The Therapeutic Community Integrated With a DBT Skills Training Program for Substance Use Disorders: The Initial Efficacy for the Treatment of Impulsivity and Related Dimensions

Objectives

This study aims at investigating the initial efficacy of a 6-month therapeutic community (TC) intervention integrated with a standard Dialectical Behavior Therapy Skills Training (DBT-ST) program (DBT-ST-TC) for treating impulsivity among patients with SUDs.

Methods

Impulsivity was assessed through self-report (UPPS-P) and neuropsychological (Attentional Network Test [ANT]-conflict monitoring, Go/No-Go, Iowa Gambling Task) measures. Furthermore, mindfulness (FFMQ, MAAS) emotion dysregulation (DERS) and distress tolerance (DTS) were evaluated. Intention-to-treat analysis was performed to evaluate pre- post-treatment changes controlling for baseline levels. Pre- and post-treatment results of the DBT-ST-TC group were also compared to baseline levels of variables of interest measured in two control groups (i.e., untreated outpatient with SUDs; healthy controls [HCs]).

Results

Sixty-eight patients with SUDs were screened and admitted to the DBT-ST-TC. Thirty-eight (55.9%) patients completed the first cycle of DBT-ST-TC. The clinical control group included 41 untreated individuals with SUDs. The HC group was composed of 53 participants. DBT-ST-TC patients reported pre- post-treatment improvements of emotion dysregulation (t ₍₆₇₎ = −2.10; p = 0.04), positive urgency (t ₍₆₇₎ = −3.27; p = 0.002) and sensation seeking (t ₍₆₇₎ = −2.08; p = 0.04). The improvement of ANT-conflict monitoring performances was the most relevant pre- posttreatment change (t ₍₆₇₎ = −2.98; p = 0.005): no significant differences between posttreatment performances of the DBT-ST-TC group and HCs were detected.

Conclusion

The DBT-ST-TC might be a promising intervention for treating patients with SUDs. Future long-term outcomes are needed to corroborate and extend these provisional results.