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June 3, 2026Open Access

Effect of parallel adolescent and parent dialectical behavior therapy skills training vs. adolescent-only skills training on nonsuicidal self-injury: a pilot randomized trial

Puntos clave

This trial aimed to evaluate the effect of parallel adolescent and parent dialectical behavior therapy skills training on reducing nonsuicidal self-injury in adolescents.
Pilot randomized controlled trial with 38 adolescents aged 12–18 meeting DSM-5 criteria for NSSI disorder, randomized to two groups: DBT-SP and DBT-S.
Both groups received 120-minute group sessions weekly for 12 weeks; DBT-SP included separate sessions for parents.
Primary outcome measured was NSSI severity using the Ottawa Self-Injury Inventory at specified intervals.
NSSI frequency decreased in both groups from baseline to week 12 (time effect, p < 0.01).
DBT-SP group showed greater reductions in depressive symptoms (p = 0.03) and anxiety symptoms (p = 0.01).
Positive parent-adolescent interactions increased significantly in DBT-SP group, while remaining stable in DBT-S group (interaction p < 0.01).

Resumen

Abstract Background Family involvement in dialectical behavior therapy (DBT) improves nonsuicidal self-injury (NSSI) outcomes in adolescents, yet many adolescents resist conjoint treatment with parents, highlighting the need for alternative delivery formats. This pilot study preliminarily examined whether parallel adolescent and parent DBT skills training (DBT-SP, in which parents attended separate concurrent skills groups) shows promise compared with adolescent-only DBT skills training (DBT-S) in reducing NSSI and associated symptoms. Methods In this pilot randomized controlled trial, 38 adolescents aged 12–18 years meeting DSM-5 criteria for NSSI disorder were randomized to DBT-SP ( n = 19) or DBT-S ( n = 19). Adolescents in both groups received weekly 120-minute group sessions over 12 weeks. Additionally, parents in the DBT-SP group received parallel 120-minute skills training sessions (separate from adolescents), while parents in the DBT-S group received no structured intervention. The primary outcome was NSSI severity assessed using the Ottawa Self-Injury Inventory at baseline and at weeks 4, 8, and 12. Results NSSI frequency decreased in both groups from baseline to week 12 (time effect, p < 0.01). The DBT-SP group demonstrated greater reductions in depressive ( p = 0.03) and anxiety symptoms ( p = 0.01). Positive parent-adolescent interactions increased from a median of 2 at baseline to 11 times weekly by the end of week 11 in the DBT-SP group while remaining stable in the DBT-S group (interaction p < 0.01). Conclusions In this pilot randomized controlled trial, compared with adolescent-only delivery, parallel adolescent-parent DBT skills training was associated with reduced anxiety and depressive symptoms in adolescents and increased positive family interactions. These preliminary findings warrant replication in larger, fully powered confirmatory trials. Clinical trial number Chinese Clinical Trial Registry, ChiCTR2500105036. Retrospectively registered on June 27, 2025.

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