Background
Dialectical behavior therapy (DBT) is an internationally recognized evidence-based treatment that directly addresses suicidal behavior and other forms of self-injury in adult populations (Linehan 1993). DBT has been adapted for use with adolescents as well and is considered an empirically supported treatment for decreasing repeated suicide attempts (SA) and nonsuicidal self-injury (NSSI) in adolescents (McCauley et al. 2018). However, research on the impact of DBT on depressive and manic symptoms more broadly, as well as domains of functioning, is limited.
The effect of DBT on depressive and anxiety symptoms has been examined for adult patients within inpatient and outpatient settings. Among adult patients with borderline personality disorder (BPD), outpatient DBT treatment has shown efficacy in decreasing depressive and anxiety symptoms, as well as anger (Lynch et al. 2007; Soler et al. 2009). Outpatient DBT has also been shown to reduce depressive symptoms for adults diagnosed with major depressive disorder (MDD) (Harley et al. 2008; Neacsiu et al. 2014). With an inpatient population, Bohus et al. (2004) reported that adults with BPD who received 3 months of inpatient DBT treatment had significant reductions in depression and anxiety.
There is some support for DBT decreasing mood symptoms within an outpatient adolescent population. Among adolescents treated with DBT, Mehlum et al. (2014) reported that DBT treatment decreased depressive symptoms among those who received 19 weeks of outpatient DBT compared with patients who received enhanced usual care. Goldstein et al. (2015) reported in their pilot study of outpatient DBT treatment for adolescents diagnosed with bipolar disorder that adolescents reported a significant decrease in depressive symptoms over a 1-year treatment course compared with patients who received treatment as usual (TAU).
To date, there is limited research on DBT for adolescents treated within an inpatient setting. Tebbett-Mock et al. (2020) reported in a recently published study that after implementing DBT onto an acute-care psychiatric unit for adolescents with an average length of stay of 8 days, DBT was effective at decreasing incidents of SA, of NSSI, and of restraints, as well as hours of constant observation for self-injurious behavior compared to patients who received TAU before DBT implementation. DBT treated patients also had a shorter length...
