Investigating the efficacy of a Dialectical behaviour therapy-based universal intervention on adolescent social and emotional well-being outcomes

• Published in: Behaviour research and therapy 2023-10, Vol.169, p.104408-104408, Article 104408
• Main Authors: Harvey, Lauren J., White, Fiona A., Hunt, Caroline, Abbott, Maree
• Format: Article
• Language: English
• Subjects: Adolescent; DBT; Dialectical behaviour therapy; Early intervention; Mental health; Prevention; School
• ISSN: 0005-7967; 1873-622X
• DOI: 10.1016/j.brat.2023.104408

There is increasing research interest as to whether Dialectical Behaviour Therapy (DBT), specifically the group skills training component, is an effective early intervention approach when delivered universally in schools. The current study aimed to provide the first large-scale examination of a universal DBT-based intervention and to also determine the extent to which home practice of DBT skills predicted changes in social and emotional outcomes over time. A non-randomised controlled trial design was employed whereby 1071 participants (51.30% Male; M age = 13.48 years) completed either an adapted eight-session DBT skills-training intervention (‘WISE Teens) (n = 563) or class-as-per-usual (n = 508). On average, the ‘WISE Teens’ intervention did not improve outcomes with significant deteriorations or null effects observed across outcomes relative to class-as-per-usual immediately post-intervention. The largest deteriorations were observed for depressive (d = −0.22; 95% CI = −0.35, −0.08) and anxiety symptoms (d = −0.28; 95%CI - = −0.41, −0.14). Applying Bonferroni corrections, most group differences in outcomes had dissipated at follow-up, however, ‘WISE Teens’ participants continued to report significantly poorer quality of parent-child relationships relative to control (d = .16 for mother (95% CI = 0.01, 0.31); d = 0.17 for father (95% CI = 0.02, 0.33). While home practice was modest on average, further exploratory analyses nevertheless revealed that greater home practice was generally associated with more positive outcomes both immediately post-intervention and at follow-up. Based on these findings, the DBT-based ‘WISE Teens’ intervention is not recommended in its current format for universal dissemination amongst early adolescents in schools. Further research is needed to determine how to improve engagement and feasibility of delivery of DBT-based interventions universally in this context. •We examined the efficacy of a DBT-based universal intervention in schools (‘WISE Teens’) relative to control.•Deteriorations were observed immediately following delivery of ‘WISE Teens’ relative to control.•‘WISE Teens’ produced no discernible benefit on outcomes on average over time compared to control.•Greater home practice was linked to significantly more positive outcomes immediately post-intervention and at follow-up.•The enthusiasm for DBT-based universal interventions in schools is currently ahead of the research evidence.