ABSTRACT

Dialectical Behavior Therapy (DBT) is an outpatient treatment that addresses severe emotional and relational difficulties and is successfully applied across diagnoses, populations, and settings. In this feasibility study, we examined a residential DBT-informed treatment model in Norway, the Care and Development Model (CDM), aimed to improve adolescent mental health outcomes. Study participants included 42 adolescents (22 males and 20 females) with a mean age of 15.13 years (SD = 1.41, range 13–17 years), as well as the adolescents’ caregivers and residential staff. Data collection lasted from May 2018 until May 2021 and combined standardized self-report measures of program feasibility and acceptability, including treatment satisfaction and alliance, as well as customized program fidelity measures combining on-site observation and interviews with adolescents and staff, protocol data on treatment characteristics, and self-report checklists for treatment adherence. Results indicate that residential staff consider the implementation of CDM appropriate, but also distinct challenges were mentioned regarding the population and setting. Moderate to high satisfaction and alliance levels were reported by both adolescents and therapists. The CDM program shows promise and may be feasible and acceptable, although considerable effort to implement it is required. Implications for practice and research are discussed.

摘要

辩证行为疗法 (DBT) 是一种门诊治疗，可解决严重的情绪和关系困难，并成功应用于各种诊断、人群和环境。在这项可行性研究中，我们研究了挪威的住宅 DBT 知情治疗模型，即护理和发展模型 (CDM)，旨在改善青少年心理健康结果。研究参与者包括 42 名平均年龄为 15.13 岁的青少年（22 名男性和 20 名女性）（SD = 1.41，范围 13-17 岁），以及青少年的看护人和住宿人员。数据收集从 2018 年 5 月持续到 2021 年 5 月，结合了项目可行性和可接受性的标准化自我报告措施，包括治疗满意度和联盟，以及结合现场观察和与青少年和工作人员访谈的定制项目保真度措施，协议数据治疗特点，以及治疗依从性的自我报告清单。结果表明，住宅工作人员认为清洁发展机制的实施是适当的，但也提到了人口和环境方面的独特挑战。青少年和治疗师都报告了中度到高度的满意度和联盟水平。CDM 计划显示出前景，可能是可行和可接受的，尽管需要付出相当大的努力才能实现。讨论了对实践和研究的影响。