Delivering comprehensive school-based dialectical behavior therapy (CSB-DBT)

This manuscript provides a detailed examination of comprehensive school-based dialectical behavior therapy (CSB-DBT) as a critical component to the DBT services continuum provided in schools. Because suicide is the second leading cause of death among adolescents along with increased prevalence of self-harming behavior, schools often find themselves thrust into the role of mental health providers especially around the issues of emotion regulation. Yet school personnel are often not formally trained to provide adequate services to these at-risk students. This gap is filled by the implementation of CSB-DBT. DBT is an evidence-based, transdiagnostic treatment that has been adapted by Miller and Rathus for adolescents with a range of mental health difficulties characterized by emotional and behavioral dysregulation. Comprehensive DBT adapted for implementation in school-based settings consists of four modes: Individual counseling, group skills training, in-school coaching, and DBT provider consultation team. A fifth mode, caregiver involvement is encouraged, to the extent possible. Each mode will be explained in further detail along with the adaptation rationale that makes it distinct for school-based application. Finally, discussion of implementation strategies, barriers, and support will be examined as important components for successfully integrating CSB- DBT.