In Honor of Black History Month

In Honor of Black History Month: Research on DBT with Black and African American clients

February is Black History month, and DBT-LBC ™ wanted to specifically address the state of the research on Dialectical Behavior Therapy (DBT) with Black and African American clients. Currently, there are few studies to consider, and what studies there are highlight DBT as both promising and in need of intentional transformation to meet the needs of Black and African American communities. Our goal is to share what peer‑reviewed work currently tells us, as well as what’s being left out.

One example of DBT being adapted comes from work with African American pregnant women in community medical settings. In a pilot trial, researchers developed an eight‑week DBT‑informed skills group for low‑income African American pregnant women with depression, PTSD symptoms, and had high rates of adverse childhood experiences. The group emphasized mindfulness and emotion regulation as core skills and deliberately acknowledged chronic stressors like racism, poverty, and trauma. The outcomes were promising, as clients described the DBT informed skills groups as helpful and relevant to practicing in the real world, and the majority of clients completed all 8 sessions. The team used community‑based and culturally responsive strategies during group, integrated real-world stressors into in-vivo skills practice, actively discussed spirituality, and overtly validated experiences of racism. Today, there are ongoing studies that include delivering the model virtually with a focus on stress reduction and maternal mental health.

Some studies have asked whether DBT outcomes vary by race or ethnicity when clients are treated together in standard programs. In a recent analysis, researchers looked for differences in baseline severity, rate of change, or likelihood of dropping out between non‑Hispanic White clients and racial and ethnic minority clients. No significant differences were found; in fact, minority clients improved at similar rates and did not have higher dropout rates than White clients. This pattern is consistent across research studies, where data finds no large and consistent differences. At the same time, there are serious limitations in how identity is measured and reported. A 2025 review of DBT with clients identified as minorities showed that where data exist, DBT appears broadly effective across groups. That same data showed a lack of clear definitions of race and Black and African American identities, which likely leads to under-reporting and difficulty in replicating studies.

For DBT clinicians, one key takeaway is dialectical: current data do not suggest that DBT is inherently less effective for Black and African American clients AND the absence of clear disparities does not mean the treatment is fully meeting the needs of these groups. Essentially, a lack of evidence doesn’t define nor confirm equity.

The best available evidence suggests that DBT can be both effective and relevant for Black and African American clients AND it will require DBT clinicians to assert an anti-racist approach from the ground up. This includes the client relationship, the Consultation Team, agency practices and policies, and the community at large. The research to date shows that the field is doing as best it can, while we know that we need to do better.