Outpatient Young Adults with Concurrent Disorders: A Naturalistic Study of Clinical Characteristics and DBT Skills Training Outcomes

Introduction This naturalistic study characterized clinical profiles of outpatient young adults with concurrent substance use and nonsubstance mental health symptoms in addition to evaluating reach and outcomes of a dialectical behaviour therapy skills training group. Methods Descriptive statistics were generated to characterize demographic and clinical profiles of young adults ( N = 612) who initiated services at a psychiatric specialty clinic between June 2016 and January 2020. Chi‐square, independent t ‐tests and logistic regression models were used to examine factors associated with engagement with dialectical behaviour therapy skills training group. Paired samples t ‐tests were utilized to evaluate psychiatric symptom and functional impairment outcomes associated with group completion. Results Self‐report measures indicated a high rate of substance use and co‐occurring nonsubstance mental health concerns in the sample as a whole. Young adults who engaged in group programming differed significantly from those who did not on several clinical and demographic variables; however, no variables were significantly associated with group engagement in regression models. While referral and attendance rates were relatively low (30.6% and 15.4% of total sample), for those completing dialectical behaviour therapy skills training group we observed positive pre‐post change outcomes on measures of psychiatric symptoms and functioning ( d = 0.35–0.69). Conclusion Taken together, these findings provide initial support for offering dialectical behaviour therapy skills training as an adjunctive intervention for young adults with concurrent disorders. Future research identifying factors for enhancing engagement and examining outcome with more controlled conditions are warranted.