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DBT-K for Adolescents: Feasibility and Preliminary Outcomes of a Creative Eight-Week, DBT-Based Transdiagnostic
Elias Legat1, Lucas Rainer1,2,3, Florian Huber1
1Department of Child and Adolescent Psychiatry and Psychotherapeutic Medicine, Salzburger Landeskliniken, Paracelsus Medical University Salzburg, Ignaz-Harrer-Straße 79, 5020 Salzburg, Austria.
Abstract:
Background: Mental disorders and emotion dysregulation are highly prevalent in adolescence, yet access to intensive, age-appropriate treatments remains limited. This pilot study examined the feasibility and preliminary effects of a creative, 8-week, DBT-based transdiagnostic skills group for adolescents (DBT-K). Methods: 53 outpatients (aged 13-18, 50 female) with heterogeneous psychiatric diagnoses completed baseline self-report measures of internet use, emotion regulation, self-esteem, temperament, and psychopathology. During eight weekly group sessions, positive and negative emotions were assessed before and after each session; self-esteem and emotion regulation strategies were reassessed at the final session. Linear mixed models were used to analyze trajectories of affect and self-esteem. Results: Adolescents showed high baseline internalizing symptoms, low adaptive emotion regulation, and low self-esteem, with a substantial proportion meeting criteria for problematic internet use. Across sessions, negative affect exhibited a significant reduction, with a significant main effect of time and pre- vs. post-session condition. Positive emotions showed no systematic pre-post change and a small decline over time. Self-esteem height remained stable across sessions. No significant changes emerged for total adaptive or maladaptive strategies, but expression of emotions increased significantly. Conclusions: These findings suggest that a brief, creative DBT-based group is feasible in a highly burdened, transdiagnostic outpatient sample and was associated with a reduction in negative affect and an increase in emotional expression. However, the lack of control group, high attrition, short duration, and absence of follow-up emphasize that conclusions are preliminary.
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