A Pilot Study of the DBT Coach: An Interactive Mobile Phone Application for Individuals With Borderline Personality Disorder and Substance Use Disorder

• Published in: Behavior therapy Vol. 42; no. 4; pp. 589 - 600
• Main Authors: Rizvi, Shireen L, Dimeff, Linda A, Skutch, Julie, Carroll, David, Linehan, Marsha M
• Format: Journal Article
• Language: English
• Published: Amsterdam Elsevier Ltd 01.12.2011; Elsevier; Academic Press
• Subjects: Adaptation, Psychological; Adult; Adult and adolescent clinical studies; Behavior Modification; Behavior Therapy - instrumentation; Behavior Therapy - methods; Biological and medical sciences; Borderline personality disorder; Borderline Personality Disorder - psychology; Borderline Personality Disorder - therapy; Cell Phone; Cellular telephones; Coaching; Computer Software; Computers, Handheld; Coping; Counseling Techniques; Depression (Psychology); Diagnosis, Dual (Psychiatry); Drug use; Female; Generalization; Humans; Male; Medical sciences; Mental depression; Middle Aged; Personality; Personality disorders; Personality Problems; Pilot Projects; Pilot studies; Psychiatry; Psychology. Psychoanalysis. Psychiatry; Psychopathology. Psychiatry; Quasiexperimental Design; Software; Substance Abuse; Substance abuse disorders; Substance-Related Disorders - psychology; Substance-Related Disorders - therapy; Technology; Telecommunications; Therapy; Treatment Outcome; Usability; Human; Pilot test; Mobile phone; Substance abuse; Borderline; Personality disorder
• ISSN: 0005-7894; 1878-1888
• DOI: 10.1016/j.beth.2011.01.003

Abstract Dialectical behavior therapy (DBT) has received strong empirical support and is practiced widely as a treatment for borderline personality disorder (BPD) and BPD with comorbid substance use disorders (BPD-SUD). Therapeutic success in DBT requires that individuals generalize newly acquired skills to their natural environment. However, there have been only a limited number of options available to achieve this end. The primary goal of this research was to develop and test the feasibility of the DBT Coach, a software application for a smartphone, designed specifically to enhance generalization of a specific DBT skill (opposite action) among individuals with BPD-SUD. We conducted a quasiexperimental study in which 22 individuals who were enrolled in DBT treatment programs received a smartphone with the DBT Coach for 10 to 14 days and were instructed to use it as needed. Participants used the DBT Coach an average of nearly 15 times and gave high ratings of helpfulness and usability. Results indicate that both emotion intensity and urges to use substances significantly decreased within each coaching session. Furthermore, over the trial period, participants reported a decrease in depression and general distress. Mobile technology offering in vivo skills coaching may be a useful tool for reducing urges to use substances and engage in other maladaptive behavior by directly teaching and coaching in alternative, adaptive coping behavior.