Original Investigation

Dialectical Behavior Therapy vs Schema Therapy for Patients With Borderline Personality Disorder

JAMA Psychiatry 10.1001/jamapsychiatry.2026.0418

April 22, 2026 at 11:00 AM EDT

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What is the comparative effectiveness of dialectical behavior therapy (DBT) vs schema therapy (ST) for individuals with borderline personality disorder (BPD)?In this multicenter randomized clinical trial that included 204 adults with BPD, BPD severity decreased markedly over the 3-year study period, with no statistically significant differences in effectiveness between DBT and ST.The findings indicate no evidence of superiority of either treatment for outpatients with BPD, with both treatments associated with substantial long-term improvements.

Corresponding Author: Carlijn J. M. Wibbelink, MSc, Department of Clinical Psychology, University of Amsterdam, Nieuwe Achtergracht 129-B, 1018 WS Amsterdam, the Netherlands (c.j.m.wibbelink@uva.nl).

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