Citation

Weinberg E. J. Am. Med. Assoc. JAMA 2022; 327(22): 2246.

Copyright

(Copyright © 2022, American Medical Association)

DOI

10.1001/jama.2022.5880

PMID

35699711

Abstract

A recent study1 found that care management did not alter the risk of serious self-harm compared with treatment as usual for suicidal and self-harm ideation. Moreover, the DBT used in this study was associated with a significant increase in risk of self-harm. These findings appear to contradict evidence supporting caring interventions2 as suicide risk reduction and the accepted efficacy of DBT3 in reducing suicidality. As suggested in the related Editorial,4 the study findings may have been affected by the mode of implementation. Dialectical behavior therapy is a comprehensive treatment that includes individual therapy and group skills training. Even when skills training is used as a stand-alone intervention, effective implementation has included a high level of clinician engagement as well as the interpersonal context of the group training.3 This study1 demonstrates that separating DBT skills from meaningful interpersonal contact, whether through therapy or skills groups, may be detrimental, not merely ineffective...

Language: en