[Dialectical Behaviour Therapy for adolescents (DBT-A)—a pilot study on the therapy of suicidal, parasuicidal, and self-injurious behaviour in female patients with a borderline disorder]

Christian Fleischhaker, Michael Munz, Renate Böhme, Barbara Sixt, Eberhard Schulz
Zeitschrift Für Kinder- und Jugendpsychiatrie und Psychotherapie 2006, 34 (1): 15-25; quiz 26-7

OBJECTIVES: In Germany suicide ranks as the second leading cause of death in adolescents. Risk factors for suicide are impulsive and self-injurious behaviour, depression, and conduct disorder. The main hypothesis of our study is that Dialectical Behavior Therapy (DBT) for adolescents is an effective method of treatment for these patients.

METHODS: DBT was developed by Marsha Linehan specifically for the outpatient treatment of chronically parasuicidal female patients with a diagnosis of borderline personality disorder. Miller & Rathus modified DBT for use with adolescents (DBT-A). and our group adapted the DBT-A for use in an outpatient treatment setting in Germany. In a pre-post comparison, the efficacy of treatment was measured using standardized instruments (SCL-90-R, CBCL, YSR, ILK, CGI, etc.).

RESULTS: In a pilot study of 12 adolescents, we found effect sizes between 1.1 and 2.9. During treatment, self-injurious behaviour declined significantly. Prior to entering therapy, 8 of the 12 patients had attempted suicide at least once. During treatment according to DBT-A there were no suicide attempts.

CONCLUSIONS: These results are so promising that we are now planning a randomized, multi-centre study.

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