A comparative study of the effectiveness of group-based cognitive behavioral therapy and dialectical behavioral therapy in reducing depressive symptoms in Iranian women substance abusers

Abstract

A comparative study of the effectiveness of group-based cognitive behavioral therapy and dialectical behavioral therapy in reducing depressive symptoms in Iranian women substance abusers Sara Sahranavard * and Mohammad Reza Miri AbstractVarious therapeutic approaches have been used to improve depressive symptoms in substance abusers. In a quasiexperimental study with a pretest-posttest design and experimental and control groups, we examined and compared the effectiveness of two group-based treatment strategies-cognitive behavioral therapy (CBT) and dialectical behavioral therapy (DBT)-in reducing depressive symptoms among Iranian women substance abusers.The statistical population included all female addict patients who referred to addiction treatment centers of Birjand city in 2015. A sample of 30 subjects were selected through the available sampling method and randomly assigned into experimental (CBT and DBT) and control groups (each group, 10 patients). The data collection instrument was the Beck Depression Inventory (BDI) questionnaire. The patients in the experimental groups were given skills in eight sessions of 90 min. The data were analyzed by the SPSS-19 software by using mean, standard deviation, and percentages at the descriptive level and analysis of covariance (ANCOVA) test at the inferential level. The comparison of the mean depression score before intervention in all the groups showed no significant difference. However, after intervention, the findings showed that both CBT and DBT interventions could reduce the mean scores of depression in women substance abusers, 17.5 ± 3.0 vs 29.3 ± 4.1 (F[1,17] = 51.91, p value < 0.01) and 14.7 ± 1.8 vs 29.3 ± 4.1 (F[1,17] = 106.62, p value < 0.01), respectively, for CBT and DBT. Post-treatment effect sizes were large and did not differ statistically for CBT (η p 2 , 0.75) and DBT (η p 2 , 0.86). Therefore, this study highlights the importance of CBT and DBT skills training to substance abusers and provides initial evidence of their effectiveness.

Dialectical Behaviour Therapy Skills Training Groups for Common Mental Health Disorders: A Systematic Review and Meta-Analysis

“…Participants had, on average, high baseline levels of emotion dysregulation as measured by the DERS (M = 108.87), whereas healthy controls generally score between 63-76 (Becerra et al, 2013;Harrison et al, 2010). Among studies examining the BDI I and II as a measure of depression, both with and without depression as the primary diagnosis, baseline scores showed Two major outliers were detected, (i.e., Sahranavard & Miri, 2018). with z-scores well above 1.96 (z = 3.23 and 2.23, respectively).…”

“…In order to avoid overestimating the effect of DBT skills groups, we focused on sensitivity analyses in which the two outliers with very large effect sizes (>2 standard deviations) were excluded Sahranavard & Miri, 2018). Notably, both outlier studies were conducted in Iran, indicating potential cultural differences in aspects including mental health, outcome measures, and treatment delivery.…”

“…The first outlying study (n = 30) of binge eating disorder reported very high baseline DERS scores (M = 148) and increased therapeutic focus on emotion regulation skills . The second outlying study (n = 10) included participants with high baseline depression scores and co-occurring substance use disorder as part of the inclusion criteria (Sahranavard & Miri, 2018). Generally, when clients present with higher distress at baseline, there is naturally more room on the given mental health scale to come down from, indicating a possible ceiling effect (Salkind, 2010).…”

A pilot Randomized Controlled Trial of Dialectical Behavior Therapy (DBT) for Craving and Cessation in Marijuana Use Disorder Patients: Feasibility, Acceptability, and Appropriateness

“…Nevertheless, studies have shown contradictory results about the effectiveness of implementing DBT on various SUD populations (17,18). Furthermore, these pieces of literature have recommended the use of the larger samples, more clear instruments for outcome variables, speci c, and integrated protocols (19).…”

A Pilot Randomized Controlled Trial of Dialectical Behavior Therapy (DBT) for Craving and Cessation in Marijuana Use Disorder Patients: Feasibility, Acceptability, and Appropriateness

“…Research literature shows the e cacy and effectiveness of DBT in various comorbid problems and diseases such as suicide (14), forensic psychiatric patients (15), and irritable bowel syndrome (16). Nevertheless, studies have shown contradictory results about the effectiveness of implementing DBT on various SUD populations (17,18). Furthermore, these pieces of literature have recommended the use of the larger samples, more clear instruments for outcome variables, speci c, and integrated protocols (19).…”