Academic Journal
An implementation "Field Trial" of DBT for adolescents with bipolar disorder: Training procedures and therapist outcomes.
| Τίτλος: | An implementation "Field Trial" of DBT for adolescents with bipolar disorder: Training procedures and therapist outcomes. |
|---|---|
| Συγγραφείς: | Goldstein TR; University of Pittsburgh Medical Center, 3811 O'Hara St., Pittsburgh, PA, 15213, USA. Electronic address: goldtr@upmc.edu., Dimick MK; Sunnybrook Health Sciences Centre, 2075 Bayview Ave, North York, Toronto, Ontario, M4N 3M5, Canada. Electronic address: mikaela.dimick@camh.ca., Hotkowski N; University of Pittsburgh Medical Center, 3811 O'Hara St., Pittsburgh, PA, 15213, USA. Electronic address: nina@njhotkowski.com., Chugani C; University of Pittsburgh Medical Center, 3811 O'Hara St., Pittsburgh, PA, 15213, USA. Electronic address: c.chugani@mantrahealth.com., Curcio D; Sunnybrook Health Sciences Centre, 2075 Bayview Ave, North York, Toronto, Ontario, M4N 3M5, Canada. Electronic address: danielle.curcio@camh.ca., Roane J; Sunnybrook Health Sciences Centre, 2075 Bayview Ave, North York, Toronto, Ontario, M4N 3M5, Canada. Electronic address: jessica.roane@camh.ca., Timmins V; Sunnybrook Health Sciences Centre, 2075 Bayview Ave, North York, Toronto, Ontario, M4N 3M5, Canada. Electronic address: vanessa.rajamani@camh.ca., Mitchell R; Sunnybrook Health Sciences Centre, 2075 Bayview Ave, North York, Toronto, Ontario, M4N 3M5, Canada. Electronic address: rachel.mitchell@sunnybrook.ca., Rode N; University of Pittsburgh Medical Center, 3811 O'Hara St., Pittsburgh, PA, 15213, USA. Electronic address: roden@upmc.edu., Khoubaeva D; Sunnybrook Health Sciences Centre, 2075 Bayview Ave, North York, Toronto, Ontario, M4N 3M5, Canada. Electronic address: diana.khoubaeva@camh.ca., Kolko D; University of Pittsburgh Medical Center, 3811 O'Hara St., Pittsburgh, PA, 15213, USA. Electronic address: kolkodj@upmc.edu., Goldstein BI; Sunnybrook Health Sciences Centre, 2075 Bayview Ave, North York, Toronto, Ontario, M4N 3M5, Canada. Electronic address: benjamin.goldstein@camh.ca. |
| Πηγή: | Journal of affective disorders [J Affect Disord] 2026 Nov 15; Vol. 413, pp. 122211. Date of Electronic Publication: 2026 Jul 03. |
| Τύπος έκδοσης: | Journal Article |
| Γλώσσα: | English |
| Στοιχεία περιοδικού: | Publisher: Elsevier/North-Holland Biomedical Press Country of Publication: Netherlands NLM ID: 7906073 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1573-2517 (Electronic) Linking ISSN: 01650327 NLM ISO Abbreviation: J Affect Disord Subsets: MEDLINE |
| Imprint Name(s): | Original Publication: Amsterdam, Elsevier/North-Holland Biomedical Press. |
| Ιατρικοί όροι (MeSH): | Bipolar Disorder*/therapy , Bipolar Disorder*/psychology , Dialectical Behavior Therapy*/methods , Dialectical Behavior Therapy*/education , Psychotherapists*/education, Suicide, Attempted/psychology ; Adolescent ; Female ; Humans ; Male ; Treatment Outcome ; Health Plan Implementation |
| Περίληψη: | Background: The only efficacious psychosocial intervention for decreasing suicide attempts among adolescents with bipolar disorder (BP) is an adaptation of Dialectical Behavior Therapy (DBT). Yet myriad factors, including clinician training, limit DBT uptake. To enhance dissemination, we systematically operationalized, implemented and studied procedures for training and supervising community clinicians to adherently deliver DBT for adolescents with BP. Methods: This study was conducted at a University-affiliated clinic serving youth with BP. Guided by the Enhanced-Replicating Effective Programs (E-REP) framework, we focused on internal and external facilitation components. Participants included master's level therapists (n = 3) at the implementation site; expert training and consultation were provided by an independent site. Validated measures of therapist satisfaction and acceptability, barriers and facilitators, and therapist competency were assessed at 0, 6, 12, 24 months using validated measures. Results: Data indicate high satisfaction and acceptability with the DBT approach and supervision model. Therapists initially identified difficulty changing their practice and low patient skills application as barriers; these improved with time. Administrative-level barriers were few, though therapists consistently cited competing demands. Ratings of the implementation climate, specifically perception of the environment's support for DBT, decreased over time (nonsignificant trend). All therapists passed the external DBT certification process by study-end and maintained fidelity through 2-years via independent adherence coding. Conclusions: The resultant training and supervision model of DBT for adolescents with BP holds promise to inform dissemination efforts for this high-risk population. Data indicate careful attention to therapist- and organizational-level facilitators and barriers should be considered throughout the implementation process. Clinicaltrials: govID:NCT03661333. (Copyright © 2026 Elsevier B.V. All rights reserved.) |
