Dialectical Behavior Therapy-Based Interventions for Externalizing Problems Among Adolescents: A Meta-Analysis

Dialectical behavior therapy (DBT) is an evidence-based intervention that aims to reduce maladaptive behavior by facilitating development of emotion regulation, with support for use with diagnostically diverse adolescents. We conducted a meta-analysis evaluating change in externalizing symptoms among adolescents in DBT-based interventions across 17 studies (with 25 data points). Results indicate that interventions have a small-to-medium effect in reducing externalizing symptoms (Hedge's g = -0.499, 95% CI [-0.683, -0.315], p < .001). Greater intervention duration was associated with greater decrease in symptoms (slope = -0.014, Z = -2.312, SE = 0.006, p = .021), though this finding was no longer significant following removal of an outlier. No other moderators were significant (ps range: .182-.862). Findings provide meaningful information about the utility of DBT-based interventions for externalizing problems as currently delivered among adolescents.