Group DBT Skills Training for First Episode Psychosis

Despite evidence that individuals with psychotic disorders experience marked emotion dysregulation, impulsivity and elevated suicide risk, they have largely been excluded from clinical trials evaluating DBT. Nevertheless, emerging pilot studies support the feasibility and potential efficacy of brief DBT-informed skills group in individuals with psychosis, with participants reporting high satisfaction and improvements in understanding and managing emotions, suicidality, and interpersonal functioning. However, this literature remains preliminary and underdeveloped, and no studies have evaluated group DBT skills intervention specifically for individuals with first-episode psychosis.

Aim 1: To evaluate the acceptability of the group DBT skills training invention and the feasibility of conducting a fully powered randomized controlled trial (RCT) of in young men with psychosis.

Aim 2: To assess the preliminary efficacy of group DBT skills training in improving emotion regulation, resilience, and functioning and reducing, mood and anxiety and substance use, in a single-arm exploratory clinical trial.

This study will provide evidence of the feasibility, acceptability, and preliminary efficacy of a group DBT skills training for young men with first-episode psychosis. Findings will advance understanding of emotion regulation as a treatment target in psychosis and inform the development of larger controlled trials evaluating emotion-focused interventions in early psychosis care. The intervention could represent a scalable and practical psychosocial treatment to address emotional difficulties that are common but often under-treated in psychosis.

This study employing qualitative and quantitative methods to evaluate the group DBT skills training intervention and test its feasibility, and acceptability in individuals with psychosis. A single arm trial where DBT skills group delivered over 8-weeks, will be conducted. Thirty-two participants are planned to be enrolled in the trial. Participants will continue with their standard outpatient care during the trial. Outcome measures will be completed at study entry and post-treatment. For the qualitative component of the study, 15 post-intervention semi-structured interviews will be conducted.

Inclusion criteria

• Be 14-35 years old.
• All gender identities are eligible to participate.
• Being competent as demonstrated by comprehension of the study procedures, risks, benefits and their rights as a volunteer in the research study and willing to consent to study participation.
• Meets criteria for a psychotic spectrum disorder as determined by Diagnostic and Statistical Manual of Mental Disorders (DSM-5) (e.g., schizophrenia, schizoaffective disorder, schizophreniform disorder, brief psychotic disorder, delusional disorder, other specified schizophrenia spectrum disorder, or other unspecified schizophrenia spectrum disorder), or bipolar disorder with psychotic features, and is within 3 years of their initial diagnosis.

Exclusion criteria

• Diagnosis of intellectual disability previously documented in the patient chart.
• Acute suicidality requiring immediate life-saving intervention (i.e., inpatient psychiatric care).
• Receiving any additional structured psychotherapy interventions during the study period.