The effectiveness of dialectical behaviour therapy training: a quantitative systematic review using Kirkpatrick's four-level model.

Effective therapist training is critical to the successful implementation of Dialectical Behaviour Therapy (DBT) in routine clinical practice. Although various training approaches exist, their outcomes have not been comprehensively synthesised. This systematic review examined the effectiveness of DBT training across different delivery formats and identified key factors associated with training success. Four databases (Medline, CINAHL, PsycInfo, and PubMed) were searched for quantitative studies, and the quantitative components of mixed-methods studies, evaluating training outcomes according to Kirkpatrick’s Four-Level Model. Twenty-four studies met inclusion criteria. Six priority outcomes were assessed for certainty using the GRADE approach. Overall, DBT training was well received and associated with positive effects on therapists’ knowledge, self-efficacy, attitudes, and self-reported DBT use. More intensive training models with implementation support were linked to improved knowledge acquisition, motivation, self-reported DBT use, and, in some cases, client outcomes. The studies were highly heterogeneous in design and measures, few reported effect sizes, and most carried moderate risk of bias. As a result, the overall certainty of evidence was generally low. These findings highlight the potential effectiveness of DBT training while emphasising the need for more rigorous, standardised evaluations to strengthen the evidence base.