McCauley et al. (2018). Efficacy of dialectical behavior therapy for adolescents at high risk for suicide: A randomized clinical trial.” – Article summary

Prior suicide attempts are indicators of suicide death. Prior suicide attempts and non-suicidal self-injury (NSSI) are indicators of future suicide attempts. Therapeutic interventions for reducing self-harm have better outcomes than treatment as usual.

Dialectical behavioural therapy (DBT) refers to a multicomponent cognitive-behavioural treatment that targets treatment engagement and the reduction of self-harm and suicide attempts. It focuses on teaching skills for enhancing emotion regulation (1), distress tolerance (2) and building a life worth living (3). It is efficacious in reducing suicide attempts and NSSIs.

DBT is efficacious among adolescents for reducing suicide attempts (1), NSSI (2) and self-harm (3) for people at risk for suicide. At six months after the treatment, participants who followed DBT had a lower suicide risk than those who followed IGST. At twelve months, there were no differences. After twelve months, half of the participants stopped with self-harm in the DBT group. This was one third in the IGST group.

Participation was higher in the DBT group. The results may thus occur due to increased exposure. Greater participation may have occurred as DBT included greater family involvement. This may have learned parents and youth new coping skills.