support to the accumulating evidence that mental health professionals outside academic research centres can effectively learn and conduct DBT.

Another key follow-up study was carried out to determine whether the success of DBT was attributed to treatment factors that were common to most psychotherapies conducted by experts instead of the unique DBT treatment itself. Linehan’s, et al. (2006) RCT replicated the original study (Linehan, et al.,1991) but introduced a rigorous control condition known as community treatments by experts (CTBE) that was designed to maximise internal validity and control for factors previously uncontrolled for in TAU conditions. CTBE is distinct from TAU conditions whereby the characteristics of CTBE therapists are controlled for the study via selection of therapists and supervisory arrangements. CTBE therapists were experts in treating high-risk clients and were categorised into six groups based on treatments they would usually provide BPD patients (the groups ranged from “behavioural therapist” to “very non-behaviroural”). Linehan’s, et al. (2006) study revealed that DBT surpassed the efficacy of CTBE in preventing suicide attempts by reducing it by half compared with the latter. Additionally, DBT was more effective in reducing inpatient psychiatric hospitalisation and had a significantly greater treatment retention. These results suggest that DBT may be uniquely effective in treating suicidal BPD individuals and its success is not solely due to the general features linked to receiving expert psychotherapy care.

Impulsivity seems to be a key traits of BPD that triggers parasuicidal acts; hence, perhaps the efficacy of DBT is attributed to the control of these impulsive tendencies. Impulsive self-ha