Analysis of behavioral skills utilized by suicidal adolescents receiving dialectical behavior therapy

Researchers are currently applying dialectical behavior therapy (DBT), originally developed for adult chronically parasuicidal women diagnosed with borderline personality disorder (BPD), to a suicidal adolescent population diagnosed with BPD or borderline features. The four characteristic problem areas often found among these multiproblem patients are (a) confusion about self, (b) impulsivity, (c) emotional instability, and (d) interpersonal problems. DBT employs four corresponding behavioral skills modules aimed at increasing adaptive behaviors while simultaneously reducing maladaptive behaviors. The four skill modules include mindfulness skills, distress tolerance skills, emotion-regulation skills, and interpersonal effectiveness skills. The present study examines adolescent self-report of the helpfulness and overall effectiveness of these skills by using pre- and posttreatment evaluations. Consistent with prior research of DBT with adolescents, this study found significant reductions in BPD symptoms in all four problem areas. The four most highly rated skills included distress tolerance and mindfulness skills. Relationships found between the helpfulness of specific skills and improvement in particular problem areas are described. Lastly, implications for future research of DBT skill comprehension and application among adolescents are discussed.