Ongoing Research » Current Trials
Current Clinical Trials
Research at the BRTC is focused primarily on the development and evaluation of psychotherapies for individuals with severe and chronic personality disorders. Research focuses on the understanding, assessment and treatment of suicidal behaviors. To date, most research has focused on treatment development for suicidal individuals meeting criteria for Borderline Personality Disorder. Most research has been funded by the National Institutes of Health.
The BRTC is currently accepting referrals for the following research study:
DBT for Women with BPD and Post-Traumatic Stress Disorder
This study is focused on the development and initial evaluation of a protocol to treat Post-Traumatic Stress Disorder (PTSD) in women with Borderline Personality Disorder (BPD) that can be integrated into standard Dialectical Behavior Therapy (DBT). DBT is a comprehensive, cognitive-behavioral treatment for BPD that has been shown effective in reducing the primary problems it is designed to treat; namely, the frequency and severity of self-injurious and suicidal behavior, maintenance in treatment, and severe problems in living. However, the DBT treatment manual does not currently include a protocol specifying when or how to treat PTSD, a comorbid diagnosis that is prevalent in BPD patients. Similarly, many of the existing treatment outcome studies for PTSD have excluded suicidal, substance abusing, and multiply diagnosed patients, thereby making it difficult to determine the generalizability of these approaches to individuals with BPD. The present study will occur in two phases. In Phase 1, approximately 12 women meeting criteria for BPD and PTSD will participate in clinical pre-testing to develop and standardize the PTSD protocol which will be based on Prolonged Exposure therapy. In Phase 2, 36 women meeting criteria for BPD and PTSD will participate in a randomized controlled trial comparing standard DBT + the PTSD Protocol to standard DBT only to determine the feasibililty, acceptability, and efficacy of this new treatment. In both phases, treatment will last for one year. Clinical assessments will occur up to four times during the treatment year as well as at three months following treatment completion. We anticipate that the treatment portion of the study will begin in August 2009. This study is funded by the National Institute of Mental Health. For more information please call us at 206-543-BRTC extension 1.
No longer accepting referrals
Component Analysis of DBT for Suicidal BPD Women
This ongoing randomized clinical trial is evaluating which components of Dialectical Behavior Therapy (DBT) are most effective in treating suicidal women meeting criteria for Borderline Personality Disorder (BPD). All empirical studies of DBT with severely dysfunctional BPD patients to date have provided both DBT skills training and DBT individual therapy. In practice, however, DBT skills training is frequently offered with standard case management instead of individual DBT (usually in resource-poor mental health clinics). Other providers offer DBT individual therapy without any skills training (usually in solo private practice where group therapy is not offered). DBT skills training is viewed as a sufficient DBT component in one setting and as expendable in the other. The overarching aim of this study is to begin the process of dismantling DBT by examining the importance of DBT skills training in reducing suicidal behavior and use of crisis services, and improving quality of life in suicidal BPD patients. The secondary aim is to evaluate knowledge, use, and perceived benefits of DBT skills and their relation to outcome. This study uses a three arm, randomized component analysis design comparing standard full-program DBT (SDBT), standard DBT Individual therapy without the skills training component (DBT-I), and standard DBT Skills training without the DBT individual therapy (DBT-S). Ninety-nine women meeting criteria for both current and chronic suicidal behavior and BPD have enrolled in one year of treatment and one year of follow-up assessments. As in our previous studies, clinical assessments occur at four-month intervals over the two years. This study has completed enrollment and is no longer recruiting subjects. We anticipate that the treatment portion of the study will end in October 2008 and the final follow-up assessments will occur in October 2009. This study is funded by the National Institute of Mental Health.
DBT for Opiate-Addicted BPD Men and Women
The purpose of this ongoing randomized clinical trial is to conduct an efficacy trial to determine whether Dialectical Behavior Therapy (DBT) added to suboxone (an opiate drug replacement) is an efficacious treatment for male and female opiate addicts with Borderline Personality Disorder (BPD). DBT, originally developed for chronically suicidal women with BPD, is a synthesis of behavior therapy strategies aimed at change, and validation strategies aimed at acceptance, both held together by a set of dialectical strategies and underlying assumptions. DBT has been adapted for BPD substance abusers by the addition of 1) specific targets relevant to drug use, 2) a set of attachment strategies, 3) greater reliance on arbitrary reinforcers at treatment start, 4) weekly urinalysis, and 5) an opiate drug-replacement program (suboxone, i.e., buprenorphine in combination with naloxone) plus DBT clinical management. This ongoing study is a two arm, randomized clinical trial comparing a one year treatment program of DBT + suboxone for opiate addicted BPD individuals to a one year treatment program of Individual and Group Drug Counseling (IGDC) + suboxone. One hundred and twenty-five individuals with opiate dependence and BPD have enrolled in a one-year treatment and a one-year follow-up assessment across the two study sites (University of Washington and Duke University). Assessments measuring drug use, suicidal behaviors, retention and other treatment-related behaviors, general psychopathology, and increases in behavioral skills are given at four month intervals for the entire two years. This study has completed enrollment and is no longer recruiting subjects. We anticipate that the treatment portion of the study will end in October 2008 and the final follow-up assessments will occur in October 2009. This study is funded by the National Institute on Drug Abuse.