Thursday, July 31, 2014

DBT Appears Effective in Treating Suicidality, Self-Harm in Adolescents, Study Shows

Dialectical behavior therapy (DBT) may be an effective intervention to reduce self-harm, suicidal ideation, and depression in adolescents with repetitive self-harming behavior, according to a report published online in the Journal of the American Academy of Child and Adolescent Psychiatry. Researchers at Norway's National Centre for Suicide Research and Prevention at the University of Oslo, randomized 77 adolescents with recent and repetitive self-harm treated at community child and adolescent psychiatric outpatient clinics to receive either a shortened form of DBT or an enhanced form of usual care (EUC). Assessments of self-harm, suicidal ideation, depression, hopelessness, and symptoms of borderline personality disorder were made at baseline and after nine, 15, and 19 weeks, and frequency of hospitalizations and emergency department visits over the trial period were recorded.

DBT was found to be superior to EUC in reducing self-harm, suicidal ideation, and depressive symptoms. Effect sizes were large for treatment outcomes in patients who received DBT, whereas effect sizes were small for outcomes in patients receiving EUC.

A form of therapy originally developed by Marsha Linehan, Ph.D., of the University of Washington to treat borderline personality disorder, DBT combines cognitive and behavioral strategies with validation and Eastern mindfulness, among other techniques, to help individuals change unwanted or unhealthy behaviors.

Psychiatrist Paula Clayton, M.D., former medical director of the American Foundation for Suicide Prevention, told Psychiatric News the results of the new study are not surprising. “There are some effective psychotherapies [for the] treatment of suicidal thoughts and actions that are based on cognitive and behavioral techniques, and DBT is one of them. It has proven successful in previous research on adults with borderline personality disorder to decrease self-harming behaviors. It combines a number of elements and is very intensive.”

To read more about the use of DBT, see the Psychiatric News article, “Several Therapies Show Success in Treatment of Personality Disorders.” For information on how clinicians can address suicide risk in their patients, see the American Psychiatric Publishing Textbook of Suicide Assessment and Management, Second Edition.

(Image: MitarArt/