Outpatient Dialectical Behavior Therapy for Adolescents Engaged in Deliberate Self-Harm: Conceptual and Methodological Considerations

Freeman, Kimberly; James, Sigrid; Klein, Keith P.; Mayo, Danessa; Montgomery, Susanne

doi:10.1007/s10560-015-0412-6

Cited by 19 publications

(13 citation statements)

References 75 publications

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“…We propose that these problems are due to limitations in the designs of these research studies that are related to monitoring and measuring self-injury in study participants. This explanation aligns with the findings in another study in which researchers identified substantial inadequacies in outcome research on DBT-A for self-injury, including a lack of consistency in inclusion criteria and inconsistent use of formalized assessments to measure self-injury (Freeman, James, Klein, Mayo, & Montgomery, 2016).…”

Section: Effectiveness Of Dialectical Behavior Therapy For Adolescentssupporting

confidence: 80%

Preliminary Evidence for the Effectiveness of Dialectical Behavior Therapy for Adolescents

Hollenbaugh

Lenz

2018

Jour of Counseling & Develop

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This meta‐analysis evaluated the effectiveness of dialectical behavior therapy for adolescents in reducing symptoms of depression, anxiety, self‐injury, and suicide risk. Twelve between‐group studies (N = 834) were chosen that met the inclusion criteria. Results revealed small‐to‐medium Hedges's g effect sizes for all 4 symptoms compared with control and alternative treatment groups. However, the small number of effect sizes available for each analysis limited the generalizability of the findings. Implications and suggestions for future research are discussed.

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Section: Effectiveness Of Dialectical Behavior Therapy For Adolescentssupporting

confidence: 80%

Preliminary Evidence for the Effectiveness of Dialectical Behavior Therapy for Adolescents

Hollenbaugh

Lenz

2018

Jour of Counseling & Develop

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“…In a review of six controlled trials, Freeman et al . () concluded that dialectical behaviour therapy and family therapy was an effective intervention for adolescents who had attempted suicide. It led to significant reductions in non‐suicidal self‐harming behaviour, suicidal ideation and depressive symptoms.…”

Section: Emotional Problemsmentioning

confidence: 99%

“…Both sets of factors are targeted in family-based treatment for self-harm in adolescence. A series of studies has found that a range of specialized systemic interventions improved the adjustment of adolescents who had self-harmed (Asarnow et al, 2011;Diamond et al, 2010;Freeman et al, 2016;Harrington et al, 1998;Huey et al, 2004;King et al, 2006King et al, , 2009Rotheram-Borus et al, 2000), although family interventions were not always more effective than alternative treatments in reducing recurrence of self-harm. For example, in a large (N5832) UK randomized controlled trial, Cottrell et al (2018) found that family therapy was no more effective than treatment-asusual in preventing repeated self-harm at eighteen months follow up.…”

Section: Self-harmmentioning

confidence: 99%

“…The adolescentfocused therapy component includes modules on mindfulness, distress tolerance, emotion regulation, and interpersonal effectiveness skills to address problems in the areas of identity, impulsivity, emotional lability and relationship problems respectively. In a review of six controlled trials, Freeman et al (2016) concluded that dialectical behaviour therapy and family therapy was an effective intervention for adolescents who had attempted suicide. It led to significant reductions in non-suicidal self-harming behaviour, suicidal ideation and depressive symptoms.…”

Section: Self-harmmentioning

confidence: 99%

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Family therapy and systemic interventions for child‐focused problems: the current evidence base

Carr

2018

Journal of Family Therapy

209

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This review updates previous similar papers published in JFT in 2000, 2009 and 2014. It presents evidence from meta‐analyses, systematic literature reviews, narrative literature reviews and controlled trials for the effectiveness of systemic interventions for families of children and adolescents with common mental health problems and other difficulties. In this context, systemic interventions include both family therapy and other family‐based approaches such as parent training, or parent implemented behavioural programmes. The evidence supports the effectiveness of systemic interventions either alone or as part of multimodal programmes for sleep, feeding and attachment problems in infancy; recovery from child abuse and neglect; conduct problems, emotional problems, eating disorders, somatic problems, and first episode psychosis.

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“…Treatment duration is one of the number of variations in DBT-A studies to date that needs to be addressed (e.g. Freeman, James, Klein, Mayo, & Montgomery, 2016;MacPherson, Cheavens, & Fristad, 2013). To the best of our knowledge, no empirical research has compared the effectiveness of 16-and 24-week DBT-A programmes.…”

Section: Introductionmentioning

confidence: 99%

Dialectical behaviour therapy for adolescents: a comparison of 16‐week and 24‐week programmes delivered in a public community setting

Gillespie

Joyce

Flynn

et al. 2019

Child Adoles Ment Health

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Background Dialectical behaviour therapy for adolescents (DBT‐A) is an intervention with a growing evidence base for treating adolescents with emotional and behavioural dysregulation. Previous studies have reported on varying lengths of treatment, however, and optimal treatment duration has not yet been identified. While the treatment developers initially proposed a 16‐week programme, they have more recently recommended an extension to 24 weeks. This study compares outcomes for adolescents and parent/guardians who participated in 16‐ and 24‐week DBT‐A programmes in a community setting. Methods Eighty‐four adolescents and 100 parent/guardians participated in 16‐week DBT‐A, while 68 adolescents and 67 parent/guardians participated in the 24‐week programme. Outcome measures for adolescents included the presence and frequency of self‐harm, suicidal ideation and depression; and for parents were burden, grief and parental stress. Outcomes were assessed at pre‐ and postintervention. Linear mixed‐effects models were used to estimate the treatment duration effect (24‐week vs. 16‐week) utilising all available data at pre‐ and postintervention. Results Data analyses showed a reduction in the presence and frequency of self‐harm at postintervention for adolescents in both programmes. Both adolescent and parent participants in the 16‐ and 24‐week programmes also showed changes indicating significant improvement on all self‐report outcome measures (p < .05). A treatment duration effect was identified with adolescents in the 24‐week programme reporting greater gains on measures of suicidal ideation and depression (p < .05). However, drop‐out rates were higher for the 24‐week programme. Conclusions The findings of the current study indicate that 24‐week DBT‐A may have additional benefits in comparison to 16‐week DBT‐A in terms of further reductions in suicidal ideation and depression. Given the nature of this study, it was not possible to explore a potential time effect, however, so these results should be interpreted with caution. Further research will assist in determining an optimal programme duration of DBT‐A.

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Outpatient Dialectical Behavior Therapy for Adolescents Engaged in Deliberate Self-Harm: Conceptual and Methodological Considerations

Cited by 19 publications

References 75 publications

Preliminary Evidence for the Effectiveness of Dialectical Behavior Therapy for Adolescents

Preliminary Evidence for the Effectiveness of Dialectical Behavior Therapy for Adolescents

Family therapy and systemic interventions for child‐focused problems: the current evidence base

Dialectical behaviour therapy for adolescents: a comparison of 16‐week and 24‐week programmes delivered in a public community setting

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