Enhanced Dialectical Behavior Therapy for Adolescents

Enhanced Dialectical Behavior Therapy for Adolescents: Impacts of Individualized Skills Coaching on Constructs of Suicidality

Suicide is a leading cause of death and significant concerns for adolescents and young adults. Dialectical Behavior Therapy for Adolescents (DBT-A) is an evidence-based intervention that effectively reduces life-threatening behaviors. Limited research examines the impact of adding individualized skills coaching sessions (ISCS) to the DBT-A model, a novel intervention referred to in this paper as "Enhanced DBT-A". This study evaluates the effectiveness of Enhanced DBT-A in reducing suicidality over 1 year of treatment in an outpatient and intensive outpatient setting.

Study Overview

• Status: Completed
• Conditions: Suicidality
• Intervention / Treatment: Behavioral: Enhanced DBT-A

• Study Type: Interventional
• Enrollment (Actual): 47
• Phase: Not Applicable

Contacts and Locations

Study Locations

• United States
  • California
    • Tustin, California, United States, 92780
      • Compass Behavioral Health

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Child; Adult
• Accepts Healthy Volunteers: No

Description

Inclusion Criteria:

• appropriateness for Stage 1 DBT, completion of all assessments within the designated timeframe, a non-zero score on the Columbia-Suicide Severity Rating Scale (C-SSRS) at intake, and participation in at least one ISCS between intake and 1 year from the first individual therapy session.

Exclusion Criteria:

• presenting with active psychosis, a primary diagnosis of substance use, who did not consent to data collection, or who had a zero score on the C-SSRS at intake

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Treatment
• Allocation: N/A
• Interventional Model: Single Group Assignment
• Masking: None (Open Label)

Number of Arms

1

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Enhanced DBT-A Group; Participants engaged in Enhanced DBT-A services, including individual therapy, group skills training, phone coaching, and ISCS. Participants completed assessment batteries at intake, 6 months, and 1 year, and the outcome measures assessed participants' severity and intensity of suicidal ideation (SI), reasons for living, and depressive symptoms.	Behavioral: Enhanced DBT-A; Participants engaged in Enhanced DBT-A services, including individual therapy, group skills training, phone coaching, and ISCS. Participants completed assessment batteries at intake, 6 months, and 1 year, and the outcome measures assessed participants' severity and intensity of suicidal ideation (SI), reasons for living, and depressive symptoms.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Reasons for Living Inventory for Adolescents (RFL-A)	The Reasons for Living Inventory for Adolescents (RFL-A; Osman et al, 1998) is a 32-item self-report questionnaire that assesses adaptive reasons that may prevent an adolescent from engaging in life-threatening behavior.	1 year
PHQ-9	The current study administered the PHQ-9 to participants 18 years and older. The PHQ-9 (Kroenke et al, 2001) is a widely-used and psychometrically-robust self-report measure used to assess the prevalence of depressive symptoms in adults during a two-week period.	1 year
Columbia-Suicide Severity Rating Scale - Self Report Screener - Recent (C-SSRS).	To capture the severity and intensity of participants' SI and their corresponding suicide risk, we used items from the Columbia-Suicide Severity Rating Scale - Screen Version - Recent (C-SSRS; Posner et al, 2011).	1 year

Collaborators and Investigators

• Sponsor: Compass Behavioral Health

Study record dates

Study Major Dates

• Study Start (Actual): October 17, 2014
• Primary Completion (Actual): August 26, 2022
• Study Completion (Actual): August 26, 2022

Study Registration Dates

• First Submitted: November 20, 2025
• First Submitted That Met QC Criteria: November 20, 2025
• First Posted (Actual): December 1, 2025

Study Record Updates

• Last Update Posted (Actual): December 1, 2025
• Last Update Submitted That Met QC Criteria: November 20, 2025
• Last Verified: November 1, 2025

More Information

Terms related to this study

• Additional Relevant MeSH Terms: Behavioral Symptoms; Self-Injurious Behavior; Suicide; Behavior; Suicidal Ideation
• Other Study ID Numbers: Pro00078098

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No