An exploratory study of service user and clinical outcomes in telehealth-delivered dialectical behavior therapy for adolescents skills groups.

Abstract

The COVID-19 pandemic led many in-office therapeutic programs to pivot to virtual programming without empirical data supporting the acceptability and efficacy of the remote-delivered adaptations. These adaptations were essential for continuing care and addressing surging youth psychological problems at the time. To serve adolescents with comorbid psychiatric disorders and associated problems (e.g., emotion dysregulation), we adapted and implemented virtual and hybrid formats of a dialectical behavior therapy for adolescents (DBT-A; Rathus & Miller, 2015) program within a public university training clinic, such as separating the traditional multifamily group into adolescent-only and caregiver-only groups. Building on qualitative reports on virtual DBT-A, we explored preliminary service user and clinical outcomes of the virtual and hybrid DBT-A adolescent skills group component in a longitudinal retrospective cohort study for teenagers treated during the first 2 years of the pandemic (N = 21; 81% Hispanic/Latinx; 100% White). Aim 1 described service user outcomes (e.g., retention, group cohesion, client satisfaction) in the remote-delivered skills groups. Most youth completed treatment. Caregiver satisfaction was high, whereas adolescent satisfaction was mild. Aim 2 explored preliminary clinical outcomes of remote-delivered skills group adaptations. Overall anxiety, panic, and two emotion regulation facets (i.e., emotional awareness; goal pursuit when upset) significantly reduced across treatment. There were no significant reductions in depression. No suicide attempts or suicides occurred during the program. Further work is needed to clarify the efficacy of telehealth formats of DBT-A skills groups in larger, more racially diverse samples and to identify which adolescents are most appropriate for virtual and/or hybrid DBT-A. (PsycInfo Database Record (c) 2024 APA, all rights reserved).