Long Term Effectiveness of Dialectical Behavior Therapy versus Enhanced Usual Care for Adolescents with Self-Harming and Suicidal Behavior

Home Resources Long Term Effectiveness of Dialectical Behavior Therapy versus Enhanced Usual Care for Adolescents with Self-Harming and Suicidal Behavior

The Journal of Child Psychology and Psychiatry  |  September 2019

TAGS: Dr. Alec L. Miller, Publications

Authors: Mehlum, L., Ramleth, R.K., Tørmoen, A.J., Haga, E., Diep, L.M, Stanley, B.H., Miller, A.L., Larsson, B., Sunda, A.M., & Grøholt

APA Reference: Mehlum, L., Ramleth, R.K., Tørmoen, A.J., Haga, E., Diep, L.M, Stanley, B.H., Miller, A.L., Larsson, B., Sunda, A.M., & Grøholt. (2019). Long Term Effectiveness of Dialectical Behavior Therapy versus Enhanced Usual Care for Adolescents with Self-Harming and Suicidal Behavior. Journal of Child Psychology and Psychiatry, 60(10), 1112-1122. Doi: 10.1111/jcpp.13077

Results:

The main findings from this 3-year follow-up of self-harming adolescents with borderline traits having received either DBT-A or EUC were:

1) The frequency of self-harm episodes among participants receiving DBT was substantially lower from post-treatment through 3 year follow-up as compared to EUC.

1a) A substantial proportion of the effect of DBT-A on self-harm over the long-term appears to be mediated by a reduction in participants' experience of hopelessness during the treatment trial.

(DBT targets hopelessness in several ways: a) Use of DBT cognitive strategies including psycho-education helping teens link problem-behaviors to their goals; b) Use of DBT commitment strategies and helping teens clarify the pros/cons of choices they are making about their treatment and future life; c) Use of dialectical thinking, helping teens change their often extremely polarized perceptions of self and others; d) Helping teens identify and build a life worth living and increase reasons for living.)

2) DBT participants receiving more than 3 months follow-up treatment during the first year after completion of the treatment trial was associated with further enhanced outcomes.

3) For the most part participants in both groups had retained treatment gains with no sign of relapse and no significant between-group differences on most other outcomes apart from what was mentioned above.

 

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