The Therapeutic Community Integrated With a DBT Skills Training Program for Substance Use Disorders: The Initial Efficacy for the Treatment of Impulsivity and Related Dimensions

ABSTRACT Objectives This study aims at investigating the initial efficacy of a 6‐month therapeutic community (TC) intervention integrated with a standard Dialectical Behavior Therapy Skills Training (DBT‐ST) program (DBT‐ST‐TC) for treating impulsivity among patients with SUDs. Methods Impulsivity was assessed through self‐report (UPPS‐P) and neuropsychological (Attentional Network Test [ANT]‐conflict monitoring, Go/No‐Go, Iowa Gambling Task) measures. Furthermore, mindfulness (FFMQ, MAAS) emotion dysregulation (DERS) and distress tolerance (DTS) were evaluated. Intention‐to‐treat analysis was performed to evaluate pre‐ post‐treatment changes controlling for baseline levels. Pre‐ and post‐treatment results of the DBT‐ST‐TC group were also compared to baseline levels of variables of interest measured in two control groups (i.e., untreated outpatient with SUDs; healthy controls [HCs]). Results Sixty‐eight patients with SUDs were screened and admitted to the DBT‐ST‐TC. Thirty‐eight (55.9%) patients completed the first cycle of DBT‐ST‐TC. The clinical control group included 41 untreated individuals with SUDs. The HC group was composed of 53 participants. DBT‐ST‐TC patients reported pre‐ post‐treatment improvements of emotion dysregulation ( t (67) = −2.10; p = 0.04), positive urgency ( t (67) = −3.27; p = 0.002) and sensation seeking ( t (67) = −2.08; p = 0.04). The improvement of ANT‐conflict monitoring performances was the most relevant pre‐ posttreatment change ( t (67) = −2.98; p = 0.005): no significant differences between posttreatment performances of the DBT‐ST‐TC group and HCs were detected. Conclusion The DBT‐ST‐TC might be a promising intervention for treating patients with SUDs. Future long‐term outcomes are needed to corroborate and extend these provisional results.