Effectiveness of Dialectical Behavior Therapy in Patients in Forensic Psychiatry and Prison: Primary and Exploratory Meta-Analyses

We conducted primary and exploratory meta-analyses to evaluate the effectiveness of dialectical behavior therapy (DBT) and its forensic (DBT-F) and correctional (DBT-CM) adaptations in forensic psychiatric and correctional settings. Following PRISMA 2020 guidelines, a systematic search across multiple databases identified studies assessing the effects of DBT on aggression, impulsivity, emotion regulation, depression, and borderline symptoms. The primary meta-analysis included eight pretest-posttest control group studies ( N = 394) and found a significant overall effect ( b = −.51, p = .04) with notable heterogeneity. In a moderator analysis, a significant improvement was observed for borderline symptoms ( b = −1.43, p < .001), but not for other domains. The exploratory meta-analysis of 21 studies (including one-group designs) found significant moderator effects for impulsivity, emotion regulation, depression, aggression and borderline symptoms. DBT appears promising for reducing borderline pathology in forensic and correctional settings, though more high-quality studies using well-adapted protocols are needed.