Dialectical Behavior Therapy and Suicidal Behavior in Adolescence: Linking Developmental Theory and Practice

Adolescent suicide is a significant public health concern; however, relatively little empirical research has investigated the etiology or effective treatment of adolescent suicidal behaviors. Linehan's biosocial theory posits that problems with regulating emotions underlie suicidal and self-harm behavior, and Dialectical Behavior Therapy (DBT) was developed to improve emotion regulation skills (Crowell, Beauchaine, & Linehan, 2009; Linehan, 1993). Currently, DBT is an empirically supported treatment for adults, and results of nonrandomized trials with adolescents have been promising. This article discusses the application of DBT with adolescents from a developmental perspective, drawing links between Linehan's biosocial theory and the development of emotion regulation. More specifically, the authors (a) review the biosocial theory, (b) review research on the development of emotion regulation in childhood and adolescence and highlight areas of overlap with the biosocial theory, (c) describe specific DBT interventions that are developmentally appropriate for adolescents, and (d) provide a clinical case example illustrating the application of these techniques.