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Outpatient Dialectical Behavior Therapy for Adolescents Engaged in Deliberate Self-Harm: Conceptual and Methodological Considerations

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Abstract

The current review examines conceptual and methodological issues related to the use of dialectical behavior therapy for adolescents (DBT-A) in treating youth who engage in deliberate self-harm. A comprehensive review of the literature identified six studies appropriate for the review. Results indicated several inconsistencies and limitations across studies including the mixing of various forms of self-harm; variations in diagnostic inclusion/exclusion criteria, insufficient use of standardized self-harm outcome measures, variable lengths and intensity of provided treatment, and inadequate attention paid to DBT adherence. Each of these areas is reviewed along with a discussion of ways to improve the quality of future research.

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Acknowledgments

This work was funded in part by NIMH K01 MH077732-01A1 (PI: S. James) and UniHealth Foundation. It was also supported by the National Institute of Health Disparities and Minority Health of the National Institutes of Health under award number P20MD006988 and by the Implementation Research Institute (IRI), at the George Warren Brown School of Social Work, Washington University in St. Louis, through an award from the National Institute of Mental Health (R25 MH080916-01A2) and the Department of Veterans Affairs, Health Services Research & Development Service, Quality Enhancement Research Initiative (QUERI). The content is solely the responsibility of the authors and does not necessarily represent the official views of the funding agencies. Finally, the authors would like to thank the SHIELD treatment team for their dedication and passion for helping adolescents who struggle with self-injury and for their ongoing commitment to supporting research in this area.

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  1. Department of Social Work and Social Ecology, Loma Linda University, 1898 Business Center Drive, San Bernardino, CA, 92408, USA

    Kimberly R. Freeman, Sigrid James, Keith P. Klein & Susanne Montgomery

  2. Department of Psychology, Loma Linda University, 11130 Anderson Street, Loma Linda, CA, 92350, USA

    Danessa Mayo

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Freeman, K.R., James, S., Klein, K.P. et al. Outpatient Dialectical Behavior Therapy for Adolescents Engaged in Deliberate Self-Harm: Conceptual and Methodological Considerations. Child Adolesc Soc Work J 33, 123–135 (2016). https://doi.org/10.1007/s10560-015-0412-6

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