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Dialectical Behavior Therapy for Suicidal Youth

JAMA Psychiatry; ePub 2018 Jun 20; McCauley, et al

Findings from a recent trial support the efficacy of dialectical behavior therapy (DBT) for reducing self-harm and suicide attempts in highly suicidal self-harming adolescents. On the basis of the criteria of 2 independent trials supporting efficacy, results support DBT as the first well-established, empirically supported treatment for decreasing repeated suicide attempts and self-harm in youths. The trial was conducted from January 1, 2012, through August 31, 2014, at 4 academic medical centers. A total of 173 participants aged 12 to 18 years with a prior lifetime suicide attempt (≥3 prior self-harm episodes, suicidal ideation, or emotional dysregulation) were studied. Participants were followed up for 1 year. Researchers found:

  • Significant advantages were found for DBT on all primary outcomes after treatment: suicide attempts (65 [90.3%] of 72 receiving DBT vs 51 [78.9%] of 65 receiving individual and group supportive therapy [IGST] with no suicide attempts), nonsuicidal self-injury (41 [56.9%] of 72 receiving DBT vs 26 [40.0%] of 65 receiving IGST with no self-injury), and self-harm (39 [54.2%] of 72 receiving DBT vs 24 [36.9%] of 65 receiving IGST with no self-harm).
  • Rates of self-harm decreased through 1-year follow-up.


McCauley E, Berk MS, Asarnow JR, et al. Efficacy of dialectical behavior therapy for adolescents at high risk for suicide. A randomized clinical trial. [Published online ahead of print June 20, 2018]. JAMA Psychiatry. doi:10.1001/jamapsychiatry.2018.1109.