(PS9-15) Mindfulness Improves for Both Adolescents and Caregivers in Dialectical Behavior Therapy for Adolescents (DBT-A) in Standard and Intensive Outpatient Programs

Objective: Dialectical Behavior Therapy for Adolescents (DBT-A) is the leading evidence-based intervention for youth with suicidal and self-injurious behaviors (Glenn et al., 2019). DBT-A is a comprehensive, modular, transdiagnostic treatment, and includes an emphasis on caregiver involvement. As a third wave cognitive behavioral therapy, improving client mindfulness is a core proposed active ingredient of the treatment. Eeles and Walker’s (2022) recent review of mindfulness outcomes in DBT suggests that adult patients indeed improve on this core outcome, though there is little to no research examining mindfulness outcomes in adolescents and their caregivers. The current study examines mindfulness outcomes in a diverse clinically referred sample of adolescents and caregivers receiving DBT.  

Method: Participants included 40 racially diverse youth-caregiver dyads aged 13-17, enrolled in an adolescent-focused DBT program in either an intensive outpatient (IOP; 50% of the sample) or standard outpatient (SO) level of care at an urban children’s hospital that serves Medicaid-eligible families. All youth initially presented with clinically significant suicidal and/or self-injurious behavior. Both youth and caregivers completed the Five Facet Mindfulness Questionnaire (FFMQ) - Short Form at intake and follow up. Families for whom at least the adolescent or one caregiver completed both pre-test and post-test mindfulness survey data are included in this sample. 

Results: Youth reported a significant increase in mindfulness skills throughout treatment, t(16) = -3.11, p = .003 with a moderately large effect size (d = 0.75). Caregivers similarly reported a significant increase in mindfulness skills throughout treatment, t(22) = -3.07, p = .003 with a medium effect size (d = 0.64). SO care was associated with a greater gain in mindfulness relative to IOP care for youth, t(15) = 8.12, p = .012, d = 0.16. For caregivers, there was no evidence of a difference in mindfulness gains based on level of care, t(21) = 1.26, p = .075. 

Conclusions: This data suggests that mindfulness skills increase for both youth and caregivers engaged in a DBT-A intervention. Implications for mindfulness as a potential mediator of treatment outcomes are discussed.