DBT Therapist Adherence-Why It Really Matters

September is National Suicide Prevention Awareness Month, so what better time to review the impact Dialectical Behavior Therapy has on reducing suicidal thoughts and urges?  DBT was initially developed for suicidal clients and has rigorous research data supporting Dialectical Behavior Therapy (DBT) as an effective evidence-based treatment.  We also know that adherent DBT programs yield the most significant patient outcomes. 

What is less well known, based on the research, is whether therapist adherence influences patient outcomes. 

In 2022, Harned and Colleagues published research on this very topic, looking at the temporal relationship between therapist adherence to DBT and patient outcomes. The study also reviewed if there were any moderators of those relationships. 

What did they find?

Higher therapist adherence significantly predicted:

 - Fewer subsequent suicide attempts

 - Lower risk of dropout (strongest impact to those with co-occurring opioid dependence)

 - Fewer subsequent hospitalizations (among community therapists) and for patients that were not exclusively suicidal/self-injuring

The study also found if patients have more frequent non-suicidal self-injury (NSSI) and had worse global functioning this predicted higher subsequent therapist adherence was also found when patients had more frequent non-suicidal self-injury (NSSI) as well as worse global functioning. This was moderated by patient population. 

What does this mean?

Therapist adherence to DBT as it was designed to be delivered predicts fewer suicide attempts in their clients. This highlights the importance of delivering DBT with fidelity. The study also provides evidence that therapist adherence helps bolster patient retention. It also highlights that when working with patients presenting with higher severity, the model feels easier for therapists to deliver the adherently. 

Where to from here?

Suicide Prevention and Awareness month is an incredibly relevant time to share the link between therapist adherence to DBT and reduced suicide attempts, a lowered risk of dropping out, and fewer inpatient admissions. Would you like to assess you and your Consultation Team’s adherence to DBT?  Consider reviewing the measures of adherence at https://www.dbtadherence.com/home.

This September, your support can save lives.

Understanding the Statistics

The numbers are sobering. In the United States, suicide was the 11th leading cause of death overall in 2023, and the second leading cause of death for individuals aged 10–34. Globally, suicide is the third leading cause of death for people aged 15–29.

These statistics are heartbreaking especially when we consider how many adolescents and teenagers are affected. For families in Connecticut, knowing how to recognize warning signs and where to turn for support can make all the difference.

Suicide in Teenagers

If you are looking for resources about suicide in adolescents and teenagers, McLean Hospital (Belmont, MA) provides excellent information ([consider linking here if appropriate]). They explain why teens may consider suicide, how to recognize warning signs, and how to approach the conversation with your child.

One critical concept they highlight is the “suicide contagion effect.” This underscores the importance of knowing what your teen is exposed to through social media, entertainment, and their social circles.

At The Harmony Center for Change, we offer Dialectical Behavior Therapy (DBT) in Farmington, CT, which includes dedicated parent sessions, separate from your teen’s sessions. These meetings give parents and guardians guidance, support, and a space to process their own feelings of overwhelm or burnout. They also ensure parents understand the skills their teen is learning in therapy, so you can reinforce those tools at home when emotional challenges arise.

If you’re searching for teen counseling in Connecticut or want to learn more about how DBT can help your family, our team is here for you.

Approaching Difficult Conversations

Suicide is a delicate and complex subject. Talking about it with your teenager may feel like navigating a minefield. A good starting point is to listen without judgment. Let your teen know they are loved unconditionally and that you will be there for them when they feel stressed or overwhelmed.

As parents, it’s natural to want to solve problems or “fix” what our child is going through. But often, what teenagers need most is for us to listen and to connect them with professional help.

Our therapists specialize in adolescent mental health counseling in Connecticut, guiding teens and families through some of life’s most difficult moments.

You Are Not Alone

Parents, you are not alone. It is normal to feel scared, isolated, or unsure of what to do when facing this topic. The good news is there are many resources available to guide you in recognizing warning signs, finding support, and preventing suicide.

Brown University Health has published a resource-rich article with helpful information ([consider linking here as well]). And of course, therapy can be a powerful step forward—not only for your teenager, but for your whole family.

If you have questions about how to get started with therapy for your teen, we encourage you to reach out. The Harmony Center for Change proudly provides teen counseling, DBT therapy, and suicide prevention resources in Farmington, Avon, Simsbury, West Hartford and across Connecticut.