TY - JOUR
PY - 2017//
TI - Adapting dialectical behavioral therapy to francophone adolescents, a pilot study in female adolescents with major depressive disorder and borderline personality disorder
JO - Neuropsychiatrie de l'enfance et de l'adolescence
A1 - Garny De La Rivière, S.
A1 - Houinou Ebo, B.
A1 - Naepels, B.
A1 - Segard, V.
A1 - Gueant, A.
A1 - Rey, N.
A1 - Legrand, E.
A1 - Labelle, R.
A1 - Guile, J.-m.
SP - 5
EP - 13
VL - 65
IS - 1
N2 - 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
LA - en SN - 0222-9617 UR - http://dx.doi.org/10.1016/j.neurenf.2016.12.005 ID - ref1 ER -