Journal of Pediatric Care

Dialectical behaviour therapy for pre-adolescent children: current evidence and future direction

EuroSciCon Conference on Pediatrics 2017
November 13-14, 2017 London, UK

Francheska Perepletchikova, Donald Nathanson1 and Seth Axelrod

Weill Cornell Medical College, USA Yale University School of Medicine, USA

Posters & Accepted Abstracts: J Pediatr Care

DOI: 10.21767/2471-805X-C1-003

Abstract

Background: Chronic irritability and difficulty with selfcontrol may negatively affect child��?s emotional, social and cognitive development and are predictive of personality disorders, dysphoric mood, substance and alcohol abuse, suicidality and non-suicidal self-injury in adolescence and adulthood. Dialectical Behaviour Therapy for pre-adolescent children (DBT-C) aims to facilitate adaptive responding by teaching coping skills and encouraging caregivers to create a validating and change-ready environment. Method: Two RCTs were conducted to examine feasibility and initial efficacy of DBT-C. 1) In the NIMH funded RCT of DBT-C for Disruptive Mood Dysregulation Disorder, 43 children (712 years) were randomly assigned to DBT-C or TAU. Children were provided with 32 individual sessions that included child counselling, parent sessions and skills training. 2) In the Private Foundation funded RCT of DBT-C for children in residential care, 47 children (7-12 years) were randomly assigned to DBT-C or TAU. Children were provided with 34 individual sessions, 48 group skills trainings and 12 parent trainings. Results: 1) Subjects in DBT-C attended 40.4% more sessions than subjects in TAU. No subjects dropped out of DBT-C, while 36.4% dropped from TAU. Further, 90.4% of children in DBT-C responded to treatment compared to 45.5% in TAU, on the Clinical Global Impression Scale. All changes were clinically significant and sustained at 3-months follow-up. 2) In the residential care trial significant differences were observed on the main measure of outcome ��? Child Behavior Checklist (CBCL) staff report. Children in the DBT-C condition as compared to TAU had significantly greater reduction in symptoms on both Internalizing and Externalizing subscales. All changes were clinically significant. Results were maintained at 3- and 6-month follow-up. Conclusions: Results of both trials supported the feasibility and initial efficacy of DBT adapted for pre-adolescent children with severe emotional and behavioural dysregulation in multiple settings.