Universal delivery of a dialectical behaviour therapy skills programme (DBT STEPS-A) for adolescents in a mainstream school: feasibility study

The social and emotional wellbeing of young people is an area of increased focus for policy and practice. Schools are required to provide a holistic approach to education that includes teaching and implementing programmes designed to promote resilience and address difficult behaviours. Preliminary studies in the USA have shown promise for DBT STEPS-A (Dialectical Behavior Therapy- Skills for Emotional Problem Solving- Adolescents) but there have been no published UK evaluations. The aim of this study was to adapt DBT STEPS-A for a UK setting and test the feasibility of training teachers to deliver this universal programme as part of a mainstream school curriculum. The programme was delivered by teachers to students aged 13-14 years (n = 183) using a waitlist (non-randomised) controlled design. We investigated potential changes in level of emotional and behavioural problems using the Strength and Difficulties Questionnaire (SDQ) and Difficulties of Emotion Regulation Scale (DERS) and changes in psychological skills using the Child and Adolescent Mindfulness Measure (CAMM) and DBT Ways of coping checklist (DBT-WCCL). The views of students (n = 50) and teachers (n = 4) were explored using a participant satisfaction questionnaire. Feasibility outcomes indicate that it is possible to recruit participants from a school setting and to train teachers in the delivery of DBT STEPS-A. A statistically significant treatment effect was observed on the SDQ prosocial subscale (p = 0.04) with a large effect size (0.92). The intervention and some measures were acceptable to participants and teachers. Areas to improve future implementation are discussed.