A Blended Learning Approach to Online DBT Skills Training: Preliminary Clinical Outcomes and Intervention Acceptability (Preprint)

BACKGROUND The prevalence of mental health concerns has been increasing, but few people manage to access evidence-based mental health interventions. Standalone dialectical behavioral therapy (DBT) skills training can effectively address emotion dysregulation and emotional distress across a range of diagnoses. However, delivering DBT requires specialized training and can be challenging to scale. In response to this, TheraHive was developed as an internet-delivered, blended learning model that provides 6-months of self-guided, self-paced learning across DBT modules in conjunction with weekly live skills review groups. Despite the potential for its success in addressing common mental health concerns, no prior studies have examined clinical and acceptability outcomes of TheraHive. OBJECTIVE This pre-post study examined preliminary clinical outcomes and acceptability of a blended online DBT skills group delivered on the TheraHive platform. METHODS TheraHive students completed online questionnaires as part of their routine participation in TheraHive. These questionnaires included the Depression Anxiety Stress Scale (DASS-21) at the end of each of the four DBT modules (n=251 respondents) and an acceptability questionnaire (n=67 respondents). RESULTS TheraHive students were predominantly ages 25-34 and female. Results indicate that anxiety, F(1, 164) = 11.16, p=.001, ηp2=.07, stress, F(1, 164) = 5.49, p=.02, ηp2=.03, and total DASS-21 scores, F(1, 164) = 9.04, p=.003, ηp2=.05 improved over the course of the intervention. Depression symptoms did not significantly improve (p=.07), and there were no differences in symptom change by age group. Acceptability was rated highly on a 5-point scale (M=4.69; SD=0.63). CONCLUSIONS Results support the preliminary effectiveness and acceptability of TheraHive as a scalable model for delivering DBT skills groups to patients with transdiagnostic concerns. Future research will examine these outcomes in a randomized controlled trial and will examine a lay-instructor led model of TheraHive in which non-specialists facilitate skills groups. This has the potential to further enhance access to evidence-based transdiagnostic mental health care.