Dialectical Behavior Therapy with Suicidal Adolescents

Alec L. Miller, PsyD, is Cofounder and Clinical Director of Cognitive and Behavioral Consultants, White Plains and New York, New York, and Clinical Professor of Psychiatry and Behavioral Sciences at Montefiore Medical Center/Albert Einstein College of Medicine, Bronx, New York. Dr. Miller served for over 20 years as Professor of Clinical Psychiatry and Behavioral Sciences, Chief of Child and Adolescent Psychology, Director of the Adolescent Depression and Suicide Program, and Associate Director of Psychology Training at Montefiore Medical Center. He is a scientific advisor to the American Foundation of Suicide Prevention and the National Educational Alliance of Borderline Personality Disorder, a Fellow of the American Psychological Association, and past Chair of the International Society for the Improvement and Training of DBT. He has published numerous peer-reviewed journal articles, book chapters, and books on topics including DBT, adolescent suicide, childhood maltreatment, and borderline personality disorder. He is the coauthor of DBT Skills in Schools, DBT Skills Manual for Adolescents, and Dialectical Behavior Therapy with Suicidal Adolescents. He has conducted over 400 lectures and workshops around the world, training thousands of mental health professionals in DBT.Jill H. Rathus, PhD, is a former Professor of Psychology at Long Island University Post, where she directed the DBT Clinical Research Lab. She is also cofounder and codirector of Cognitive Behavioral Associates, a treatment and training center in Great Neck, New York. Dr. Rathus is coauthor of books including Dialectical Behavior Therapy with Suicidal Adolescents and DBT Skills Manual for Adolescents, and is a coauthor of the DBT STEPS-A and DBT STEPS-E curricula for secondary and elementary school settings. She consults internationally, has trained thousands of mental health professionals in the United States and worldwide, and is widely published in peer-reviewed journals. Dr. Rathus is a recipient of the Cindy Sanderson Outstanding Educator Award from the International Society for the Improvement and Training of DBT and serves as Co-Chair of the Treatment Integrity Committee of the World DBT Association.Marsha M. Linehan, PhD, ABPP, the developer of Dialectical Behavior Therapy (DBT), is Professor Emeritus of Psychology and Director Emeritus of the Behavioral Research and Therapy Clinics at the University of Washington. Before retiring in 2019, she devoted her career to developing and evaluating evidence-based treatments for populations with high suicide risk and multiple, severe mental disorders. Dr. Linehan is the 2025 recipient of the Lifetime Achievement Award from the American Foundation for Suicide Prevention. Her contributions to suicide research and clinical psychology research have also been recognized with the University of Louisville Grawemeyer Award for Psychology, the Career/Lifetime Achievement Award from the Association for Behavioral and Cognitive Therapies, the Gold Medal Award for Life Achievement in the Application of Psychology from the American Psychological Foundation, and the James McKeen Cattell Award from the Association for Psychological Science. In her honor, the American Association of Suicidology created the Marsha Linehan Award for Outstanding Research in the Treatment of Suicidal Behavior. Dr. Linehan was featured in TIME Great Scientists: The Geniuses and Visionaries Who Transformed Our World. She is founder of the Linehan Institute and is a Zen master.

• Foreword, Charles R. SwensonIntroduction 1. Suicidal Behaviors in Adolescents: Who Is Most at Risk?2. What Do We Know about Effective Treatments for Suicidal Adolescents?3. Dialectical Behavior Therapy: Treatment Stages, Primary Targets, and Strategies4. DBT Program Structure: Functions and Modes5. Dialectical Dilemmas for Adolescents: Addressing Secondary Targets6. Assessing Adolescents: Suicide Risk, Diagnosis, and Treatment Feasibility7. Orienting Adolescents and Families to Treatment and Obtaining Commitment 8. Individual Therapy with Adolescents9. Including Families in Treatment10. Skills Training with Adolescents11. Assessing Progress, Running a Graduate Group, and Terminating Treatment12. Program IssuesAppendix A. Mindfulness Exercises for AdolescentsAppendix B. Walking the Middle Path Skills: Lecture and Discussion PointsAppendix C. Handouts for Walking the Middle Path Skills

"An excellent, practical book on a very difficult-to-treat and neglected population: teens with multiple and severe psychiatric disorders, mood dysregulation, and recurrent suicidal and/or self-harming behaviors. This book is recommended for students, psychologists, social workers, psychiatric residents, psychiatrists, and other professionals dealing with mental health issues in teenagers. Also, this book is an outstanding resource for researchers evaluating the efficacy of Dialectical Behavior Therapy for teenagers."--Boris Birmaher MD, University of Pittsburgh Medical Center"This book offers the latest thinking on core elements of DBT while illustrating important strategies specific to treating adolescents. The authors' skill and expertise with this population shine, making this an essential manual for DBT practitioners and administrators working with adolescents."--André Ivanoff, PhD, Columbia University School of Social Work"An outstanding text for graduate courses focused on cognitive-behavioral therapy and evidence-based approaches for youth. I have utilized this book in my graduate course on Adolescent Clinical Psychology and with advanced practicum students providing therapy services to youth at risk for self-harm behaviors. The book is well organized and provides a thorough review of the theoretical foundations of DBT. The chapters on skills training and the pragmatics of running groups are helpful resources for all practitioners, especially in combination with the appendices that provide detailed descriptions of the group activities, discussion points, and handouts."--Mary Louise Cashel, PhD, Associate Professor and Director of Clinical Training, Department of Psychology, Southern Illinois University Carbondale "Outstanding. This book represents a major contribution to the prevention of adolescent suicide. It is extensively detailed to inform clinicians about the applications of this effective psychosocial treatment for adolescents who present with specific risk factors. Written by pioneering developers of DBT, this book is essential reading for mental health professionals at every level of experience and training."--Cynthia R. Pfeffer, MD, Department of Psychiatry, Weill Medical College of Cornell University "This book is extremely relevant for therapists working with adolescents who engage in suicidal and other high-risk behaviors. In addition to providing an efficacious and easily understood manualized approach for this population, it offers many valuable tips for building a strong therapeutic alliance with this challenging population."--Lynn Ponton, MD, University of California, San Francisco "Humane, practical, and erudite. The authors, through their dialectical approach, provide a theoretical framework that allows for an efficient, realistic, and parsimonious approach to the core difficulties in multiple health-risk behaviors in youth. Most important, they provide clear guidelines as to how therapists should conduct themselves to be maximally effective with these challenging adolescents, and how to cope with the emotional demands of work with this population. What the reader will learn is that DBT is more than a set of skills and techniques--it is a way of understanding and conceptualizing human behavior. This book should be read by every professional who works with multiproblem teens."--David A. Brent, MD, Division of Child and Adolescent Psychiatry and Services for Teens at Risk, University of Pittsburgh School of Medicine -