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Tijdschrift voor Psychiatrie 51 (2009) 1, 31 - 41

Review article

Dialectical behaviour therapy for adolescents

H.S. Backer, A.L. Miller, L.M.C. van den Bosch

background According to several randomised controlled trials (rct's) dialectical behaviour therapy (dbt) is effective in treating adults diagnosed with borderline personality disorder (bpd) who present with self-injurious and suicidal behaviour. In recent years there have been several studies about dbt in adolescents with varying problems and disorders.
aim To review the literature for evidence of the effectiveness of dbt in adolescents aged 12 to 18.
method With the help of PubMed and Medline and using the search-terms 'dialectical', 'adolescent', 'suicide attempt' and 'deliberate self harm', we searched the literature for references to dbt in adolescents.
results There were no rct's involving dbt in adolescents, but we did find one quasiexperimental design and several other studies with a pre-post treatment design. However, the studies were difficult to compare. In some cases it was doubtful whether the treatment could still be called dbt. The results suggested that dbt may be just as effective with adolescents as it is with adults in reducing bpd symptoms, suicidal ideation, and comorbid depressive disorder symptoms, and in reducing the need for hospitalisation. The results also indicated that dbt might be effective in treating eating disorders, bipolar disorder, oppositionality, aggression and nonsuicidal selfinjurious behaviour (nsib) in a variety of treatment settings.
conclusion dbt is possibly effective for treating adolescents with nsib and/or bpd symptoms. It may also be an effective treatment for various other affective and behavioural disorders. rct's are needed.


keywords adolescent, dialectical behaviour therapy