Adapting Dialectical Behavior Therapy for Young Adults Diagnosed with Serious Mental Health Conditions in Residential Care: A Feasibility Study

ABSTRACT Dialectical Behavior Therapy (DBT) is an evidence-based practice found to improve emotional and relational coping skills among individuals experiencing severe psychological distress. Building on previous adolescent adaptations, a multidisciplinary steering committee adapted DBT for a residential and psychiatric care context designed for 18–20 year olds with serious mental health conditions preparing to age out of child service systems. The study examined acceptability and feasibility of the adapted-DBT. Materials & Methods. The steering committed developed and administered a DBT quality measure. Twenty-five participants enrolled, completing interviews with standardized self-report measures and open-ended questions at enrollment, three and six months of DBT participation. The research team collected and analyzed participant individual therapy and group skills training attendance, program exits, and study attrition using descriptive and non-parametric statistical tests as well as thematic qualitative coding. Results. Adapted DBT showed promise: 64% participated for three-months and 52% for six-months. Mindfulness and distress tolerance increased significantly from enrollment to six months. Perceived benefits included improved self-awareness, impulse control, communication, and relationship quality. Discussion. Interpersonal and self-management skills learned through DBT may be critical for vulnerable youth as they transition to adulthood. Additional adaptations for young adults in residential settings and implications for practice are discussed.