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Dialectical Behavior Therapy for Adolescents With Bipolar Disorder: A 1-Year Open Trial

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ABSTRACT

Objective

To describe an adapted version of dialectical behavior therapy for adolescents with bipolar disorder.

Method

The dialectical behavior therapy intervention is delivered over 1 year and consists of two modalities: family skills training (conducted with individual family units) and individual therapy. The acute treatment period (6 months) includes 24 weekly sessions; sessions alternate between the two treatment modalities. Continuation treatment consists of 12 additional sessions tapering in frequency through 1 year. We conducted an open pilot trial of the treatment, designed as an adjunct to pharmacological management, to establish feasibility and acceptability of the treatment for this population. Participants included 10 patients (mean age 15.8 ± 1.5 years, range 14-18) receiving treatment in an outpatient pediatric bipolar specialty clinic. Symptom severity and functioning were assessed quarterly by an independent evaluator. Consumer satisfaction was also assessed posttreatment.

Results

Feasibility and acceptability of the intervention were high, with 9 of 10 patients completing treatment, 90% of scheduled sessions attended, and high treatment satisfaction ratings. Patients exhibited significant improvement from pre- to posttreatment in suicidality, nonsuicidal self-injurious behavior, emotional dysregulation, and depressive symptoms.

Conclusions

Dialectical behavior therapy may offer promise as an approach to the psychosocial treatment of adolescent bipolar disorder.

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Over the past decade, bipolar disorder (BP) in children and adolescents has gained increasing attention. Research suggests that BP affects approximately 1% of community adolescents (Lewinsohn et al., 1995), with estimates as high as 6% to 15% in

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  • Cited by (0)

    This research was supported by an American Foundation for Suicide Prevention (AFSP) Pilot Grant, a seed grant from theUniversity of Pittsburgh Advanced Center for Intervention and Services Research for Early-Onset Mood and Anxiety Disorders (MH66371, D.A.B.), andNIMH traininggrant MH18951 (D.A.B.). The authors acknowledge the contributions of Heather Schwickrath, Colleen Grimm, and Pamala Pyle.

    Article Plus (online only) materials for this article appear on the Journal's Web site: www.jaacap.com.

    Disclosure: The authors have no financial relationships to disclose.

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