Universal DBT in Schools Increases Anxiety, Depression, Family Conflict

Researchers: “These findings raise discussion as to the potential for iatrogenic harm from universal interventions.”

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In recent years, teaching kids “emotion regulation” has become an increasingly large part of teachers’ responsibilities. Universal social and emotional learning programs (SEL) have become commonplace. However, a new study based on dialectical behavior therapy (DBT) finds that the intervention can actually make kids’ mental health worse. Kids became more anxious and depressed after receiving it and had more conflict with their parents.

The researchers write, “These findings raise discussion as to the potential for iatrogenic harm from universal interventions.”

There is evidence that existing SEL programs lead to slightly better outcomes, including both academically and in terms of mental health. However, publication bias, low-quality studies, the fact that each intervention for SEL is quite different from the others, and the small size of the effect makes the results of these studies difficult to interpret.

Other studies have found that universal mindfulness training in schools resulted in worse mental health outcomes.

That’s why it’s essential to test specific types of SEL interventions rigorously. In a new study in Behaviour Research and Therapy, researchers Lauren J. Harvey, Fiona A. White, Caroline Hunt, and Maree Abbott at the University of Sydney, Australia, did just that. Their intervention, called WISE Teens, was based on DBT, a psychotherapy that focuses explicitly on emotion regulation, skills for distress management, and interpersonal skills.

The researchers write that there is plenty of evidence that DBT can be effective for adults with severe emotional dysregulation (including suicidal ideation and self-harm). Thus, they write, there is great interest in using it as a universal way to teach kids emotion regulation skills.

The study included four high schools in Sydney, Australia. Five hundred sixty-three kids were in the WISE Teens group, while 508 were in the control group. On average, the kids were about 13 years old (Years 8 and 9 in the Australian school system).

The WISE Teens group received eight weekly hour-long group-based sessions of a DBT curriculum, adapted in collaboration with a senior DBT-specialized psychologist to be more relevant to adolescents. The sessions were delivered by clinical psychologists with DBT training and at least a year’s experience doing DBT in their practice. Those in the control group attended normal health and physical education classes instead.

On average, after the WISE Teens intervention, kids had worsening emotion dysregulation, lower emotional awareness, and lower quality of life. However, the outcomes that worsened the most over the intervention were depression and anxiety.

 Over time, many of the poor outcomes normalized, but the kids’ relationships with both parents were worse, on average, even at the six-month follow-up.

The researchers write:

“Significantly poorer outcomes were observed immediately following participation in the 8-week DBT-based universal intervention (‘WISE Teens’) compared with curriculum-as-per-usual. Of concern, the current study is the first to show in the universal intervention literature that both in the immediate and short-term (6 months), such a program may foster significantly poorer quality parent-child relationships relative to curriculum-as-per-usual.”

 More than 10% of kids in the control group (who did not receive the DBT intervention) improved in emotion regulation. Compare that with just under 5% in the DBT group whose emotion regulation skills improved. This indicates that receiving the intervention, though designed to improve emotion regulation, actually interfered with kids’ natural development of emotional regulation skills.

After six months, in the control group, 9.16% of the kids had a better relationship with their mothers, while only 2.55% of the kids who received DBT found that the relationship improved.

Outcomes after DBT were worse for boys, challenging the notion that boys (stereotypically less emotionally aware) need to receive therapy to become more emotionally skilled. Instead, after the intervention, boys had worse outcomes than girls in every measure except anxiety (which got worse for both boys and girls equally).

At the six-month follow-up, boys who received DBT still had worse emotional awareness than boys in the control group, indicating that the intervention impeded long-term natural emotional awareness growth for boys.

Thus, the researchers write, “Based on these findings, the DBT-based ‘WISE Teens’ intervention is not recommended in its current format for universal dissemination amongst early adolescents in schools.”

Though their intervention made kids more depressed and anxious in the short term, and even after six months, had damaged their family relationships, the researchers write that more research needs to be conducted on how better to engage kids and families with the DBT program:

“Further research is needed to determine how to improve engagement and feasibility of delivery of DBT-based interventions universally in this context.”

