Effectiveness of Dialectical Behavior Therapy (DBT) versus Standard Therapeutic Milieu (STM) in a Cohort of Adolescents Receiving Residential Treatment

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Organizations that would like to evaluate the effectiveness of different therapy methods are often forced to use existing outcomes measures and to match subjects that received one form of treatment compared to another.This study of adolescents compared two different forms of treatment used in two different states. One state used Dialectical Behavior Therapy (DBT), and the other used Standard Therapeutic Milieu (STM). Data were abstracted from the hospital system and adolescents were matched on age, gender, and primary Axis I diagnosis, yielding a primary “perfect” match sample (n = 14), and a secondary match sample (n = 24) where the secondary Axis I diagnosis was used. Outcomes were measured by the BPRS-C, which is the standard outcome measure used by KidsPeace Lee Salk Center for Research.Results indicated that DBT was clinically and statistically more effective than STM for the Depression subscale of the BPRS-C. In addition, Organicity symptoms were eliminated by DBT treatment. STM demonstrated greater efficacy on the Psychomotor Excitation subscale, but the power of the statistical model was low.