Effectiveness of Outpatient Adolescent Dialectical Behavior Therapy Adapted for Spanish-Speaking Families: A...

Latinx adolescents are the largest minoritized ethnic group in the United States. They are at elevated risk for suicidal and non-suicidal behaviors and symptoms of borderline personality disorder (BPD). Dialectical behavior therapy for adolescents (DBT-A) is an evidence-based treatment that targets these behaviors, yet limited evidence exists on the effectiveness of adapting DBT-A to Latinx adolescents with Spanish-speaking families.

This study compared an established English-language DBT-A program to a Spanish DBT Program for Adolescents (DBT-SPA), a translated and adapted Spanish version designed for Latinx adolescents and their Spanish-speaking families.

A retrospective chart review was completed on 201 adolescents (ages 11-18) who began the first cycle of an outpatient DBT-A program. The sample included 148 teens who participated in DBT-A and 53 adolescents from Spanish-speaking households who participated in DBT-SPA. Before beginning treatment, adolescents completed baseline assessments on borderline personality disorder (BPD) symptoms (BPD subscale of the Structured Clinical Interview for DSM-IV; Life Problems Inventory), lifetime history of suicidal and non-suicidal self-injurious behaviors (Lifetime Suicide Attempt Self-Injury Interview), depression (Beck Depression Inventory), and higher-level care utilization.

The results showed no significant differences in baseline psychopathology symptoms between the two programs. Participants, regardless of program language, exhibited relatively high rates of clinically significant improvements, with at least 60% achieving abstinence for all outcomes at all time points. The findings indicated that both the English and Spanish programs were comparably effective at reducing suicide attempts, non-suicidal self-injury, BPD symptoms, depression, and service utilization in statistically significant and clinically meaningful ways, with high participant satisfaction.

This study contributes to the growing body of research on DBT-A, particularly regarding Spanish-speaking adaptations. To the authors' knowledge, this is the first study to demonstrate the effectiveness of a community-based, translated, and culturally adapted DBT-A program in the United States.