A Review Comparing Dialectical Behavior Therapy and Mentalization for Adolescents with Borderline Personality Traits, Suicide and Self-harming Behavior

Abstract

A growing number of evidence-based interventions have offered treatment for adults with Borderline Personality Disorder. Dialectical Behavior Therapy and Mentalization Based Therapy are both evidence-based treatments initially developed for chronically suicidal adults and have been adapted for adolescents relatively recently. There is increasing interest in treatment for Borderline Personality Disorder traits for adolescents using these two therapies. This article provides the results of a review of treatment outcomes for Dialectical Behavior Therapy versus Mentalization Based Therapy for adolescents. These interventions target Borderline Personality Disorder symptoms, self-harm and suicidal behavior. Adolescents with Borderline Personality traits are at considerable risk for suicide or long-term negative adult psychosocial outcomes. In order to assist clinicians and service providers in choosing the most appropriate treatment, six main electronic databases were searched from inception to April 11, 2019, to identify relevant studies. Twenty-five studies were included in this review; twenty-one on Dialectical Behavior Therapy for Adolescents and four concerning Mentalization Based Therapy for Adolescents. Significant improvements in suicidal ideation, suicidal attempts, self-harm (with or without suicidal intention), Borderline Personality Disorder symptoms, depressive symptoms, trauma, behavior problems and general functioning were reported for both interventions. In addition to outcome comparisons, this review contrasts the theoretical background and implementation issues of these two important psychological treatments for adolescents with Borderline Personality Disorder symptoms.