From the Guidelines
Dialectical Behavior Therapy (DBT) has shown efficacy in reducing suicidality, depressive symptoms, and emotion dysregulation in adolescents with bipolar spectrum disorders, but its effectiveness in adolescents with autism is not directly addressed in the provided studies. The provided evidence focuses on the application of DBT in adolescents with bipolar spectrum disorders (BPSDs) rather than autism specifically [ 1 ]. However, considering the skills DBT aims to teach, such as mindfulness, distress tolerance, emotion regulation, and interpersonal effectiveness, it is plausible that DBT could be beneficial for adolescents with autism, especially given the common comorbidities of emotional dysregulation and mental health issues in this population. Key points to consider in potentially applying DBT to autistic adolescents include:
- The need for modifications to standard DBT protocols, such as simplified language and the incorporation of visual supports [ 1 ].
- The importance of parent/caregiver involvement and extended skill practice [ 1 ].
- The potential for DBT to help bridge the gap between autism-related social-communication difficulties and emotional regulation challenges. Given the lack of direct evidence on DBT's efficacy in autistic adolescents, any recommendation for its use would need to be cautious and consider the individual's specific needs and circumstances. Therefore, while DBT shows promise, its application in adolescents with autism should be approached with careful consideration of the need for autism-specific adaptations and the limited direct evidence supporting its use in this population [ 1 ].
From the Research
Efficacy of DBT in Adolescents with Autism
- There are no studies directly evaluating the efficacy of Dialectical Behavior Therapy (DBT) in adolescents with autism, as the provided studies focus on autistic adults or children with Autism Spectrum Disorders (ASDs) undergoing Cognitive Behavioral Therapy (CBT) [(2,3,4,5)].
- However, the studies on autistic adults suggest that DBT can be effective in reducing emotion dysregulation, depressive symptoms, and improving quality of life [(2,4,5)].
- One study on autistic adults found that DBT was effective in reducing emotion dysregulation, with improvements lasting at follow-up, and that alexithymia improvement mediated the therapy effects on emotion dysregulation 2.
- Another study suggested that DBT may be therapeutically beneficial to autistic individuals struggling with emotional and sensory challenges, and that modifications such as visuals, graphics, and a gaming format can enhance DBT for autistic people 3.
- A review of DBT in autism found that DBT has amassed the most evidence for treatment of emotion dysregulation across a range of clinical conditions, and that adaptations are likely to improve its dissemination and acceptability for autistic individuals 5.
- A systematic review of Cognitive Behavioral Therapy (CBT) for Autism Spectrum Disorders (ASDs) found that CBT may significantly improve the symptoms of ASD and social-emotional problems in children or adolescents with ASD, based on informant-reported outcomes, clinician-rated outcomes, and task-based outcomes 6.