And We Could Do Better: Comparing the Efficacy of Dialectical Behavior Therapy Between LGBQ and Heterosexual Adults With Borderline Personality Disorder

The present study compared the efficacy of dialectical behavior therapy (DBT) for lesbian, gay, bisexual, and queer (LGBQ) and heterosexual adults who were diagnosed with borderline personality disorder (BPD). Clients were 100 clients (n = 35 LGBQ and n = 70 heterosexual) who participated in a 6-month comprehensive DBT program. The study had two aims: (a) to examine change in outcomes within LGBQ clients and (b) to compare outcomes between LGBQ and heterosexual clients. Results demonstrated that LGBQ clients reported significant decreases in BPD symptoms, depressive symptoms, general psychopathology, functional impairment, emotion dysregulation, and dysfunctional coping. LGBQ clients also reported significant increases in DBT skills use. Comparisons between LGBQ and heterosexual clients found that, while LGBQ clients experienced significant decreases in all measures of psychopathology, they had significantly less change than heterosexual clients for depressive symptoms, functional impairment, emotion dysregulation, and dysfunctional coping. Additionally, the rate of increases in DBT skills use was significantly lower among LGBQ clients. While DBT is likely effective in reducing symptoms associated with BPD among LGBQ clients, results suggest that improvement in some symptoms may be less in comparison to heterosexual clients. Recommendations to enhance the effectiveness for DBT for the specific challenges that LGBQ clients may face are discussed.