完整的 DBT-A 治療同樣包括每周一次個別治療、團體治療、治療者團隊會議及24小時電話輔導,另外加入家庭治療。研究發現 DBT 所教授的技能包括基本社交和情感生活能力,非常適用於相似的臨床症狀、情緒行為調節困難、或自殺自傷的青少年(Mehlum L, et al., 2014; Flynn D, et al., 2018; Glenn CR, et al., 2019)。
在針對自傷自殺行為的高危兒童青少年,DBT 是少數具有實證療效的治療方法(Perepletchikova F, et al., 2011; McCauley E, et al. 2018; Kothgassner OD, et al., 2021; Witt KG, et al., 2021),研究發現 DBT 不只可以降低青少年自殺自傷行為想法與邊緣性人格症狀(Chugani CD, 2013),DBT 的情緒調節對改善青少年或大學生的憤怒情緒(Haktanir A, et al., 2022)、憂鬱症狀(Panepinto AR, et al., 2015; Turan B et al, 2022)、焦慮症狀(Webb CA, et al. 2016)、物質濫用、外化行為等都有顯著療效。 Poon等人(2022)以完整 DBT-A 治療男同性戀、女同性戀、雙性戀或質疑自己性向的青少年,都能顯著的改善他們的情緒調節、憂鬱、邊緣症狀和應對策略能力等(Poon et al. 2022; Tilley JL, et al. 2022)。此外,DBT 也可以幫助罹患注意力缺失過動症的青少年顯著改善其過動/衝動、行為問題和情緒失調症狀(Meyer J, et al. 2022)。在Goldstein 等人的研究中(2015)證實 DBT 可以作為罹患雙極性情感疾患的青少年藥物療法的輔助治療,尤其可改善鬱期時的憂鬱症狀和自殺意念,且可以加強青少年對治療的承諾。其他 DBT 在青少年的實證研究還包括治療青少年飲食疾患(Kamody RC et al., 2019; Reilly EE, et al., 2020; Vogel EN, 2021)、對立反抗疾患(Nelson-Gray RO et al., 2006)、侵擾性情緒失調疾患(Perepletchikova F, et al. 2017)等都有顯著療效的研究報告。
參考文獻:
Chugani, C.D., M.N. Ghali, and J. Brunner, Effectiveness of short term dialectical behavior therapy skills training in college students with cluster B personality disorders. Journal of College Student Psychotherapy, 2013. 27(4): p. 323-336.Flynn, D., et al., Innovations in Practice: Dialectical behaviour therapy - skills training for emotional problem solving for adolescents (DBT STEPS-A): evaluation of a pilot implementation in Irish post-primary schools. Child Adolesc Ment Health, 2018. 23(4): p. 376-380.
Glenn, C.R., et al., Evidence Base Update of Psychosocial Treatments for Self-Injurious Thoughts and Behaviors in Youth. J Clin Child Adolesc Psychol, 2019. 48(3): p. 357-392.
Goldstein, T.R., et al., Dialectical behavior therapy for adolescents with bipolar disorder: results from a pilot randomized trial. J Child Adolesc Psychopharmacol, 2015. 25(2): p. 140-9.
Haktanir, A., et al., The use of dialectical behavior therapy in adolescent anger management: A systematic review. Clin Child Psychol Psychiatry, 2022: p. 13591045221148075.
Kamody, R.C., et al., Implementing a condensed dialectical behavior therapy skills group for binge-eating behaviors in adolescents. Eat Weight Disord, 2019. 24(2): p. 367-372.
Kothgassner, O.D., et al., Efficacy of dialectical behavior therapy for adolescent self-harm and suicidal ideation: a systematic review and meta-analysis. Psychol Med, 2021. 51(7): p. 1057-1067.
McCauley, E., et al., Efficacy of Dialectical Behavior Therapy for Adolescents at High Risk for Suicide: A Randomized Clinical Trial. JAMA Psychiatry, 2018. 75(8): p. 777-785.
Mehlum, L., et al., Dialectical behavior therapy for adolescents with repeated suicidal and self-harming behavior: a randomized trial. J Am Acad Child Adolesc Psychiatry, 2014. 53(10): p. 1082-91.
Meyer, J., et al., Moderators of long-term treatment outcome when comparing two group interventions for adolescents with ADHD: who benefits more from DBT-based skills training? BMC Psychiatry, 2022. 22(1): p. 767.
Nelson-Gray, R.O., et al., A modified DBT skills training program for oppositional defiant adolescents: promising preliminary findings. Behav Res Ther, 2006. 44(12): p. 1811-20.
Panepinto, A.R., et al., Beyond borderline personality disorder: Dialectical behavior therapy in a college counseling center. Journal of College Student Psychotherapy, 2015. 29(3): p. 211-226.
Perepletchikova, F., et al., Adapting Dialectical Behaviour Therapy for Children: Towards a New Research Agenda for Paediatric Suicidal and Non-Suicidal Self-Injurious Behaviours. Child Adolesc Ment Health, 2011. 16(2): p. 116-121.
Perepletchikova, F., et al., Randomized Clinical Trial of Dialectical Behavior Therapy for Preadolescent Children With Disruptive Mood Dysregulation Disorder: Feasibility and Outcomes. J Am Acad Child Adolesc Psychiatry, 2017. 56(10): p. 832-840.
Poon, J., et al., Dialectical behavior therapy for adolescents (DBT-A): Outcomes among sexual minorities at high risk for suicide. Suicide Life Threat Behav, 2022. 52(3): p. 383-391.
Rathus JH, M.A. 2015, DBT Skills Manual for Adolescents .New York: Guildford.
Reilly, E.E., et al., Dialectical behavioral therapy for the treatment of adolescent eating disorders: a review of existing work and proposed future directions. Eat Disord, 2020. 28(2): p. 122-141.
Tilley, J.L., et al., Dialectical behaviour therapy (DBT) for high-risk transgender and gender diverse (TGD) youth: A qualitative study of youth and mental health providers' perspectives on intervention relevance. Psychol Psychother, 2022. 95(4): p. 1056-1070.
Turan, B. and M.A. Akinci, A clinical follow-up study of dialectical behavior therapy skills groups among female adolescents diagnosed with depressive disorder. Clin Child Psychol Psychiatry, 2022. 27(3): p. 701-715.
Vogel, E.N., S. Singh, and E.C. Accurso, A systematic review of cognitive behavior therapy and dialectical behavior therapy for adolescent eating disorders. J Eat Disord, 2021. 9(1): p. 131.
Webb, C.A., et al., Differential role of CBT skills, DBT skills and psychological flexibility in predicting depressive versus anxiety symptom improvement. Behav Res Ther, 2016. 81: p. 12-20.
Witt, K.G., et al., Interventions for self-harm in children and adolescents. Cochrane Database Syst Rev, 2021. 3(3): p. CD013667.