That’s because most families didn’t engage in the home practice part of the intervention. Those who did had better outcomes. However, it could be argued that those who engaged in home practice were a small, self-selected group who found the intervention helpful—in contrast to most families who found it harmful.

 

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Harvey, L. J., White, F. A., Hunt, C., & Abbott, M. (2023). Investigating the efficacy of a dialectical behaviour therapy-based universal intervention on adolescent social and emotional well-being outcomes. Behaviour Research and Therapy, 169, 104408. https://doi.org/10.1016/j.brat.2023.104408 (Link)

103 COMMENTS

  1. Dang, was hoping this would work. Better but when you said they didn’t do the at home work with the families, it’s like, I could have told you that. Like if everybody isn’t psychologically aware and talking the same language it’s just bad and I do think you need to measure the type of parenting beliefs and strategies people have in these families as you would likley have more problems from authoritarian families who are rigid and of course the neglectful ones also.

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  2. Could it be that the interventions were helpful but that one person in a family learning emotional regulation skills and inspirational skills, especially a young adolescent still very reliant on primary caregivers, interrupted the status quo and naturally increased conflict in the family? Seems more plausible than DBT increasing anxiety and depression on it’s own… but we’re both just guessing at causation with the information about a correlation.

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      • Sort of like saying if you focus on a painful wound it gets worse…just not always true or moreover relevant. I’m not sure what your suggesting as much pop psych has been pushing over positivity when 1. Some pain cannot be tuned out 2. Pain serves a purpose 3. The purpose of pain is to alert us to need for care of that wound.

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    • This is definitely accurate in my experience – therapy can only help so much when the adults in the family aren’t on-board. If they aren’t, you just become a powerless teenager who’s keenly aware that the adults around you aren’t managing themselves in a healthy way but gets punished for identifying it or trying to do anything about it.

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    • Actually there are narratives by clinical psychologists that mention that often in families where there is narcicistic abuse the healthier person, the one that understand better the problems and dynamics is the victim, usually in defenseless or less strong position within the family. Sometimes even mobbed within it.

      So, it could be the average increase in the “bad” metrics could reflect renewed, reinforced or started narcicistic abuse, at the least, when the now or more victimized teenager defended him or herself. The added bad scores of those teenagers to the average so to say. Which for them individually could have been very, very bad.

      Which as far as I remember, standing up, resisting narcicistic abuse is a trigger for more or new violence.

      So I kinda agree, but I think it could be still iatrogenic, in the sense that the intervention did, by proxy, hopefully unsuspected before the study, caused the problem. Hence the danger/risk of “playing”, intervening with narcicistic families, or psychopatic ones.

      Now my doubt would be: what responsability moral and legal would the researchers had for putting or causing narcicistic abuse on the research subjects?. Did they even realized or considered that?.

      And further down along the line: How does one help a teenager to defend him or herself from narcicistic abuse without causing further harm?. Considering that attempts to increase understanding, resistance and defense could lead to more aggresion to the now, or previous victim?.

      And narcicisism/psychopathy, aware of the thin distinction, as label, diagnosis or behavioural description could be put in around 5% of the population. So, not that rare.

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    • Hi Shannon, I’m wondering what it means for an intervention to be “helpful” if the side effect is that it worsens depression, anxiety, emotion regulation, quality of life, and family conflict (and didn’t improve any academic outcomes either, by the way). What is the “helpful” part of that? Thanks!

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  3. DBT is a fancy word for mind control which is bound to interfere with the natural development of a young person’s mind which isn’t mature enough to process bullshit like DBT. At the very least I would imagine it makes them uncomfortably self-conscious which usually leads to more insecurity and confusion. Kids are already told what to do all day long. Quit programming kids and leave them alone.

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  4. This is not surprising that the children would be worse off…

    Real DBT would involve the family (parents/caregivers) too because the family contributes to the chaotic emotional dysregulation in the child. If you teach children DBT and caregivers don’t get taught DBT/how or what to reinforce as far as the children using DBT at home, the children will become frustrated because they are trying hard to use the DBT skills and the caregivers continue to not care/maintain an environment that discourages emotional expression/regulation

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    • I would add that the teachers need to learn and practice any skills they want the kids to have.

