Cited by 112Personality Disorders and PsychopathologyPsychotherapy Techniques and ApplicationsAnxiety, Depression, Psychometrics, Treatment, Cognitive Processes

The DOI matches its Crossref record; 47 of the 48 references it cites were found in a registry or an index, and 1 are not checked yet; 7 of the 75 sources its claims cite were checked for support.

Transdiagnostic Applications of DBT for Adolescents and Adults

Open access
Ritschel, Lorie A., Lim, Noriel E., Stewart, Lindsay M.·2015·American Journal of Psychotherapy

Abstract

Dialectical behavior therapy (DBT) is an empirically supported treatment that was originally developed for chronically suicidal adults. Since the publication of the original treatment manual, DBT has been reconceptualized as a treatment that is broadly applicable for individuals who have difficulties regulating emotion. As such, the treatment can be applied transdiagnostically. Based on the flexibility and adaptability of the treatment, several adaptations have been made to the original protocol. Considerable empirical evidence now supports the use of DBT adapted for eating disorders, substance use disorders, and posttraumatic stress disorder. Moreover, developmentally appropriate adaptations have made the treatment applicable to youth samples. The current paper is geared toward practitioners and describes the various ways in which DBT has been modified for use with various populations and age ranges.

Verified 2026-11-06 · 1 reference not checked yet

Overview

AI snapshot

Written from the paper’s full text.

TL;DR

This paper reviews transdiagnostic adaptations of dialectical behavior therapy (DBT) for adolescents and adults, framing DBT as a treatment for pervasive emotion dysregulation rather than for borderline personality disorder alone. It describes clinical modifications for substance use disorders, eating disorders, comorbid PTSD, and emotional overcontrol (radically open DBT).

Key findings

  • DBT has been adapted for substance use disorders (DBT-SUD), eating disorders (DBT-ED), comorbid PTSD (DBT-PE), and emotional overcontrol (RO-DBT), using standard DBT modalities plus added skills and strategies.
  • The paper cites comorbidity figures: individuals with BPD meet criteria for approximately four additional disorders on average; among individuals receiving treatment for BPD, 21%–67% also meet criteria for SUDs; 15%–40% of clients with bulimia nervosa attempt suicide.
  • In a pilot randomized controlled trial of DBT-PE versus standard DBT, 60%–100% of combined-therapy completers showed significant improvement across outcomes at follow-up, compared with 20% in standard DBT; after one year of DBT, PTSD remission was approximately 35%.
  • RO-DBT targets emotional overcontrol and emotional loneliness, adding radical openness skills and replacing standard states of mind with fatalistic mind, fixed mind, and flexible mind.

Methods

  • Narrative/clinical review geared toward practitioners; no primary data collection or systematic review is described.
  • Synthesizes empirical literature and clinical adaptations for DBT-SUD, DBT-ED, DBT-PE, and RO-DBT across adult and adolescent populations.
  • Main analysis is descriptive and conceptual, drawing on cited trials, case studies, and treatment manuals.

Limitations

  • Stated: comprehensive DBT is intensive, requires considerable therapist training and a sizable client commitment; the authors caution against full-package DBT when a more parsimonious, streamlined approach is likely equally or more effective.
  • Evident: the paper is a narrative review without a systematic search or meta-analysis, and the cited evidence includes case studies, open trials, and pilot RCTs, so conclusions about adapted DBT protocols are not definitive.
  • Evident: no formal limitations section is included, and the review does not report new outcome data.

Model-written summary. Check it against the paper before relying on it.

Integrity signals

Registry

Crossref · 10.1176/appi.psychotherapy.2015.69.2.111

Cites

47 of 48 references verified0 citation errors · 0 not checkable

Statistics

Nothing to recompute.

Verification

Claims the paper makes

23 Sources not found · 21 No full text of the sources · 18 Own interpretation · 12 No basis given · 7 Partly supported · 6 Not checked yet · accuracy not yet measured

  • It may state two separate claims as one. 34
  • Probably not a substantial claim. 23
48 of 48
  • The paper relies on this without support.

    Emotion dysregulation is the common element across most psychological disorders.

    “The recent psychological literature has focused strongly on the construct of emotion dysregulation as the common element across most psychological disorders.”
  • The authors state this as an assumption.

    Substance use functions to modulate painful emotions and negative mood states.

    “Similar to the conceptualization of NSSI as a way to regulate intense negative emotions, substance use in DBT is viewed as a learned behavior whose function is to modulate painful emotions and negative mood states, such as sadness, boredom, shame, emptiness, rage, and misery.”
  • The authors state this as an assumption.

    Problem behaviors such as suicide attempts and NSSI are the result of difficulty tolerating intense and painful emotions.

    “Given the assumption that problem behaviors such as suicide attempts and NSSI are the result of difficulty tolerating intense and painful emotions”
3 of 3

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Citations

Cites

Show all 48 references

Research works printed but not linked: 3

  1. Alcoholics Anonymous, 1981, Twelve steps and twelve traditions.
  2. Ritschel L. A., 2013, Transdiagnostic Mechanisms and Treatment for Youth Psychopathology, 203
  3. Wisniewski L., 2007, Dialectical Behavior Therapy in Clinical Practice: Applications Across Disorders and Settings, 174

Cited by

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Metadata

Authors
Ritschel, L. A., Lim, N. E., & Stewart, L. M.
Affiliations
  • University of North Carolina at Chapel Hill (US)
  • Emory University (US)
Venue
American Journal of Psychotherapy
Published
2015-04
Volume
69
Issue
2
Pages
111-128
ISSN
  • 0002-9564 (ISSN-L)
  • 2575-6559
OpenAlex
W2185597551
Cited by
112
References
48
Citations by year
2026: 8 · 2025: 11 · 2024: 12 · 2023: 12 · 2022: 12 · 2021: 16 · 2020: 14 · 2019: 9 · 2018: 10 · 2017: 3 · 2016: 4 · 2015: 1
FWCI
7.44
Type
journal article
Language
en
Open access
Locations
  • American Journal of Psychotherapy (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Social Sciences › Psychology › Clinical Psychology › Personality Disorders and Psychopathology
  • Social Sciences › Psychology › Clinical Psychology › Psychotherapy Techniques and Applications
  • Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
Keywords
dialectical behavior therapy, transdiagnostic treatment, emotion regulation, eating disorders, substance use disorders, post-traumatic stress disorder, adolescents, treatment manual
MeSH terms
Adaptation, Physiological, Adolescent, Adult, Affective Symptoms, Feeding and Eating Disorders, Borderline Personality Disorder, Female, Humans, Male, Quality of Life, Stress Disorders, Post-Traumatic, Comorbidity, Cognitive Behavioral Therapy, Self-Injurious Behavior, Substance-Related Disorders, Behavior Control

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