1 - (SYM 38) Effectiveness of an Outpatient Adolescent Dialectical Behavior Therapy Program Adapted for Spanish-speaking Families

Latinx adolescents represent the largest ethnic minority in the United States and face heightened risks for suicidal and non-suicidal self-injurious behaviors, as well as symptoms of borderline personality disorder (BPD). Barriers such as language, socioeconomic challenges, acculturation stress, and stigma limit access to mental health services for Latinx families. There is limited evidence on adapting Dialectical Behavior Therapy for Adolescents (DBT-A), an evidence-based treatment, to Latinx youth and their families. This study aimed to compare an English-language DBT-A program with a Spanish-translated and culturally adapted version (DBT-SPA) for Latinx adolescents and their families.

A total of 201 adolescents (ages 11–18) and their families began the first cycle of an outpatient DBT-A program: 148 teens who participated in DBT-A and 53 adolescents who participated in DBT-SPA. Cultural traditions and norms were integrated, (e.g., potluck graduation celebrations, and a greater emphasis on fostering community through shared experiences). Therapists also utilized metaphors specific to the cultures of immigrant families to describe tensions experienced by first generation adolescents in the US, including balancing collectivistic versus individualistic cultures, acculturative stress, and language brokerage. At the beginning and end of treatment, adolescents completed baseline assessments on BPD symptoms, lifetime history of suicidal and non-suicidal self-injurious behaviors, depression, and higher-level care utilization.

The results showed that participants, regardless of program language, exhibited relatively high satisfaction ratings from parents and adolescents. The findings further indicated that both the English and Spanish programs were comparably effective at reducing suicide attempts, non-suicidal self-injury, BPD symptoms, depression, and service utilization in statistically significant and clinically meaningful ways, with high participant satisfaction. These positive outcomes make sense, as while DBT-SPA was adapted to make it more accessible and culturally consistent with Spanish-speaking families, the theoretical foundations, principles, and strategies of DBT were maintained. 

This study contributes to the growing body of research on DBT-A, particularly regarding Spanish-speaking adaptations. To the authors’ knowledge, this is the first study to demonstrate the effectiveness of a community-based, translated, and culturally adapted DBT-A program in the United States.