Implementing Dialectical Behavior Therapy With Adolescents and Their Families in a Community Outpatient Clinic

Dialectical behavior therapy (DBT), an empirically supported treatment for adult women diagnosed with borderline personality disorder (BPD), has been increasingly adapted for use with adolescents across a variety of settings. This article describes a community-based application of DBT principles and strategies for adolescents and their families. It is the first study of DBT with suicidal and self-injuring adolescents to provide parent as well as adolescent reports of change. Uncontrolled pre- to posttreatment effects ranged from d = .62 to .94 for adolescent-reported depressive symptoms, anger, dissociative symptoms, overall symptoms and functional difficulties, and items on which adolescents reported wanting to hurt or kill themselves. Not only did parents report similar changes ( d = .55 to .65) in adolescent internalizing, externalizing, and total problem behaviors, they reported a large change ( d = .72) in their own depressive symptoms as well. The consistency of these effects with those of other preliminary studies of adolescent DBT suggests that this model is indeed feasible within a naturalistic community treatment setting and may have benefits for families as well as adolescents.