Dialectical behaviour therapy for special populations: treatment with adolescents and their caregivers
| Published date | 16 September 2011 |
| Pages | 6-14 |
| Date | 16 September 2011 |
| DOI | https://doi.org/10.1108/20441281111180619 |
| Author | Margaret Charlton,Eric J. Dykstra |
| Subject Matter | Education,Health & social care |
Research
Dialectical behaviour therapy for special
populations: treatment with adolescents
and their caregivers
Margaret Charlton and Eric J. Dykstra
Abstract
Purpose – 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.
Design/methodology/approach – 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-SPskills 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.
Findings – 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 (Bu
¨tz et al., 2000; Nezu and Nezu, 1994) as has
been found with DBT-SP.
Research limitations/implications – 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.
Originality/value – The information in this paper will be useful to therapists providing treatment to
clients with intellectual disabilities and mental illnesses.
Keywords Dialectical behavior therapy, DBT, Intellectual disability, Psychotherapy, Behaviour,
Learning disabilities, Mental illness
Paper type Research paper
Development of DBT-SP
To adapt psychotherapy for people with intellectual disabilities, information should be
provided in a variety of different modes, for example, using both auditory and visual
information together (Spackman et al., 1990). It is helpful to simplify language, structure the
therapy session, and use a more directive and active approach (Bu
¨tz et al., 2000). Concrete
activities such as modeling and role play are useful with clients who have language deficits,
as well as setting clear limits, maintaining structure and focus to the session, and allowing
flexibility for the expression of thoughts and feelings (Szymanski et al., 1994). Suggestions
PAGE 6
j
ADVANCES IN MENTALHEALTH AND INTELLECTUAL DISABILITIES
j
VOL. 5 NO. 5 2011, pp. 6-14, Emerald Group Publishing Limited, ISSN 2044-1282 DOI 10.1108/20441281111180619
Margaret Charlton is a
Psychologist at the
Intercept Center, Aurora
Mental Health Center,
Aurora, Colorado, USA.
Eric J. Dykstra is based at
Developmental
Enhancement, PLC,
Jenison, Michigan, USA.
This paper is a condensed
version of a chapter by the
same title originally published
in Psychotherapy for
Individuals with Intellectual
Disabilities, edited by Robert
J. Fletcher and published by
NADD Press, 2011. This version
appears in Advances in Mental
Health and Intellectual
Disabilities courtesy of NADD
Press.
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