| Competing Interests: | Declaration of competing interest Dr. T Goldstein receives royalties from Guilford Press. Dr. Kolko provides training and consultation through the University of Pittsburgh (www.afcbt.org). Dr. Chugani is an employee of Mantra Health and receives consulting fees for DBT program consultation. All other authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article. |
| References: | Prim Care Companion J Clin Psychiatry. 2010;12(3):. (PMID: 20944774) Arch Gen Psychiatry. 2006 Jul;63(7):757-66. (PMID: 16818865) Psychiatr Serv. 2009 Jul;60(7):989-92. (PMID: 19564234) BMC Psychiatry. 2018 Sep 19;18(1):302. (PMID: 30231865) Behav Ther. 2015 May;46(3):283-95. (PMID: 25892165) Clin Psychol (New York). 2010 Mar;17(1):1-30. (PMID: 20877441) Implement Sci. 2006 Oct 18;1:23. (PMID: 17049080) Clin Child Fam Psychol Rev. 2020 Sep;23(3):297-315. (PMID: 32103361) Behav Res Ther. 2011 Jan;49(1):4-10. (PMID: 20970117) Arch Gen Psychiatry. 2006 Oct;63(10):1139-48. (PMID: 17015816) J Consult Clin Psychol. 2004 Dec;72(6):1050-62. (PMID: 15612851) Implement Sci. 2007 Dec 09;2:42. (PMID: 18067681) Psychiatr Serv. 2020 Nov 1;71(11):1170-1178. (PMID: 32517640) J Child Adolesc Psychopharmacol. 2015 Mar;25(2):140-9. (PMID: 25010702) J Clin Child Adolesc Psychol. 2014;43(3):339-55. (PMID: 23927375) Adm Policy Ment Health. 2014 Sep;41(5):608-14. (PMID: 23754686) Psychol Assess. 2021 Jun;33(6):552-561. (PMID: 33764118) Behav Res Ther. 2015 May;68:1-12. (PMID: 25768982) Br J Psychiatry. 2003 Feb;182:135-40. (PMID: 12562741) J Am Acad Child Adolesc Psychiatry. 2007 Jul;46(7):820-30. (PMID: 17581446) J Ment Health. 2012 Dec;21(6):548-55. (PMID: 22958107) Adm Policy Ment Health. 2015 Nov;42(6):672-81. (PMID: 25315183) Neurotherapeutics. 2017 Jul;14(3):537-545. (PMID: 28653278) Clin Psychol (New York). 2020 Sep;27(3):. (PMID: 34092941) Am J Psychiatry. 2009 Dec;166(12):1365-74. (PMID: 19755574) Adm Policy Ment Health. 2009 Jan;36(1):63-81. (PMID: 19016321) Implement Sci. 2013 Nov 20;8:136. (PMID: 24252648) Behav Ther. 2019 Jan;50(1):60-72. (PMID: 30661567) Cognition. 2025 Apr;257:106065. (PMID: 39854968) J Consult Clin Psychol. 1995 Oct;63(5):683-7. (PMID: 7593860) Child Adolesc Ment Health. 2008 May;13(2):54-65. (PMID: 32847169) Depress Res Treat. 2012;2012:325249. (PMID: 23050134) Eval Program Plann. 2014 Apr;43:55-63. (PMID: 24333657) J Eval Clin Pract. 2003 May;9(2):287-301. (PMID: 12787192) Med Care Res Rev. 2012 Apr;69(2):123-57. (PMID: 22203646) Curr Opin Psychol. 2021 Feb;37:152-157. (PMID: 33588325) BMC Psychiatry. 2020 May 14;20(1):235. (PMID: 32410670) Borderline Personal Disord Emot Dysregul. 2019 Feb 12;6:2. (PMID: 30805193) J Psychiatr Res. 1998 Nov-Dec;32(6):379-84. (PMID: 9844954) Behav Ther. 2011 Jun;42(2):263-75. (PMID: 21496511) Clin Psychol Rev. 2013 Nov;33(7):883-900. (PMID: 23647856) JAMA Psychiatry. 2024 Jan 1;81(1):15-24. (PMID: 37703037) Annu Rev Public Health. 2018 Apr 1;39:55-76. (PMID: 29328872) Behav Res Ther. 2009 Nov;47(11):921-30. (PMID: 19695562) Behav Ther. 2013 Dec;44(4):568-79. (PMID: 24094782) Dev Psychopathol. 2006 Fall;18(4):1023-35. (PMID: 17064427) Am Psychol. 2010 Feb-Mar;65(2):73-84. (PMID: 20141263) J Am Acad Child Adolesc Psychiatry. 2011 Oct;50(10):1001-16.e3. (PMID: 21961775) |
| Grant Information: | R01 MH100056 United States MH NIMH NIH HHS |
| Contributed Indexing: | Keywords: Dialectical Behavior Therapy (DBT); implementation; pediatric bipolar disorder; suicide |
| Molecular Sequence: | ClinicalTrials.gov NCT03661333 |
| Entry Date(s): | Date Created: 20260703 Date Completed: 20260723 Latest Revision: 20260923 |
| Update Code: | 20260923 |
| PubMed Central ID: | PMC13390273 |
| DOI: | 10.1016/j.jad.2026.122211 |
| PMID: | 42398677 |
| Βάση Δεδομένων: | MEDLINE |
καταχωρήστε σχόλιο πρώτοι!