Effectiveness of a modified dialectical behaviour therapy for adolescents within a stepped-care model

Objective: Early intervention with evidence-based treatment is important to halt the progression from early manifestations of personality disorder traits to adult personality disorders. The purpose of this study is to evaluate dialectical behaviour therapy (DBT) modified for an adolescent population with borderline personality disorder (BPD), offered within a stepped-care model.

Methods: Seven adolescents (M=1, F=6, Mage=16.86) diagnosed with either BPD or BPD traits participated in a modified 15-week DBT group. The group was offered within a stepped-care model, which required participants to have previously completed an 8-week distress-tolerance module. Pre/post scores on self-report measures of BPD symptomatology, including impulse control, emotional regulation and awareness, anxiety, depression, and substance use, were collected.

Results: Participants showed a post-treatment decrease in anxiety symptoms (large effect size) and disruptive behaviours (medium effect size). There was also an increase in emotional symptoms (medium effect size) and hyperactivity/inattention (medium effect size).

Conclusion: The modified DBT group shows promise in alleviating symptoms of anxiety and some of the disruptive behaviours associated with BPD. The increase in emotional symptoms may be due to the expressive nature of DBT, and may contribute to their eventual therapeutic processing in the next step of the program.