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THEORY-922: Among 56 of 88 patients in one DBT intensive outpatient programme, kept because they finished a four-month cycle and gave enough diary data, skills-homework completion in months 1–3 correlated with larger falls in suicide and substance-use urges (r ≈ .35) and phone-coaching frequency with a larger fall in self-harm urges (r = .31); neither correlated with change in how often the behaviours occurred, and only homework separated patients with and without a target behaviour in month 4

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StatusActive
Version2
Tagspsychopathology-and-treatment, learning-and-conditioning
SourceLIT-1480 — Skills‐homework completion and phone coaching as predictors of therapeutic change and outcomes in completers of a DBT intensive outpatient programme
Bears onQUESTION-307 — In dialectical behaviour therapy, do skills-homework completion and phone coaching predict falling urges and less frequent target behaviour once baseline functioning and motivation are controlled and patients with missing diary data are kept, and does skill use between sessions mediate the change?
Cited as “corroborated by” byCLAIM-443 — A learned prior over which processes govern, P(g | z, H) ∝ exp(βQ(g, z) + b_H(g, z)), its bias b_H trained by reward-modulated Hebbian updates to the relations by which one process recruits or endorses another, is a candidate mechanism for durable authority and for amortized governance; but persistence is not amortization, which is shown only when earlier work replaces later computation, communication or recruitment, and a prior over authority differs from a prior over actions only when what is appropriate changes

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Source

Edwards et al., LIT-1480, read in full in NOTE-1121 from the version of record posted on the Yale CANLab site: pp. 509–513 and 517–519, with Tables 2–4.

What was actually shown

  • Urges (p. 513; Table 4). Homework completion with change in suicide urges r = .35 and in substance-use urges r = .36 (.37 in the table); with alcohol urges r = .25, p = .06. Coaching calls with change in self-harm urges r = .31. The other pairings were not significant.
  • Behaviour (p. 513). “Regarding frequency of engagement in target behaviours, results reflected no significant associations.”
  • Month 4 (p. 513). Patients with no target behaviour (27) against those with one or more (27), controlling for attendance: homework 91.3% against 79.8% (p = .02); coaching calls 6.00 against 3.85 (p = .096).

What could have come out otherwise: homework and coaching could have been unrelated to change, as attendance was.

What this does not say

  • That homework or coaching causes the change. Correlational; reverse order and confounding by motivation or functioning cannot be excluded (p. 518).
  • That they change behaviour. No association with behaviour frequency; the one behavioural difference is homework and any behaviour in month 4.
  • That generalization is the mechanism. No measure of skill use between sessions.
  • That it holds for all completers. 28 of 88 were dropped for missing diary data.
  • That the result survives correction. None was applied (p. 519).

Connections

  • CLAIM-443. The claim’s DBT example has practice change which process is recruited. This is evidence that practice and outcome go together, weakly, and says nothing about what practice changed or what it costs.
  • CLAIM-349. Its note of 2026-10-23 separates knowing a skill from deploying it under pressure. Phone coaching is deployment supported from outside at the moment of need, and its association is with falling self-harm urges only.

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