Towards online delivery of Dialectical Behaviour Therapy: A scoping review.
Richard Lakeman, Peter King, John Hurley and 4 others
PMID 35048482WHAT IT FOUND
Online DBT skills groups were reported as feasible and sometimes better attended than face-to-face, but the evidence for equal effectiveness is weak and based on small, flawed studies.
Key findings
01The included studies suggested that online DBT was feasible and at least as effective as control conditions, but all were underpowered or had methodological flaws.
02In the BPD trial, both e-DBT and face-to-face groups improved significantly after the programme, but over 50% of participants in each group terminated early.
03In an online DBT skills group, participants had lower connection with each other, but weekly attendance was 91% versus 75% for the face-to-face group and satisfaction was high.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
Read the rest of this summary
You get three full summaries a month, free, and we do not ask for a card. Search, the TL;DRs and your library stay unlimited either way.
What it does not show
The review included only 11 papers, and several were case studies, commentaries or surveys rather than controlled trials. There were no large-scale trials comparing online DBT with high-fidelity face-to-face treatment for BPD. The effectiveness evidence came from small or flawed studies, and the authors said it cannot support generalisations about efficacy. Dropout and non-completion were high in some studies, including over 50% premature termination in both arms of a BPD trial and more than 50% dropout in a computer-guided pilot. Seven of the 11 included studies were from the United States, and one provider survey was 89.5% United States, so findings may not transfer to other services. The review did not examine the digital divide, and access, privacy, security and cost issues were not resolved.
Declared interests
External funding was provided by the Council of Australian University Librarians. The supplied text does not report author conflicts of interest.
The easy way to misread this
Do not read this review as proof that online DBT is equivalent to face-to-face DBT for BPD. The included trials were small, underpowered or had methodological flaws, and there was no large-scale comparison with high-fidelity face-to-face treatment.