A randomized clinical trial was conducted to evaluate whether Dialectical Behavior Therapy (DBT), an effective cognitive-behavioral treatment for suicidal individuals with borderline personality disorder (BPD), would also be effective for drug-dependent women with BPD when compared with treatment-as-usual (TAU) in the community. Subjects were randomly assigned to either DBT or TAU for a year of treatment. Subjects were assessed at 4, 8, and 12 months, and at a 16-month follow-up. Subjects assigned to DBT had significantly greater reductions in drug abuse measured both by structured interviews and urinalyses throughout the treatment year and at follow-up than did subjects assigned to TAU. DBT also maintained subjects in treatment better than did TAU, and subjects assigned to DBT had significantly greater gains in global and social adjustment at follow-up than did those assigned to TAU. DBT has been shown to be more effective than treatment-as-usual in treating drug abuse in this study, providing more support for DBT as an effective treatment for severely dysfunctional BPD patients across a range of presenting problems.

The process whereby a phenomenon is transformed is the dialectic, which essentially is a three-stage process. The first stage is the beginning (which, of course, is essentially indivisible from the ending). It is the initial proposition, a positive statement, an affirmation (e.g., "life has meaning and possibility"). The second stage involves the negation of the beginning phenomenon and is therefore the contradiction of the initial proposition. DIALECTICS IN DBT

Forensic agencies and institutions are charged with treating the most socially disruptive and mentally disordered individuals while securing public safety. Egregious behaviors in these settings demand immediate response and scarce resources. Functional assessment, sometimes used synonymously with functional or behavioral analysis, is presented as a cornerstone tool to help identify targets for intervention and hypothesize causal behavioral connections. Using an interactive chain analysis approach, the temporal sequence of behavior is examined across domains with an emphasis on obtaining operational knowledge about the functions and controlling variables of target behaviors. A clinical case example is used to illustrate the potential contribution of FA in forensic assessment and case conceptualization.

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