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Research in DBT is relatively new and even more sparse as it relates to adolescents (James, Taylor, Winmill, & Alfoadari, 2008). Quite promising though is the research on adult clients diagnosed with BPD showing effectiveness in controlling and stabilizing self-destructive behavior and violence and decreasing the frequency of use of psychiatric crisis services (DeCou et al., 2019). DBT is adjusted to meet the needs of couples and to address intimate partner violence (Rathus, Cavuoto, & Passarelli, 2006). Dialectical behavior therapy for adolescents (DBT-A; Miller, Rathus & Linehan, 2007) was developed with adolescents in mind and utilizes a biosocial model (Linehan, 2015) recognizing challenges with emotional dysregulation due to the interaction of an environment that is invalidating and some sort of biological predisposition. There is a small to medium effect size for depression, self-injury, anxiety, and suicide risk for DBT-A therapy participants (Hunnicutt Hollenbaugh & Lenz, 2018).

DBT utilizes mindfulness, interpersonal effectiveness, emotional regulation, and distress tolerance as skills. There are now multiple workbooks outlining particular DBT skill-development exercises for multiple purposes and populations. The program typically lasts 6 to 12 months, includes multihour groups where participants learn a skill, practice it, and then utilize it in the milieu. Other unique components of DBT include a systematic implementation and dialectic framework. For example, clients utilizing multiple systems (e.g., outpatient mental health, inpatient, case management, therapy) will encounter DBT-trained persons who utilize similar language during crisis. The dialectic is a broad framework supporting acceptance and change as central opposites occurring simultaneously. Practically, this means accepting ourselves just as we are while concurrently moving toward change in particular (Linehan, 1993, 2020). One similarity to Kabat Zinn’s MBSR is including both formal practice time and informal learning experiential practices as part of the group meetings and extending into daily life.

MBSR and other mindfulness programs should be adapted to meet the needs of marginalized populations (Vallejo & Amaro, 2009). Professionals, researchers, educators, and program specialists modify both DBT and MBSR curriculum to meet developmental needs and contexts as well. Mindfulness with youth emerged much later and programs such as Mindful Schools have an intensive manualized training path (see McKeering & Hwang, 2018 for review of adolescent programs). A few programs designed specifically for families, although sometimes inaccessible to highly stressed families, include mindfulness-based relationship enhancement (Carson et al., 2004), a family program similarly structured to MBSR although targeting nondistressed couples in order to cultivate their relationships. Participants show improved relationship stress, overall stress, happiness, and coping efficacy with greater improvements among those who practice more (Carson et al., 2004). The Mindfulness-Enhanced Strengthening Families Program (MSFP), combines mindfulness activities with an already evidence based family program (Coatsworth, Duncan, Berrena, Bamberger, Loeschinger, Greenberg, Nix, 2014).