Feasibility of dialectical behavior therapy with suicidal and self-harming adolescents with multi-problems: training, adherence, and retention

Arch Suicide Res. 2014;18(4):432-44. doi: 10.1080/13811118.2013.826156.

Abstract

We evaluated the feasibility of DBT training, adherence, and retention preparing for a randomized controlled trial of Dialectical Behavior Therapy (DBT) adapted for Norwegian adolescents engaging in self-harming behavior and diagnosed with features of borderline personality disorder. Therapists were intensively trained and evaluated for adherence. Adherence scores, treatment retention, and present and previous self-harm were assessed. Twenty-seven patients were included (mean age 15.7 years), all of them with recent self-harming behaviors and at least 3 features of Borderline Personality Disorder. Therapists were adherent and 21 (78%) patients completed the whole treatment. Three subjects reported self-harm at the end of treatment, and urges to self-harm decreased. At follow up, 7 of 10 subjects reported no self-harm. DBT was found to be well accepted and feasible. Randomized controlled trials are required to test the effectiveness of DBT for adolescents.

Keywords: adolescents; psychotherapy; self-harm; suicidal behavior; treatment.

MeSH terms

  • Adolescent
  • Behavior Therapy* / education
  • Behavior Therapy* / methods
  • Borderline Personality Disorder* / complications
  • Borderline Personality Disorder* / diagnosis
  • Borderline Personality Disorder* / psychology
  • Borderline Personality Disorder* / therapy
  • Diagnostic and Statistical Manual of Mental Disorders
  • Feasibility Studies
  • Female
  • Follow-Up Studies
  • Guideline Adherence
  • Humans
  • Interview, Psychological
  • Male
  • Norway
  • Retention, Psychology
  • Risk Assessment
  • Self Report
  • Self-Injurious Behavior* / diagnosis
  • Self-Injurious Behavior* / etiology
  • Self-Injurious Behavior* / prevention & control
  • Self-Injurious Behavior* / psychology
  • Suicidal Ideation
  • Suicide, Attempted* / prevention & control
  • Suicide, Attempted* / psychology
  • Teaching / methods
  • Treatment Outcome