Previously submitted to: JMIR Mental Health (no longer under consideration since Feb 09, 2026)
Date Submitted: Feb 6, 2026
Open Peer Review Period: Feb 9, 2026 - Feb 9, 2026
(closed for review but you can still tweet)
NOTE: This is an unreviewed Preprint
Warning: This is a unreviewed preprint (What is a preprint?). Readers are warned that the document has not been peer-reviewed by expert/patient reviewers or an academic editor, may contain misleading claims, and is likely to undergo changes before final publication, if accepted, or may have been rejected/withdrawn (a note "no longer under consideration" will appear above).
Peer review me: Readers with interest and expertise are encouraged to sign up as peer-reviewer, if the paper is within an open peer-review period (in this case, a "Peer Review Me" button to sign up as reviewer is displayed above). All preprints currently open for review are listed here. Outside of the formal open peer-review period we encourage you to tweet about the preprint.
Citation: Please cite this preprint only for review purposes or for grant applications and CVs (if you are the author).
Final version: If our system detects a final peer-reviewed "version of record" (VoR) published in any journal, a link to that VoR will appear below. Readers are then encourage to cite the VoR instead of this preprint.
Settings: If you are the author, you can login and change the preprint display settings, but the preprint URL/DOI is supposed to be stable and citable, so it should not be removed once posted.
Submit: To post your own preprint, simply submit to any JMIR journal, and choose the appropriate settings to expose your submitted version as preprint.
Warning: This is an author submission that is not peer-reviewed or edited. Preprints - unless they show as "accepted" - should not be relied on to guide clinical practice or health-related behavior and should not be reported in news media as established information.
A Blended Learning Approach to Online DBT Skills Training: Preliminary Clinical Outcomes and Intervention Acceptability
ABSTRACT
Background:
The prevalence of mental health concerns has been increasing, but few people manage to access evidence-based mental health interventions. Standalone dialectical behavioral therapy (DBT) skills training can effectively address emotion dysregulation and emotional distress across a range of diagnoses. However, delivering DBT requires specialized training and can be challenging to scale. In response to this, TheraHive was developed as an internet-delivered, blended learning model that provides 6-months of self-guided, self-paced learning across DBT modules in conjunction with weekly live skills review groups. Despite the potential for its success in addressing common mental health concerns, no prior studies have examined clinical and acceptability outcomes of TheraHive.
Objective:
This pre-post study examined preliminary clinical outcomes and acceptability of a blended online DBT skills group delivered on the TheraHive platform.
Methods:
TheraHive students completed online questionnaires as part of their routine participation in TheraHive. These questionnaires included the Depression Anxiety Stress Scale (DASS-21) at the end of each of the four DBT modules (n=251 respondents) and an acceptability questionnaire (n=67 respondents).
Results:
TheraHive students were predominantly ages 25-34 and female. Results indicate that anxiety, F(1, 164) = 11.16, p=.001, ηp2=.07, stress, F(1, 164) = 5.49, p=.02, ηp2=.03, and total DASS-21 scores, F(1, 164) = 9.04, p=.003, ηp2=.05 improved over the course of the intervention. Depression symptoms did not significantly improve (p=.07), and there were no differences in symptom change by age group. Acceptability was rated highly on a 5-point scale (M=4.69; SD=0.63).
Conclusions:
Results support the preliminary effectiveness and acceptability of TheraHive as a scalable model for delivering DBT skills groups to patients with transdiagnostic concerns. Future research will examine these outcomes in a randomized controlled trial and will examine a lay-instructor led model of TheraHive in which non-specialists facilitate skills groups. This has the potential to further enhance access to evidence-based transdiagnostic mental health care.
Citation
Request queued. Please wait while the file is being generated. It may take some time.
Copyright
© The authors. All rights reserved. This is a privileged document currently under peer-review/community review (or an accepted/rejected manuscript). Authors have provided JMIR Publications with an exclusive license to publish this preprint on it's website for review and ahead-of-print citation purposes only. While the final peer-reviewed paper may be licensed under a cc-by license on publication, at this stage authors and publisher expressively prohibit redistribution of this draft paper other than for review purposes.