Dialectical behaviour therapy for special populations: treatment with adolescents and their caregivers

This paper aims to present preliminary findings regarding the types of adaptations made to dialectical behavior therapy (DBT) and their effectiveness in working with a population who have both intellectual disabilities and mental illnesses.

A pilot study conducted with adolescent clients in a day treatment program was completed in an effort to determine the effectiveness of dialectical behavior therapy for special populations (DBT‐SP). The study utilized all three components of DBT, in addition to the normal milieu management techniques. As such, clients received DBT‐SP focused individual therapy, skills training groups using the DBT‐SP skills training manual, and the whole treatment team staff participated in a DBT‐SP supervision/consultation group. Observations of client behavior by staff, client outcome when leaving the program, and daily diary card information was collected.

Although there are a number of issues that must be addressed when providing psychotherapy to individuals with intellectual disabilities and mental illnesses, many psychotherapeutic techniques are effective if they are suitably modified (Bütz et al., 2000; Nezu and Nezu, 1994) as has been found with DBT‐SP.

As with most pilot studies, there are many limitations to the data. While each client serves as his/her own control, there is no random control group as all the youths receive DBT‐SP. Further, DBT‐SP is used in conjunction with other techniques and the study lacks the ability to control for any additional factors in the students' environment that may influence their behavior. In addition, clients enter and leave the program at different times, and so the data gathered can be hard to interpret. Thus, far, the data are suggestive, but not conclusive, regarding the effectiveness of DBT‐SP.

The information in this paper will be useful to therapists providing treatment to clients with intellectual disabilities and mental illnesses.