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ncluding skills training group and individual therapy. Surprisingly, all three conditions resulted in significantly reduced suicide attempts, suicide ideation, lethality and use of crisis services. Specifically, the DBT-S condition showed greater reduction in frequency of self-harm than the DBT-I condition. Surprisingly, standard DBT did not show a significant difference in effectiveness compared to DBT-S despite the substantial gap in total hours of treatment (average 55.3 hours in standard DBT versus 31.7 hours in DBT-S) (Linehan, et al., 2015). Overall the findings suggest that skills training is a necessary component to achieve optimal outcomes in suicidality and illustrates that well-organised but less intensive DBT treatments are also effective. Moreover, they challenge previous claims that DBT must be employed in its methodological standard format to prove effective. On a separate note, Haga and colleagues (2018) recently published a distinct dismantling study assessing the cost-effectiveness of DBT for adolescents (DBT-A) by comparing it to enhanced usual care (EUC). The research described DBT-A as a shortened version of DBT that has been adapted for adolescents to focus more on teaching distress tolerance skills and enhancing family functioning. This treatment was delivered in an outpatient setting with the aim of using more outpatient resources than usual care and, consequently, reduce the need for hospitalisation. While DBT-A was superior to EUC in reducing self-harm over the set time interval, the study found no statistical significant differences in total treatment cost between DBT-A and EUC, however, that could be due to low statistical power of their small sample size (Haga, et al., 2018). To elaborate, DBT-A group may have had a higher outpatient treatment cost during the intervention but the EUC groups had a higher cost during the follow-up period, which shows that intensified use of resources during the intervention resulted in a reduced need for treatment during follow-up sessions. Additionally, DBT-A patients rapidly improved at 19 weeks, considering the total treatment cost to be similar at 71 weeks, this shows that initial extra use of resources garnered a higher improve
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