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. 2025 Oct 7:16:1669524.
doi: 10.3389/fpsyt.2025.1669524. eCollection 2025.

Dialectical behavioral therapy skills training in assisted living: transdiagnostic effects on goal attainment, self-efficacy, and symptom severity

Philipp Koziol  1 , Carina Florin  1 , Kathleen Heft  2 , Robert Fellinger  1 , Thomas Probst  1
Affiliations

Dialectical behavioral therapy skills training in assisted living: transdiagnostic effects on goal attainment, self-efficacy, and symptom severity

Philipp Koziol et al. Front Psychiatry. .

Abstract

Background: Dialectical Behavior Therapy Skills Training (DBT-ST) is an evidence-based intervention targeting emotion regulation, self-efficacy, and psychological well-being. While widely applied in clinical settings, its effectiveness and feasibility in long-term residential care remain underexplored. This study hypothesized that an 8-week DBT-ST program would increase goal attainment and self-efficacy, and decrease psychological distress among assisted living residents, with further improvements expected at a two-week follow-up.

Method: A total of 52 residents from four assisted living facilities operated by Pro Mente Salzburg, Austria, participated in an 8-week DBT-ST program. The intervention was delivered by the facilities' psychologists and by staff supervised by psychologists in weekly group sessions. Self-reports were used to assess goal attainment (ranging from 0% to 100% in 10% intervals), self-efficacy (Self-Efficacy Scale - Short Form; ASKU), and psychological distress (Kessler Psychological Distress Scale; K10).

Results: Goal attainment (p = .040, d = 0.28) and psychological distress (p =.034, d = 0.26) showed initial improvements from baseline to post-intervention, but these effects did not withstand Bonferroni correction. No significant changes were observed between post-intervention and follow-up.

Conclusions: While nominal improvements were observed, these did not remain significant after correction for multiple testing. The study nonetheless offers preliminary evidence on the feasibility and the challenges of DBT-based interventions in assisted living settings and highlights the need for future research on their context-sensitive adaptations.

Keywords: assisted living; dialectical behavior therapy; goal attainment; psychological distress; self-efficacy; skills training; transdiagnostic intervention.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. The author(s) declared that they were an editorial board member of Frontiers, at the time of submission. This had no impact on the peer review process and the final decision.

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