Overview
The goal of this study is to learn if Dialectical behavior therapy Skills
Training for Adolescents (DBT-A-ST) works on emotional disorders in adolescents. The main questions it aims to answer are:
Does DBT-A-ST produce faster improvements (i.e., steeper slopes), compared to ASG, on primary and secondary outcome measures during treatment and 3-month follow-up?
Does DBT-A-ST produce greater improvements, compared to SBG, on primary and secondary outcome measures?
Participants is:
Randomly assigned to (a) a culturally adapted DBT-A-ST or (b) Satir-based group (SBG).
Received five assessments before the start of the trial (T1), after 4, 8 sessions (T2, T3), at post-intervention (T4), and 3-month follow-up (T5).
Description
The 1st-year project is to develop the culturally adapted DBT-A-ST using a consensus method and to test its feasibility and acceptability through a pilot study and focus groups. Twenty adolescents with emotional disorders attended a 15-session 120-min DBT-A-ST. After finishing the treatment, they were invited to participate in a 90-min focus group. Cultural adaptation of the treatment is based on these results. From the 2nd to 4th year, a partially randomized patient preference (PRPP) trial is conducted in the child and adolescent psychiatry department of a medical center. Participants aged 12-18 years with current depressive or anxiety disorders as diagnosed using the K-SADS-E are recruited and randomly allocated 1:1 or patient preference to one of two study arms: a) culturally adapted DBT-A-ST group, b) Satir group. Both interventions in group format include 15 weekly sessions, 120 min/ each session. A target sample size of 160 youths is included, based on power calculation. Five assessments are conducted: before the start of the trial (T1), after 4 sessions (T2), after 8 sessions (T3), at post-intervention (T4), and at 3-month follow-up (T5). Primary outcomes are the severity of depression and anxiety, rated by blind assessors. Secondary outcomes include general psychopathology, number of DSM-5 disorders, quality of life, and a battery of self-reported measures. The treatment mechanisms and implementation processes are also examined.
Eligibility
Inclusion Criteria:
- Age 12-18 years.
- Informed consent provided by the youth and one parent.
- Sufficient Mandarin Chinese proficiency to complete study questionnaires.
- Total score of PHQ-9 ≥ 8 or GAD-7 ≥ 8, or SDQ total score ≥ 10, or SDQ hyperactivity subscale score ≥ 3.
- Primary diagnosis of depressive, anxiety disorder, or ADHD based on K-SADS-
E interview, including:
Depression (F32-33) Persistent mood disorder (F34) Phobic anxiety disorder (F40) Other anxiety disorder (F41) Adjustment disorders (F43.2) ADHD (F90)
- Stable medication use for at least four weeks and willingness to maintain stable dosage during the study.
- Individuals with comorbid emotional disorders are included; comorbidities are not stratified to avoid increasing study design complexity.
Exclusion Criteria:
- Educational level of elementary school or university.
- Comorbid intellectual disability or psychotic disorder.
- Acute suicidality.
- Insufficient Chinese language skills.
- Unwillingness to discontinue current psychotherapy.
- Unwillingness to accept video recording during group therapy.
- Medication changes during the trial are not exclusionary if judged necessary or clinically important by the treating clinician, to maintain a naturalistic setting.
