Dialectical Behavior Therapy with Suicidal Adolescents

Filling a tremendous need, this highly practical book adapts the proven techniques of dialectical behavior therapy (DBT) to treatment of multiproblem adolescents at highest risk for suicidal behavior and self-injury. The authors are master clinicians who take the reader step by step through understanding and assessing severe emotional dysregulation in teens and implementing individual, family, and group-based interventions. Insightful guidance on everything from orientation to termination is enlivened by case illustrations and sample dialogues. Appendices feature 30 mindfulness exercises as well as lecture notes and 12 reproducible handouts for "Walking the Middle Path," a completely new DBT skills training module for adolescents and their families.

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Reviewer:Gary B Kaniuk, Psy.D.(Cermak Health Services)
Description:This book applies the principles of dialectical behavior therapy to suicidal adolescents. It is a pragmatic approach to a high-risk population and the appendixes are full of exercises, handouts, and lecture points.
Purpose:According to the authors, "this book focuses on treating those suicidal adolescents who exhibit multiple problem behaviors. The book definitely meets the authors' objectives.
Audience:The authors target "the thousands of mental health professionals who, on a daily basis, are confronted with the challenging task of attempting to provide effective treatment for suicidal multiproblem adolescents." They continue, "this book belongs on the desks of a wide range of mental health practitioners, including clinical psychologists, psychiatrists, and clinical social workers. It may serve as a text in graduate-level courses and clinical practica." Dr. Miller, an associate professor at Montefiore Medical Center/Albert Einstein College of Medicine, has numerous publications and has conducted over 200 lectures and workshops on DBT. Dr. Rathus, an associate professor at Long Island University/C.W. Post Campus, has published numerous peer-reviewed articles and chapters on DBT, adolescent suicide, and other topics. Dr. Linehan, professor of psychology and adjunct professor of psychiatry and behavioral sciences at the University of Washington, developed DBT from CBT (cognitive behavioral therapy) while she was treating individuals with suicidal and self-injurious behaviors.
Features:The first of the book's 12 splendid chapters introduces the problem of suicidal behavior in adolescents and provides a brief description of DBT. The other chapters then provide the framework and specifics of how to intervene. Chapter 8 on individual therapy is exemplifies the wonderful features of this book. It walks readers through a session, with illustrative figures and tables, as well as interesting case material. It is useful to both the novice and veteran therapist. I felt like I was receiving supervision on the application of DBT in the way the book is organized and written. Three appendixes are filled with exercises, lecture and discussion points, and handouts. This is a very readable and practical book, in the long tradition of therapeutic intervention volumes from Guilford Publications.
Assessment:This is must reading for those working with an adolescent population. DBT is an effective strategy in attempting to address suicidal and parasuicidal behavior. The authors make it clear that the clients they are trying to help often have multiple problem behaviors. The book does not pretend that there are easy answers, but it does walk readers through this difficult process and provides hope, evident in the final statement of the last chapter: "Together, the efforts of the clinical and research communities will increase this treatment's ability to help suicidal, multiproblem adolescents build lives worth living."

Alec L. Miller, PsyD, is Associate Professor of Psychiatry and Behavioral Sciences, Chief of Child and Adolescent Psychology, Director of the Adolescent Depression and Suicide Program, and Associate Director of the Psychology Internship Training Program at Montefiore Medical Center/Albert Einstein College of Medicine, Bronx, New York. Dr. Miller has published widely on topics including DBT, adolescent suicide, childhood maltreatment, and borderline personality disorder, and has trained thousands of mental health professionals in DBT. He is Associate Editor of Cognitive and Behavioral Practice.
 
Jill H. Rathus, PhD, is Associate Professor of Psychology, Founder and Director of the Dialectical Behavior Therapy Program, and Director of the Specialty Concentration in Family Violence in the Clinical Psychology Doctoral Program at Long Island University/C.W. Post Campus. She has developed and conducted programs in DBT for adolescents and adults as well as males referred for intimate partner violence, and has studied, adapted, and developed assessment tools for DBT. Dr. Rathus has published widely on DBT, adolescent suicide, couple therapy, intimate partner violence, personality disorders, assessment, and anxiety disorders.
 

Marsha M. Linehan, PhD, is Professor of Psychology and Adjunct Professor of Psychiatry and Behavioral Sciences at the University of Washington, Seattle, and Director of the Behavioral Research and Therapy Clinics there. She is founder of the Marie Institute of Behavioral Technology and the company Behavioral Tech, LLC. The recipient of numerous awards for her distinguished clinical and research contributions, Dr. Linehan has served as president (2007) of the Society of Clinical Psychology, Division 12 of the American Psychological Association.