whereby DBT patients improved more than TAU patients in terms of suicidal ideation, number of parasuicides and number of hospitalizations. However, I noted a major limitation whereby there was only 10 participants in each condition and they were once again all female; hence, limiting the ability to generalise from the study on top of reducing the statistical power. Additionally, in contrast to Linehan’s, et al. (1991) study, not all patients were parasuicidal at pre-treatment as required by the former study. Koon’s study revealed decreases in hopelessness and depression, unlike Linehan’s (1991) study, which could be due to Koon’s less parasuicidal sample being more amenable to change. Nonetheless, despite its small size, this study still showed improvements in the suicidal symptoms of BPD, as well as suggests that the treatment is not limited to only improving parasuicidal behaviour but could also improve other symptoms such as negative thinking patterns in BPD patients.

Moreover, in Verheul, et al. (2003)’s study, patients in the DBT group received 12-months of therapy, according to the DBT manual, by trained psychologists while TAU consisted of two clinical management sessions a month from the patients’ referral source (e.g. addiction treatment centres or psychiatric services). They found that DBT group generated a greater reduction in self-damaging impulsive acts compared to TAU. In fact, their results indicated that TAU patients’ progress deteriorated over time, suggesting that non-specialised treatment could prove detrimental rather than beneficial. Verheul and colleagues (2003) also examined if the efficacy of DBT would be modified by the baseline severity of parasuicidal acts, and found that DBT had a more profound impact on reducing the frequency of self-mutilating behaviours in participants with a higher baseline but showed similar improvements as TAU on patients in the low-severity group. This suggests that DBT should – consistent with its original aims (Linehan, 1991) – be the intervention of choice for only chronically parasuicidal BPD patients. Overall, both Koons, et al. (2001) and Verheul, et al. (2003) showed that DBT is an efficacious treatment for high-risk behaviours and can be conducted with fairly good adherence by a group of therapists at a location independent of the treatment de