Dialectical Behavior Therapy Skills Training as a Brief Intervention for Cigarette Smoking by Patients With Cancer: A Scoping Review and Narrative Synthesis of Related Literature.

Abstract

Objective: Novel behavioral interventions are needed for patients with cancer who smoke cigarettes. Standard tobacco treatment may not effectively address the psychological distress and/or emotion dysregulation that makes quitting smoking difficult for many patients. Dialectical Behavior Therapy-Skills Training (DBT-ST) has demonstrated efficacy as a brief intervention for managing emotions and stress across varied populations but has not been adapted for patients with cancer who smoke. To determine its suitability for this population, we conducted a scoping review of brief DBT-ST with similar populations: people with substance use, breast cancer, or emotion dysregulation.

Methods: We followed PRISMA-ScR (preferred reporting items for systematic reviews and meta-analyses extension for scoping reviews) guidelines. Studies were restricted to English-language publications of DBT-ST as a brief intervention of 20 or fewer sessions. We found 26 publications representing 23 research studies, extracted study details, and narratively synthesized the results.

Results: The 23 studies included 12 quasi-experimental designs, seven pilot randomized controlled trials (RCTs), and four RCTs. All studies found at least one improvement in a main outcome following DBT-ST intervention, with results maintained at follow-up. Qualitative outcomes indicated high satisfaction with DBT-ST and good retention. Studies recruited diverse participants, with some far exceeding population averages. Over half of the studies included only females or males. We found considerable heterogeneity across studies in intervention design, testing, and measurement.

Conclusion: DBT-ST as a brief intervention for people with substance use, cancer, or emotion dysregulation demonstrates sufficient positive outcomes to adapt this approach for patients with cancer who smoke cigarettes.