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Cultural Adaptation and Implementation of DBT for Adolescents With Emotional Disorders

Sponsor: Mackay Memorial Hospital • ClinicalTrials.gov ID: NCT06566235

Registry updated: 2026-09-08

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Description

The goal of this study is to learn if Dialectical behavior therapy Skills Training for Adolescents (DBT-A-ST) works on emotional disorders in adolescents. The main questions it aims to answer are: Does DBT-A-ST produce faster improvements (i.e., steeper slopes), compared to ASG, on primary and secondary outcome measures during treatment and 3-month follow-up? Does DBT-A-ST produce greater improvements, compared to SBG, on primary and secondary outcome measures? Participants is: Randomly assigned to (a) a culturally adapted DBT-A-ST or (b) Satir-based group (SBG). Received five assessments before the start of the trial (T1), after 4, 8 sessions (T2, T3), at post-intervention (T4), and 3-month follow-up (T5).

Interventions

Culturally adapted DBT-A-ST group (Behavioral)
The culturally adapted DBT-A-ST consists of 15 weekly group sessions, each lasting 120 minutes, including a 10-minute break. It maintains the core elements of standard DBT-A, including its philosophical foundation and treatment strategies. Therapists focus on teaching DBT skills through various methods such as modeling, structured behavioral rehearsals, and feedback. Each session begins with a 40-minute group mindfulness exercise and homework review, followed by 60 minutes dedicated to skill-specific didactics and experiential activities, concluding with a 10-minute homework assignment. Two group leaders facilitate the sessions, and participants track their skill usage daily with diary cards, which are reviewed weekly.
Satir-based group (SBG) (Behavioral)
SBG, grounded in Satir's Iceberg Theory, aims to enhance self-awareness and communication by exploring participants' deeper emotions and beliefs. Sessions include emotional sharing, communication skills training, and role-play exercises. The program spans 15 weekly sessions (2 hours each): 12 for adolescents and 3 involving both adolescents and their parents. Activities focus on practicing communication stances, reflection, and group discussion to foster personal growth and improved relationships. The inclusion of parents is designed to help teens build supportive, resilient connections.

Eligibility criteria

Inclusion Criteria: 1. Age 12-18 years. 2. Informed consent provided by the youth and one parent. 3. Sufficient Mandarin Chinese proficiency to complete study questionnaires. 4. Total score of PHQ-9 ≥ 8 or GAD-7 ≥ 8, or SDQ total score ≥ 10, or SDQ hyperactivity subscale score ≥ 3. 5. Primary diagnosis of depressive, anxiety disorder, or ADHD based on K-SADS- E interview, including: Depression (F32-33) Persistent mood disorder (F34) Phobic anxiety disorder (F40) Other anxiety disorder (F41) Adjustment disorders (F43.2) ADHD (F90) 6. Stable medication use for at least four weeks and willingness to maintain stable dosage during the study. 7. Individuals with comorbid emotional disorders are included; comorbidities are not stratified to avoid increasing study design complexity. Exclusion Criteria: 1. Educational level of elementary school or university. 2. Comorbid intellectual disability or psychotic disorder. 3. Acute suicidality. 4. Insufficient Chinese language skills. 5. Unwillingness to discontinue current psychotherapy. 6. Unwillingness to accept video recording during group therapy. 7. Medication changes during the trial are not exclusionary if judged necessary or clinically important by the treating clinician, to maintain a naturalistic setting.

Conditions

Emotional Disorders

Locations

MacKay Memorial Hospital — Taipei, Taiwan
MacKay Memorial Hospital — Taipei, Taiwan

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Official Source

Data sourced from ClinicalTrials.gov, a service of the U.S. National Institutes of Health.

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