Dialectical Behavior Therapy for Substance Abusers (DBT-S) is a comprehensive psychosocial treatment, efficacious for substance-dependent individuals with borderline personality disorder (BPD). In Phase I, we developed and evaluated an innovative computer-based training (CBT) prototype of a subset of DBT-S skills for drug treatment providers using an iterative process of prototype development. We tested the prototype's efficacy in a pilot randomized controlled trial (RCT). All Phase I aims were exceeded. In the RCT, statistically significant results favoring DBT were observed on all major outcome variables, including skills knowledge gains, skills recollection, self-efficacy, and motivation to treat BPD clients. In Phase II, we propose to expand the DBT-S skills CBT curricula to include two additional modules - mindfulness and interpersonal effectiveness. We will again use an iterative process of development, seeking feedback from experts and end-users. We propose to conduct a RCT (N=75) comparing three groups: the DBT CBT, a comparable text-based curriculum (Team Training), and a CBT control. Major outcome variables will include DBT-S skills knowledge, recall, self-efficacy, motivation to treat substance-dependent BPD clients, and two clinical application measures: a performance-based assessment and clinical application test. Additionally, we propose a 3-month follow-up period to assess skills use and retention over time.
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