Cognitive Behavioral Therapy In Adolescents

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Despite availability of community and home based mental health services, there are times when adolescents may need more intensive care. Residential treatment serves as a source of support for adolescents who have had frequent hospitalization, ineffective outpatient therapy, or disorders characterized by defiance, depression, self harm, mood instability, emotional dysregulation, and interpersonal conflict (Yampolskaya, Mowery, & Dollard, 2014). In addition to 24-hour support and supervision, providing treatment that is evidence-based and effective is imperative to support a successful transition back into the community and decrease the rates of readmission; however, data continues to be limited regarding adolescents in these facilities.
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Based on the integration of thoughts, behaviors, and feelings, CBT can assist the adolescents in challenging maladaptive cognitions and adverse emotions to reduce problematic behavior patterns (Henin et al., 2016). An early study exploring the effectiveness of CBT on male adolescents engaging in oppositional deviant and aggressive behaviors was conducted by Valliant in 1993. He examined the effectiveness of daily behavioral therapy and weekly cognitive-behavioral therapy on 10 participants over the course of a year by evaluation using the Coopersmith Self-Esteem Inventories, Revised Children’s Manifest Anxiety Scale, and the Buss-Durkee Hostility-Guilt Inventory. Valliant (1993) found that the intervention improved self-esteem and decreased verbal hostility over the course of the year; however, at follow up one year post discharge, eight of the 10 participants had been incarcerated. A possible explanation for this was due to the lack of family involvement during treatment and the inability to differentiate between acceptable and unacceptable behaviors outside of a structured, controlled environment (Valliant,…show more content…
This is through the acquisition of skills involving interpersonal effectiveness, distress tolerance, emotion regulation, and mindfulness (Linehan et al., 2006). Several studies have been conducted to support the use of DBT among adolescents engaging in self-injurious or suicidal behaviors (Sunseri, 2004; Linehan et al., 2006). Additionally, DBT has been found to be effective in treating those with oppositional defiance, eating disorders, and poor social relationships (Nelson-Gray et al., 2004). Still, with data supporting the use of DBT, there is limited data regarding the use of this therapy in residential treatment centers. In one study conducted by Wasser, Tyler, McIlhaney, Taplin, and Henderson (2008), DBT was utilized in an adolescent residential facility to determine the efficacy of the treatment within the center. Participants included 26 males and females with an average age of 15, who were split into two groups. The first group received DBT from trained clinicians and staff; this involved individual therapy, skills training group sessions, family therapy, and homework and skills practice. The second group received Standard Therapeutic Milieu (STM); this included individual therapy, behavioral management, group and family therapy, and pharmacotherapy with no specific therapy modality. Participants were engaged
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