      I had a neighbor kid who was in middle school. He explained to me they spent a one-hour assembly working on Carl Rogers’ reflective listening skills, including “I statements.”

      He was sitting on the stage after the session and a teacher came up and said, “You, get off the stage!” in a very loud and aggressive manner. He said, “I don’t like it when you yell at me. I’d prefer we speak in calmer tones.”

      He got sent to the Principal’s office immediately. What was the real lesson here?

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      • This is Exactly what I’m thinking, as a Child and Adolescent Inpatient Psych nurse. The program teaches kids the importance of communicating their thoughts and feelings with parents who aren’t prepared to deal with them, causing increased alienation and invalidation. I see so many young inpatients whose parents are either strongly authoritarian or unbelievably enmeshed, and very little is done to even attempt to nudge parents into more appropriate parenting behaviors. I’m Really glad I read this article and now know the results of their research, but for me it points to an entirely different conclusion, PARENTS must adapt to a changed world and improve their relationships with their kids, including learning their own emotional regulation skills or we’re going to lose more and more kids.

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        • I would add that psych ward staff also need to learn and practice these things. Some do this well, but some don’t. The real problem is POWER. The people with power are telling the kids how to “manage their emotions” and whatnot, but they are still free to be as abusive, neglectful, and thoughtless as they wish and suffer no consequences. Whether its parents, teachers, staff, doctors, pastoral leaders, or even just adults who are comfortable exercising power over those they feel are beneath them, as long as the person in the one-up power position is unwilling to step down, no amount of “emotional management” will make things any better.

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          • You have got at the crux of it, I think. Anyone who has seen the working of an EST group or a “self-critiquing”session or most any social interaction where one side holds the authority or power can recognize this dynamic. That often folks do not, and often experts steer away from doing so, can tell us just how scary and dangerous calling out power can be. 9th

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          • I think it is more appropiate calling it violence than power.

            Has any legislation or actual outcome improved by using the word power instead of aggression or violence?.

            Is there any law forbidding power? How would that compare to those that punish violence and/or agression?.

            Power in sociology might be a useful concept, but on the ground, in the laws, regulations and behaviors between humans aggression and violence are more usefull concepts:

            “I feel threatened” “I feel difamed” “I feel affraid by your aggresive stance” “I feel hurt”, “I feel violated in my personhood and right to free speech”, etc…

            And therefore, to me, educating minors about their rights, instead of power imbalances will be more useful.

            They have more remedies for their grievances, real or imagined, than speaking about loose, vague and new concepts as patriarchy, power imbalances, etc.

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        • A relevant fraction of parents/guardians will not be, by behavioural descriptions, amenable to education, psychological nor psychiatrical interventions:

          Useless for those with descriptive, not diagnostic, narcicistic behaviours or frankly psychopatic ones.

          Education might work for those ignorant of the boundaries and limitations between parenthood and child well being, but, as per the discourse, not for those in the narcicistic or psychopatic “spectrum”.

          And although no child is hopeless, it is also true not every child can be changed in a socially perceived positive way. It’s evolution, biological, cultural, social, legal, etc.

          So social adaptations might, to my mind, be sometimes more appropiate than family ones. Not arguing for “ex-familiation” though, just understanding, care, sympathy, compassion and adaptation from those willing and able to provide it, instead of just the family, “school system” and the “roughened child” industry.

          Remedies, instead of clear apparently achievable outcomes.

          Sometimes kids “are who they are” and that is not necessarily bad. (From the movie “Innocent Moves” aka “Searching for Bobby Fischer”, which actually in the final duel, points to my point: diversity is a good thing indeed).

