Adapting Dialectical Behavior Therapy for Children in Residential Care (DBT-C)

Weill Cornell Medicine (WCM)

Status: Completed

Conditions: Childhood Aggression

Treatments: Behavioral: DBT for children; Behavioral: Enhanced Supportive-Educational therapy

Study type: Interventional

Funder types: Other

Identifiers

NCT01547052

1012007764

Details and patient eligibility

About

I: Conduct Pilot Randomized Clinical Trial of Dialectical Behavior Therapy for children (DBT-C) in residential as compared with Treatment-As-Usual (TAU) (60 children in DBT-C and 60 children in the comparison condition).

II: Finalize therapist training manuals and educational materials to guide selection, training, and supervision of treatment providers.

Full description

Specific Aim 1: Examine feasibility of DBT-C by evaluating response rate in treatment attendance, treatment satisfaction, and any differences in these rates by groups.

Hypothesis 1: DBT-C will be equivalent to TAU in attendance rate and will have significantly greater treatment satisfaction rating by subjects, as well as by therapists and milieu staff.

Specific Aim 2: Examine efficacy of DBT-C as compared to TAU in reducing internalizing and externalizing symptoms.

Hypothesis 2: Children in DBT-C condition as compared to TAU will have significantly fewer internalizing and externalizing symptoms.

Specific Aim 3: Examine efficacy of DBT-C in improving adaptive coping, emotion regulation, risk taking, and social skills, and reducing depression.

Hypothesis 3: Children in DBT-C Training condition as compared to TAU will have significantly greater improvement in adaptive coping skills, emotion regulation, risk taking and impulsivity and social skills, and reducing depressive symptoms.

Specific Aim 4: Examine efficacy of DBT-C in reducing the frequency of critical incidents.

Hypothesis 4: Children in DBT-C condition as compared to TAU will have significantly fewer critical incidents, including psychiatric hospitalization, emergency room visits, total number of days inpatient, suicidal ideations and attempts, self-harm behaviors, sexual acting out, running away, stealing, police involvement, etc.

Enrollment: 47 patients

Sex: Male

Ages: 6 to 12 years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• age between 6 years 0 months and 12 years 11 months;
• male;
• in residential care at Green Chimneys;
• projected length of stay is at least 8 months.

Exclusion criteria

• pervasive developmental disorder;
• psychotic disorder;
• mental retardation; (all as per psychiatric evaluation at Green Chimneys);
• in care or custody of the Department of Social Services (DSS);
• caregivers do not speak English.

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: None (Open label)

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47 participants in 2 patient groups

DBT for children

Experimental group

Description:

Dialectical Behavior Therapy adapted for children

Treatment:

Behavioral: DBT for children

Enhanced Supportive-Educational Therapy

Active Comparator group

Description:

Enhanced Treatment-As-Usual, including supportive-educational model, cognitive-behavioral skills and parent management training

Treatment:

Behavioral: Enhanced Supportive-Educational therapy