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Citation
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Garny De La Rivière S, Houinou Ebo B, Naepels B, Segard V, Gueant A, Rey N, Legrand E, Labelle R, Guile JM. Neuropsychiatr. Enfance Adolesc. 2017; 65(1): 5-13. |
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Abstract
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Background Dialectical behavioral therapy (DBT) has been developed by Linehan and further adapted to adolescents by Miller (DBT-A). Current literature supports the efficacy of DBT for youth with suicidal/self-harming behaviours. However, no study has been published on the feasibility and clinical validity of DBT-A when used with francophone adolescents.
METHOD We followed a two-step plan: (1) a feasibility study exploring the requirements for implementing DBT-A in French child & adolescent psychiatry services and the impact of DBT-A on the team functioning; (2) a pilot evaluation study with a 12-week pre/post-design including the standardised assessment of mental disorders encompassing borderline personality disorder (BPD), suicidal behaviors (SB), borderline phenomenology as well as the DBT-trained skills: mindfulness, emotion regulation and tolerance to distress.
RESULTS Most of the feasibility objectives were achieved. Regular team meetings helped building a common view on the appropriate multimodal treatment plan for self-harmers, integrating psychodynamic, dialectical behavioral, systemic and pharmacological perspectives. Efficient connection with the referring practician eased the implementation and monitoring of DBT-A for each participant. The pre/post-test study included six female adolescents (mean age: 14.5) with major depressive disorder (MDD) and BPD who committed at least two suicidal attempts prior to the admission in DBT-A. Over the 12-week post-test, a suicidal attempt (SA) was reported for one adolescent. At 1-year follow-up, SB was reported for 2/6 adolescents. Borderline symptoms significantly decreased over the 12-week DBT-A program (P < 0.05). With respect to the DBT-trained skills, significant improvement was observed in emotion regulation (P < 0.05).
CONCLUSION Within an integrated therapy framework, implementing DBT-A in French child and adolescent psychiatry services is feasible. Given our results DBT-A for female adolescents with MDD and BPD is worth considering. © 2016 Elsevier Masson SAS
Language: en |