A dialectical behavior therapy (DBT) skills training group for learning-disabled adolescents.

摘要

Dialectical Behavior Therapy (DBT), a treatment developed for adults with Borderline Personality Disorder (BPD), has been applied to other populations, including a recent adaptation for depressed and suicidal adolescents. Participation in DBT interventions has been associated with reductions in hospitalizations, attrition, and DBT target symptoms (Miller, Wyman, Huppert, Glassman, & Rathus, 2000; Rathus & Miller, 2002). Further research on the active ingredients of the treatment, as well as on DBT adaptations, has been recommended (Scheel, 2000).; Reviews of the empirical literature on the social and emotional issues of learning disabled (LD) children and adolescents has indicated weaknesses which overlap with the DBT skills training group modules, such as low self-concept, depression, emotional unawareness, impulsivity, and social skills deficits (Greenham, 1999). These similarities suggest the possible effectiveness of an application of a DBT skills training group for LD adolescents. The need for non-academic interventions for LD children and adolescents also has been highlighted (Lyon, 1996).; The purpose of the present investigation was to examine the effectiveness of an adaptation of the DBT skills training group with LD adolescents. The study was a repeated measures design with treatment and wait-list control groups. Repeated measures multivariate analyses of variance were used to examine the hypotheses that the DBT skills training group would improve self-concept, negative mood regulation, depression, social skills and overall functioning at follow-up, and that these results would be maintained several months later, as evidenced by self- and dorm/parent-reports.; Surprisingly, little support for the utility of DBT group participation in improving life skills was demonstrated after the intervention. Some non-significant improvements were noted for emotional dysfunction, social problems and life problems, but for both groups (i.e., experimental and wait-list control). Thus, students may have been influenced by an overall effect of being enrolled in such a comprehensive school program. At follow-up, non-significant improvements were noted for social problems and total number of problems, which could be evidence of a delayed effect. However, these findings must be interpreted with caution, as it does not appear that these differences are specific to receiving the DBT skills training group.; There are many possible explanations for why the study did not find change, including that the sample had a high level of other interventions, did not fall into clinical areas with respect to the problems that were assessed for effectiveness, as well as measurement issues, lack of power, and that the intervention as rendered may not have been sufficient. Future research should include a study of standard adolescent DBT (e.g., all components; staff trained) to evaluate if the original version works with a LD population that matches more closely to samples previously studied (e.g., more impaired, female). The limitations of the current study highlight the challenge of implementing and researching empirically supported treatments in real world treatment settings, as well as adapting for use with other populations.