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      • Exactly!! Adults have to first have these skills themselves! It is like parents & trachers that force kids to say please & thank you constantly all the time & if they don they are labled as “rude.” However, earlier that day the teacher barked an order without saying please or missed saying thank you in another moment. Or that morning the mom said “Hey come get your pants on.” There was no “please” that simple barked order either. Kids DO WHAT WE DO. THEY ACT LIKE WE ACT. If we don’t say please & thank you all the time neither will they NOR should they HAVE to say it all the time! Kids get judged & labeled constantly with “rude” or “impolite” but they have underdeveloped “learning” brains. Yet adults with full developed brains can’t even say it all the time & they don’t get labeled or called names EVER when they forget to say please or thank you!

        This stuff is so backwards it isn’t even funny. Parents are complaining daily about their “kids.” And all the kids are doing is acting their age. The age of their brain. Which they cannot speed up & neither can we! So the true “FIT THROWERS?” THE ADULTS. Throw fits constantly about kids with underdeveloped brains. Just look at the memes they make about kids daily. Kids are easy to pick on. So immature adults do it allll the time & always have. It is pretty sick actually. If the kids could stand up for themselves they would act more mature than these adults ever could. I can’t wait for the day when adults actually ACT like adults. If that is even possible.

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        • Some parents, according to the lingo, the psychological and psychiatric rhetoric can’t change their narcicistic or psychopathic behaviours. Even sons/daughters victims confirm that rhetoric.

          Some kids are victimized by psychology and psychiatry precisely because parents exhibit said behaviours and service providers collude with them instead of notifying the proper authorities.

          Sometimes providers even claim it is not their job to “protect” kids by notifying authorities, but provide “support” to the family. “Kids are sick”, “it is so dificult to deal with such kids”, “it runs in families you know?”, kinda crap.

          Some parents, to my mind, can’t be helped, some of them need to be prosecuted, not encouraged to get in touch with emotions.

          As the lingo and the recalcitrancy of their behaviour won’t change. Even it it principle everyone can, just not at the risk, harm even “expense” of one child’s life.

          It’s the case of:
          https://www.madinamerica.com/2023/10/medication-overload-part-ii-the-explosion-of-drugs-for-kids/

          were the recipients of the $2.5 million settlements were the brothers/sisters of the deceased kid…

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      • To me one lesson is that calling something something without acknowledging it is actually violence serves not that good to the cause of happy, healthy children.

        Reminding myself that in the US, 19 states have corporal punishment as legal tool in schools.

        So the teacher might not have usefull knwoledge that shouting to a kid is an act of violence, and therefore it should only be used, if at all, when said violence serves a greater good. When it is justified, and punished or discouraged when it is not.

        Used not to provide to cover for some ill-gained and ill-addressed sense of authority.

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  5. This is like throwing someone into the deep end of the pool to teach them to swim.

    One of the most prominent trauma therapist/researchers, Bessel van der Kolk, has noted that early on in his trauma therapy studies he would send patients to classes by a nearby pioneer in body-focused, regulation-oriented psychotherapy, Jon Cabot-Zinn. “All of them flunked out ” as Bessel put it.

    Unfortunately, at this moment I can’t point to a specific YouTube video of his, and I hate putting words in his mouth. I think it’s probably ok to say that anyone who has any issues with sitting still can easily become *dys*-regulated, not more regulated.

    Also, DBT used to be notorious for providing signicant improvement… that disappeared in follow-up tests 6 to 18 months later.

    I think/hope one can generalize that sufficient sense of safety is necessary for whatever intervention is tried. Without sufficient trust in the process it can backfire.

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  6. I have questions: How is the study applied in the school setting? Has anyone considered the possibility that particular students, or all students, may think that the school experiment feels like coercion, feels like exposure, feels like invasion of privacy , feels like they are being made MORE vulnerable ? The presumption that the inner personal concerns of school children from different family subcultures are best explored in public group settings , which they did not choose for themselves and where they possibly feel forced to divulge personal information about themselves, is a big stretch of the imagination. The program could just as well feel like forced “group think”. Additionally, haven’t we all been indoctrinated with the concept that animals in the wild feel a need to conceal their weakness from predators in order to survive? Whatever you think a human is or is not, most readers have observed that the mental health industry looks for vulnerable humans to help. Is it possible that our adapted survival instinct tells us to be discrete with when and where and with whom we share information? Maybe a lot of kids don’t want to “turn themselves inside out” for the paid professionals. Perhaps they instinctively feel the need for something different that includes time and space and privacy and respect to work out their challenges on their own terms.

