Dialectical Behavior Therapy for Adolescents

The authors of a study of dialectical behavior therapy for adolescents (DBT-A) in Norway concluded “that it is indeed possible for adolescents [who exhibit symptoms of borderline personality disorder and engage in repetitive self -harm] to be engaged, retained, and treated successfully and safely” for self-harm, suicidal ideation, and depression over a relatively short course of outpatient treatment.

DBT-A is a treatment for self-harming adolescents with borderline personality disorder (BPD) that includes individual therapy, group skills training for parents or caregivers, and telephone coaching by therapists. This intervention was adapted from a treatment that has been shown to reduce suicidal and nonsuicidal self-harm in adults. The “adult” version of DBT also reduces emergency department visits and hospitalizations, and improves treatment completion, social adjustment, and personality functioning among adults.

The study compared two groups of Norwegian adolescents (ages 12-18) who had engaged in recent and repetitive self-harm, and who met certain diagnostic criteria for BPD (which has been shown to be associated with repetitive self-harm, a risk factor for suicide). One group of adolescents was treated with DBT-A. A matched control group was given enhanced usual care (EUC) that included other types of therapy (e.g. cognitive behavioral therapy) sometimes combined with pharmaceuticals.

Compared to the EUC group, the DBT-A group experienced fewer episodes of self-harm (although this reduction was not statistically significant), as well as statistically significant reductions in suicidal ideation and depression (both of which are risk factors for suicide). The authors point out that only one other form of therapy, mentalization-based treatment for adolescents, has produced comparable results for adolescents, and that method requires a much longer treatment period (one year, as compared to four months for DBT-A).

This summary is from: Mehlum, L., Tørmoen, A.J., Ramberg, M., Haga, E., Diep, L.M., Laberg, S.,…& Grøholt, B. Dialectical behavior therapy for adolescents with repeated suicidal and self-harming behavior: A randomized trial. Journal of the American Academy of Child and Adolescent Psychiatry 53(10), 1082-1091.