The goal of this pre-post-follow-up study is to examine how well the treatment Dialectical behavior therapy for adolescents (DBT-A) with a duration of 20 weeks for adolescents with self-harm and suicidal behavior works in routine clinical practice. The main questions it aims to answer are: * to investigate how well DBT-A works after treatment and at 3-month follow-up, measured by episodes of self-harm, suicide attempts, depressive symptoms and quality of life, drop-out from treatment and number of possible participants who decline DBT-A. * to investigate how well DBT-A works at 12 months follow-up * to investigate whether pre-treatment factors can predict who will benefit from treatment
Self-harm and suicidal ideation are prevalent among adolescents and associated with major mental health problems and adverse life events. Dialectical behavior therapy for adolescents (DBT-A) is an empirically supported treatment for self-harm and suicidal ideation in adolescents. However, knowledge is scarce on the effectiveness, long-term outcomes, acceptability, and dropout of DBT-A when implemented and delivered as part of routine clinical practice in the Norwegian national health care system. The main aim of this study is to examine the outcomes from DBT-A in terms of self-harm episodes, suicide attempts, and emergency hospital admission, in addition to acceptability and dropout, when DBT-A is delivered at the Department of Child and adolescent psychiatry (PBU), Haukeland University Hospital (HUS). The study is an uncontrolled pre-post study with one-year follow-up and includes three aims: to evaluate outcomes of DBT-A up to three months post-treatment, at one-year follow-up, and to describe predictors of outcome for adolescents receiving DBT-A.
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
TREATMENT
Masking
NONE
Enrollment
140
A 20-week DBT-A with a weekly individual session (45 minutes), a weekly session of multifamily skills training groups with a caregiver (120 minutes), and telephone consultation with individual therapists outside therapy sessions as needed. The treatment consists of four components and is delivered according to the manual except for the phone coaching that PBU offers workdays until 8 pm.
Dept. of child and adolescent psychiatry, Haukeland University Hospital
Bergen, Bergen, Norway
RECRUITINGLifetime Parasuicide Count Interview
Number of self-harm episodes in the last four weeks categorized by intention and self-harm method, number of suicide attempts, and number of emergency department visits caused by suicidal behavior.
Time frame: pre, after 20 weeks DBT-A ("post"), at 3 and 12 months follow-up
Number of participants in need of emergency department visits caused by suicidal behavior
Medical record data extraction
Time frame: pre, after 20 weeks DBT-A ("post"), at 3 and 12 months follow-up
Depressive symptom score measured by Short Mood and Feelings questionnaire (SMFQ)
Depressive symptoms. SMFQ includes 13 items, measured on a 0-2 Likert scale, with higher scores indicating a higher level of depressive symptoms.
Time frame: pre, after 20 weeks DBT-A ("post"), 3 and 12 months follow-up
Health related quality of life measured by SCREENing for and Promotion of Health Related Quality of Life in Children an Adolescents (Kidscreen 10)
Kidscreen includes 10 items measured on a 5 point Likert scale and gives a global measure from 0-100 of health-related quality of life in addition to the individual aspects. Higher scores reflects higher health related quality of life.
Time frame: pre, after 20 weeks DBT-A ("post"), 3 and 12 months follow-up
Barriers to Treatment Participation Scale (BTPS) score
The BTPS questionnaire evaluate reasons for treatment discontinuation, and treatment participation barriers.
Time frame: pre, at dropout at any time between session 1 and end of treatment at session 20.
Perceived benefit of skills training in DBT-A measured by a study specific questionnaire.
Perceived benefit of skills training in DBT-A is a study-specific patient- and parent reported evaluation measure of perceived benefits of DBT-A components rated on a 0-5 Likert scale.
Time frame: At dropout at any time between session 1 and end of treatment at session 20, or for completers after 20 weeks DBT-A ("post"),
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