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    • I would just add that some kids actually suffer from education overload, they have so many curricular and extracurricular activities that any extra “well-being” training/education will not be well received. And it might be pernicious/harmfull.

      Their careers as professional, full time students is already vexing. Even if in the past teachers called some of them slackers.

      Although not exactly on mark, the case of South Korean education points in that direction: any more “sutff” kids have to do threatens some of them to go over the edge. Just the pressure to “perform”, to be on metric is bad enough for some of them.

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        • But saddly, that’s what Alice Miller found out, somehow, the gifted kid is the one doing the heavy emotional lifting.

          That’s why many family abused kids end up being more mature than average…

          Where I disagree with Miller and she probably had no way to know is that, as I suspected, gifted kids under emotional abuse don’t necessarily wan’t to please: they have to, their health, life, limb an property depends on solving emotional problems coerced on them.

          It’s way worse than she narrated, there is no pleasing the emotionally abussive parent, it’s about survival…

          Which is monstrous and probably either unacceptable or unstatable for practitioners.

          Granted, some kids never rise to giftedness, but some do, and those end up being extraordinary human beings.

          Unlike, you know who, who also experience abuse, probably, and end up doing, well, I guess you suspect…

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    • Great point. DBT can feel very invasive.
      Given that it is a “behavioral intervention”, and in DBT, thoughts and, I believe, even bodily sensations are viewed as behaviors, DBT asks a lot of patients/students in terms of revealing themselves — revealing their thoughts and feelings in front of their peers. I can only imagine how anxiety inducing this can be for a child (it was anxiety inducing for me as a 40 year old).

      I wonder if they used the DBT “behavior analysis” exercises. Those can get excruciatingly personal and can be very shame inducing, as they are focused on a person’s “problem behavior” — everything that led up to it (events, thoughts, feelings, bodily sensations), and what the person intends to do differently in the future (how they will replace ineffective coping with effective coping) so that the problem behavior doesn’t happen.

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      • So well said, KateL. Forcing young people (or anybody) to suppress their true thoughts and feelings yet reveal their vulnerabilities, and often to people who can turn around and use those vulnerabilities against them, is a recipe for disaster as DBT unreasonably demands people ignore their healthy intuition, not to mention their self-protective bodily sensations.

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      • I do remember being a teenager. I felt I had absolutely no power. But I did. I could keep my mouth shut and my thoughts/feelings to myself in order to keep from being punished at home and school. It was not until my very first psychiatric appointment when the doctor said he was going to recommend family therapy that I went complete over the edge. I went home to a whole bottle of Tylenol so I could permanently avoid having my private thoughts/feelings exposed in front of my oppressive, abusive, cruel stepdad. That landed me on an adolescent psych ward where my antipsychotic iatrogenic serious mental illness was birthed. And 40 years later I am STILL on disability and soon to die of iatrogenic damage complications.
        When I was 17, I became and still am the identified patient and only one in my hugely dysfunctional family required (legally) to receive “treatments”.

        I agree with Pink Floyd. “teacher! Leave them kids alone!!!”

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      • I do remember being a teenager. I felt I had absolutely no power. But I did. I could keep my mouth shut and my thoughts/feelings to myself in order to keep from being punished. It was not until my very first psychiatric appointment when the doctor said he was going to recommend family therapy that I went complete over the edge. I went home to a whole bottle of Tylenol so I d permanently avoid having my private thoughts exposed to my stepdad. That landed me on an adolescent psych ward where my iatrogenic smi was birthed. And 40 years later I am still on disability and soon to die of iatrogenic damage complications.

        I became the identified patient and only one in my dysfunctional family required (legally) to receive “treatments”.

        I agree with Pink Floyd. Leave these kids alone!!!

