DBT-informed treatment in a partial hospital and intensive outpatient program: the role of step-down care

Abstract

Few studies to date have examined Partial Hospital (PH) and Intensive Outpatient (IOP) programs that utilize a Dialectical Behavior Therapy (DBT)-informed model. Preliminary findings suggest that DBT-informed PH programs are effective in reducing clinical symptoms; however, less is known about IOP programs as well as step-down care models. The present study utilized clinically relevant outcome indices and included a heterogeneous clinical sample. Specifically, the present study assessed pre-post data to examine changes in symptoms of depression, anxiety, hopelessness, and overall degree of suffering from intake to discharge in DBT-informed PH and IOP programs as well as a step-down condition (PH to IOP). Participants included 205 adults (ages M = 35.28, SD = 12.49). The sample was predominantly female (N = 139, 67.8%) and Caucasian (N = 181, 88.3%). The sample was divided into three distinct groups: PH program patients, PH to IOP program step-down patients, and IOP patients. Findings indicated significant symptom reduction from intake to discharge for all three conditions. There were no significant differences in mean change scores in symptom reduction between the three groups. Severity of depression symptoms at intake predicted program placement. However, type of program did not predict significant changes in symptoms from intake to discharge. This DBT-informed PH and IOP program was successful at reducing various psychiatric symptoms in the sample. Clinicians might consider the advantages of placing patients with higher symptoms of depression into PH programs with the intention of transitioning to step-down care through IOP programs that utilize DBT.

Applying adherent DBT Principles to treatment in a partial hospital setting: An analysis over 5‐years of outcomes from intake to discharge

“…The present study findings replicate previous findings from Lothes et al, (2014;2016) that show symptom reduction from intake to discharge with unique clinical measures of depression (BDI & CUDOS) and anxiety (BAI & CUXOS) among a DBT-PH program. These results are like those found in prior literature of DBT being used in IOP programs that have demonstrated decreased depression and anxiety symptoms (Mochrie et al, 2020;Ritschel et al, 2012). However, this study extended prior research by examining outcomes that included hopelessness, self-reported overall suffering, which both showed significant decreases in all conditions.…”

“…While in the PH program patients also had access to a medication prescriber weekly to discuss medication management and make any necessary medication changes. For a more detailed description of the DBT-PH program (Mochrie et al, 2019 andMochrie et al, 2020).…”