We first met Dr. Linehan at a dialectical behavior therapy (DBT) intensive training In Seattle, Washington. Her revolutionary addition of constructs such as mindfulness and acceptance into the cognitive-behavioral therapy model deeply resonated with us regarding the adolescent population we worked with at Montefiore Medical Center, Bronx New York. The core tenets and strategies of DBT addressed the unique challenges many adolescents and their families were facing, multiple problems, suicidal behavior, and a history of crises, hospitalizations, and ineffective therapies. This DBT Skills Manual for Adolescents builds on our previous work and broadens the use of DBT to not only multi-problem, self-injurious teens, but also to the general adolescent population.
The modification and implementation of adolescent DBT was not easy at first. Along with numerous challenges that come with introducing a new modality, we went through many iterations as we developed an approach that was developmentally appropriate for adolescents while being true to the original model. However, with the help and encouragements from Dr. Linehan and colleagues in the field who saw the DBT’s potential to effectively treat the adolescent population, this Skills Manual came to fruition. A key addition to Standard DBT made for the adolescent DBT is the parent-related interventions and psychoeducation, highlighted by the Walking the Middle Path module, family sessions, and parent involvement in skills training, which help create a more supportive environment for the teen while supporting parents as well.
The process of coming up with adolescent version of DBT has involved a commitment to increasing accessibility of an efficacious treatment modality to a broader population. We hope this in-depth presentation of skills training for teens and families will help more clinicians and researchers as they work toward improving the lives of adolescents who suffer from and struggle with emotional and behavior dysregulation. In this vein, we welcome this translation of our Skills Manual to make this modality even more accessible across cultures and language boundaries.
We would like to acknowledge Dr. Cho and the DBT Center of Korea/the Tree Group team for all their hard work in disseminating of DBT in Korea since 2005. Training and supervising for DBT is not an easy undertaking, and to ensure that the practitioners are closely observing the standards set here in the United States takes passion and dedication. And all these efforts stem from correct and clear translation of the original texts such as this book and both of Linehan’s DBT Skills Training texts (Linehan, 2015a; 2015b), which are also going to be published in Korean within the year.
The text translation for a book as clinically and research-dense as this manual takes more than just mere understanding of the constructs and languages. Finding or creating terminologies that deliver the context of the original text without distortion while ensuring compatibility with a different culture requires a deep understanding of the subject matter as well as a keen and perceptive knowledge of the two cultures over which the translation spans. And Korean not being Latin-based language makes the process all the more challenging on both technical and cultural levels. It is without doubt that extensive professional hours, energy, and commitment went into translating this Skills Manual. In fact, this has been a 3-year long endeavor that included drafts being tested out in real clinical settings with Korean adolescents suffering from symptoms such as suicidal behaviors and emotional dysregulation issues, along with their families, to ensure the finesse of the final draft.
The translation of this manual is an important landmark for the DBT Center of Korea. Korea is one of the highest ranked for suicide deaths around the world and suicide is one of the leading causes of death especially among Korean teens. DBT, as a modality that was conceptualized to treat suicidality and self-injurious behavior, can potentially change life trajectories of many adolescents and their family for the better through DBT skills built for management of suicidal behaviors as well as emotional and behavioral regulation issues.
However, this book and its contents are not enough to make an effective DBT clinician. A proper training from qualified DBT providers and a strict adherence to treatment modes and strategies as well as ethical standards are a requisite for delivering a successful DBT session.
We are excited to connect with Korean adolescents and their families through the Korean version of the DBT Skills Manual for Adolescents. We hope that the clinicians, teens, and families who come across this manual find as much guidance and hope in DBT as we have seen in the United States.
Jill Rathus, Ph.D. & Alec Miller, Ph.D
