The Inclusion of Ethnoracial, Sexual, and Gender Minority Groups in Randomized Controlled Trials of Dialectical Behavior Therapy: A Systematic Review of the Literature

This systematic review evaluated the sample reporting practices and inclusion rates for ethnoracial, sexual, and gender minority groups in randomized controlled trials (RCTs) of Dialectical Behavior Therapy (DBT; 18 RCTs, N = 1,175). Participants' race (94.4%) and ethnicity (72.2%) were frequently reported, but not their sexual orientation (11.1%) or gender identity (5.6%). Inclusion rates were 39.2% for ethnoracial minority groups (16 RCTs, n = 1,018) and 27.3% for sexual minority groups (9 RCTs, n = 428). The gender minority inclusion rate could not be determined. Compared with the U.S. population, all ethnoracial minority groups were well-represented and all sexual minority groups were overrepresented. No studies examined if treatment outcomes differed for minority groups. The evidence base for DBT appears to adequately represent ethnoracial and sexual minority groups, and improvements are needed in sample reporting and data analytic practices. Public Health Significance StatementDialectical Behavior Therapy (DBT) is an evidence-based psychotherapy for borderline personality disorder as well as suicidal and self-injurious behaviors. This systematic review indicates that the evidence base for DBT appears to include a representative number of ethnoracial and sexual minority participants, which supports the use of DBT with these minority groups in clinical practice.