed to investigate the feasibility, acceptability and efficacy of DBT-ST for SUD. Approach: English language journal articles which focused on quantitative evaluations of DBT-ST for SUD were identified by systematically searching five databases; Medline, Psychinfo, Pubmed, The Applied Social Sciences Index and Abstracts and Cumulative Index of Nursing and Allied Health Literature. Relevant grey literature was also identified using Google Scholar. The titles, abstracts and full-text of retrieved articles were independently screened by both authors. The nine retained articles were read in-depth and quality assessed by both authors. Data were synthesised narratively. Key Findings: Interventions described as DBT-ST for SUD were implemented and adapted differently across studies. Despite these inconsistencies, DBT-ST was generally found to be acceptable and feasible for people with SUD. Findings offered preliminary support for DBT-ST for substance use reduction and emotion regulation enhancement for this cohort. Findings must be considered in light of the quality of studies which ranged from weak to strong. Implications: Positive outcomes indicate that more rigorous studies, including large randomised controlled trials comparing DBT-ST to other evidence-based interventions for SUDs, are warranted. Conclusions: Despite offering preliminary support for DBT-ST for SUD, the lack of controls, small samples and inconsistent adaptations of DBT-ST across studies, limits capacity to draw causal conclusions or make specific recommendations.