Grant: CIHR Fellowship

People with concurrent disorders (CD) commonly present with depressive or anxiety and alcohol or substance use disorders at the same time. 81% of people with CD are aged 18-44. People with CD often experience emotion dysregulation, defined as challenges in applying effective strategies to regulate negative emotions, leading to maladaptive coping (e.g., substance use) and poorer quality of life. The only psychological treatment that targets emotion dysregulation is dialectical behavior therapy (DBT), but availability is limited, making access to this intervention difficult. Web-based DBT skills training (DBTST) is effective for CD in as little as 8 weeks and may be of substantial therapeutic benefit. This project seeks to leverage technology to expand treatment options for people with CD, where stigma and engagement are barriers to receiving evidence-based care. This project will implement an existing, not-for-profit, web-based DBTST intervention called PocketSkills to evaluate its efficacy against clinical monitoring (CM) in 82 adults seeking treatment for CD. CD outpatients aged 18-44, who have no history of psychotic-spectrum disorders or intravenous substance use, will be randomized to two treatment conditions: CM alone or DBTST+CM, with the latter group receiving an 8 week augmentation of PocketSkills with online exercises. Participants will be followed for 8 weeks of acute treatment with a 3-month follow-up using validated measures. Results seek to evaluate a web-based DBTST intervention in adults with CD, for whom available services are limited and treatment alternatives are sparse. PocketSkills is a promising and innovative digital health solution, co-developed by the founder of DBT and supported by initial research. Results will inform the efficacy of this intervention in CD beyond standard treatment. This project could also support the creation of standalone digital programs and other combination interventions to improve access to psychological services.