Improving Adherence in Adolescent Chronic Kidney Disease: A Dialectical Behavior Therapy (DBT) Feasibility Trial
Abstract
Adolescents with chronic kidney disease often engage in nonadherent behaviors and have poorer outcomes. Dialectical behavior therapy (DBT) promotes quality-of-life improvement, with specific focus on “treatment-interfering behaviors” such as nonadherence. DBT has demonstrated effectiveness with patients who are otherwise difficult to reach, treat, and manage in outpatient settings. This study describes a DBT adaptation for improving adherence in adolescent patients with end-stage renal disease (ESRD). Seven adolescents with ESRD were enrolled in a 9-session DBT program. Process (illness acceptance) and outcome (quality of life, depression) measures were conducted pre- and posttreatment. Transplant team reports of adherence and health improvements were conducted at pre-, mid-, and posttreatment. Significant improvements were evident at posttreatment for depression and adherence. Findings suggest that DBT may promote adherence in difficult-to-treat youth with chronic illness.
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Linehan, M. M., Comtois, K. A., Murray, A. M., Brown, M. Z., Gallop, R. J., Heard, H. L., Korslund, K. E., Tutek, D. A., Reynolds, S. K., & Lindenboim, N. (2006) · Archives of General Psychiatry · doi:10.1001/archpsyc.63.7.757 · Cited by 2,025 · see citing works
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“Many studies since its inception have illustrated the effectiveness of DBT interventions over and above treatment as usual for difficult-to-treat adult populations (Linehan et al., 2002, 2006; Lynch, Morse, Mendelson, & Robins, 2003) as well as adolescents (Rathus & Miller, 2002).”
Dialectical Behavior Therapy for Depressed Older Adults: A Randomized Pilot Study
Lynch, T. R., Morse, J. Q., Mendelson, T., & Robins, C. J. (2003) · The American Journal of Geriatric Psychiatry · doi:10.1097/00019442-200301000-00006 · Cited by 384 · see citing works
Meta-Analysis of Medical Regimen Adherence Outcomes in Pediatric Solid Organ Transplantation
Dew, M. A., Dabbs, A. D., Myaskovsky, L., Shyu, S., Shellmer, D. A., DiMartini, A. F., Steel, J., Unruh, M., Switzer, G. E., Shapiro, R., et al. (2009) · Transplantation · doi:10.1097/tp.0b013e3181b2a0e0 · Cited by 264 · see citing works
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Kleiber, B. V., Felder, J. N., Ashby, B., Scott, S., Dean, J., & Dimidjian, S. (2017) · Cognitive and Behavioral Practice · doi:10.1016/j.cbpra.2016.12.002 · Cited by 24 · see citing works
Karbasdehi, E. R., Hosseinkhanzadeh, A. A., & Karbasdehi, F. R. (2021) · DOAJ (DOAJ: Directory of Open Access Journals) · doi:10.30476/intjsh.2021.91748.1160 · Cited by 3 · see citing works
- Authors
- Hashim, B. L., Vadnais, M., & Miller, A. L.
- Affiliations
- Children's Hospital at Montefiore (US)
- Centre Hospitalier Universitaire Sainte-Justine (CA)
- Albert Einstein College of Medicine (US)
- Venue
- Clinical Practice in Pediatric Psychology
- Publisher
- SAGE Publications
- Published
- 2013-12
- Volume
- 1
- Issue
- 4
- Pages
- 369-379
- ISSN
- 2169-4826 (ISSN-L)
- 2169-4834
- OpenAlex
- W2316410137
- Cited by
- 24
- References
- 4
- Citations by year
- 2026: 3 · 2025: 1 · 2024: 3 · 2023: 1 · 2022: 1 · 2021: 2 · 2020: 1 · 2019: 2 · 2018: 4 · 2017: 2 · 2016: 1 · 2015: 2 · 2014: 1
- FWCI
- 1.17
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Clinical Practice in Pediatric Psychology (publishedVersion)
- Topics
- Health Sciences › Medicine › Family Practice › Medication Adherence and Compliance
- Social Sciences › Psychology › Clinical Psychology › Personality Disorders and Psychopathology
- Health Sciences › Health Professions › Speech and Hearing › Adolescent and Pediatric Healthcare
- Keywords
- dialectical behavior therapy, medication adherence, end-stage renal disease, acceptance of illness, quality of life, depression, kidney transplantation
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