Culturally adapted DBT skills group for adolescents with emotional disorders

Cultural Adaptation and Implementation of Dialectical Behavior Therapy Skills Training Group for Adolescents With Emotional Disorders: a Feasibility Study and a Randomized Controlled Trial

This project will test whether a culturally adapted Dialectical Behavior Therapy skills group helps adolescents ages 12–18 with depression, anxiety, or ADHD-related emotional problems more and faster than a Satir-based group.

Quick facts

• Phase: Not applicable
• Study type: Interventional
• Enrollment: 160 (estimated)
• Ages: 12 Years to 18 Years
• Sex: All
• Sponsor: Mackay Memorial Hospital (Academic / other)
• Locations: 2 sites (Taipei and 1 other locations)
• Trial ID: NCT06566235 on ClinicalTrials.gov

What this trial studies

In year one the team develops a culturally adapted DBT-A skills training using a pilot 15-session program and focus groups. Years two to four use a partially randomized patient preference design to compare the adapted DBT-A-ST group versus a Satir-based group, with participants allocated either by randomization or by preference. Both group interventions run 15 weekly sessions of 120 minutes, target a sample of 160 youths, and include five assessment points (baseline, after 4 and 8 sessions, post-intervention, and 3-month follow-up). Primary outcomes are depression and anxiety severity rated by blinded assessors, with secondary outcomes covering general psychopathology, number of DSM-5 disorders, quality of life, self-report measures, and implementation/process measures.

Who should consider this trial

Good fit: Ideal candidates are Mandarin-proficient adolescents aged 12–18 with a primary depressive, anxiety disorder, or ADHD diagnosis and elevated symptom scores (PHQ-9 ≥8, GAD-7 ≥8, or SDQ thresholds) who can provide assent and have a consenting parent.

Not a fit: Those unlikely to benefit include youths with acute suicidality, psychotic disorders, intellectual disability, insufficient Chinese language skills, or those outside the 12–18 age range.

Why it matters

Potential benefit: If successful, this could offer Mandarin-speaking adolescents a culturally tailored group skills program that reduces depression and anxiety faster and improves overall functioning.

How similar studies have performed: DBT-A has prior evidence for improving adolescent emotion regulation and reducing self-harm, but culturally adapted DBT-A skills training and direct comparisons with Satir-based group therapy are less well studied.

Eligibility criteria

Inclusion Criteria:

1. Age 12-18 years.
2. Informed consent provided by the youth and one parent.
3. Sufficient Mandarin Chinese proficiency to complete study questionnaires.
4. Total score of PHQ-9 ≥ 8 or GAD-7 ≥ 8, or SDQ total score ≥ 10, or SDQ hyperactivity subscale score ≥ 3.
5. Primary diagnosis of depressive, anxiety disorder, or ADHD based on K-SADS-

   E interview, including:

   Depression (F32-33) Persistent mood disorder (F34) Phobic anxiety disorder (F40) Other anxiety disorder (F41) Adjustment disorders (F43.2) ADHD (F90)
6. Stable medication use for at least four weeks and willingness to maintain stable dosage during the study.
7. Individuals with comorbid emotional disorders are included; comorbidities are not stratified to avoid increasing study design complexity.

Exclusion Criteria:

1. Educational level of elementary school or university.
2. Comorbid intellectual disability or psychotic disorder.
3. Acute suicidality.
4. Insufficient Chinese language skills.
5. Unwillingness to discontinue current psychotherapy.
6. Unwillingness to accept video recording during group therapy.
7. Medication changes during the trial are not exclusionary if judged necessary or clinically important by the treating clinician, to maintain a naturalistic setting.

Where this trial is running

Taipei and 1 other locations

• MacKay Memorial Hospital — Taipei, Taiwan (Active_not_recruiting)
• MacKay Memorial Hospital — Taipei, Taiwan (Recruiting)

Study contacts

• Principal investigator: Shen-Ing Liu, Ph.D — Mackay Memorial Hospital
• Study coordinator: Hui-Chun Huang, Ph.D

Conditions Emotional Disorders; Dialectical Behavior Therapy Skills Training Group; Adolescents