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  7. This is fascinating. So I recently took the DBT Steps A training with the plan to facilitate groups with 7th and 8th Graders in late October. The plan originally was to do the 30 weeks of skills groups as a tier 1 intervention at the alternative school. Upon further review, people thought that would be too much and suggested a modified 8 week group focusing on interpersonal skills and distress tolerance. Now the trainers informed us that while they had suggestions for modified groups, there was no evidence that it would be effective. And that success was determined by adhering to fidelity. I wonder if that is what happened in this study. I’m intrigued to see what happens with my kids when we do this. We shall see!

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      • Not disagreeing, but if they study it for publishing, ethics comittee, valid research desgin etc., replication is crucial for the progress of research. Particularly when causality was not even infered.

        I would just add the consideration, as I stated above, that making kids more aware of “mature” ways of communication could trigger narcicisstic/pyshcopatic aggresion from parents and other relatives. Even from friends/romantic partners.

        And narcicissism/psychopathy is not rare and could explain worse AVERAGES even if kids “function” at a higher/better level, whatever that means.

        Another cuasi-valid reason, asuming an ethics comittee is persuaded, is to find out WHY the refered outcomes worsened. Causal research, not correlational one passed as cuasi-causal with a heavy dose of psychological speculation.

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  8. We don’t need no education
    We don’t need no thought control
    No dark sarcasm in the classroom
    Teacher, leave them kids alone
    Hey, teacher, leave them kids alone
    All in all, it’s just another brick in the wall
    All in all, you’re just another brick in the wall

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    • I thought it was: “Leave THOSE kids alone”, I always wondered why?. I imagined it was from a survivors perspective.

      But yeah! No contamination with false pernicious ideas of the child’s mind!. No child pollution should be allowed. Pure, as they always were, should remain, for as long as it should be.

      Let the adultarchy fell, adults be damned!. Receded into the dust of history. We all should be like children, Jesus said it!. Kindoff..

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  9. I really can’t believe DBT is still being used. Let’s start with the history it was created and developed by Dr Linahen sp?
    She created it it specifically for those folks dx with Bodeinr Disorder. Later one she admitted she herself was dx as borderline.
    In my view of dx borderline is just an insurance / name call dx for someone in trauma and more female or othered type person than not.
    Unless you have experienced DBzT yourself one really shouldn’t comment . I did and was appalled as a MSW.
    Some of it fine. But as an ongoing tool for support No not at at all. Programmed and the YES MASTER letters revolting in terms of feminism and slavery isdues!
    It has a veneer of sophistication and can be bundled as a program with sessions thst again intially look good.A Mental Health pyramid scheme and is the good doctor getting money or residuals from the use or who is?
    And again it’s always the brand. DBT sounds so good .
    Please do a thorough in depth investigation of this so called therapy and how did in get into schools when it was formulated for so called crazy adults?

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    • I guess doing a reading against thre grain of the review and the article, on common sense ground someone should conclude that DBT is harmfull, whatever it involves, for minors. The 8 hrs is harmfull enough, TV required hundreds of hours to do harm. Social media probably requires as much. For informal comparison. 8hrs vs hundreds tells you of great harm, compared to acknowledged harmfull exposure to children.

      The statements for more research and some caveats are typical to me of missdirection.

      But, sometimes summaries or reviews lack critical stance for one reason or another. It is well known science journalists are kinda not supposed to criticize research. Odd since they are more likely to pick it’s flaws than the average reader.

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    • I earned a certificate in it earned from Marsha’s program and while like you say it has some good qualities I’d add it is highly intellectual (i think therefore i am) and individualistic vs social and experiential therapies, the latter we have so little of.

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  10. I find it interesting that the controll group engaged in a physical activity course instead of the DBT program, since physical activity and peer socialization could be considered interventions in themselves for emotion regulation and social skill building.

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    • Health & PE has been a standard part of school curricula for a very long time. That’s what makes it a control group; it’s the group that received their normal class instead of the new intervention. I am also not sure it was a “gym class” per se with actual physical activity.

      From the article:

      “Participants in the control condition attended their usual Health and Physical Education classes (matched for length and frequency). Content covered in these sessions included material regarding a) body changes associated with puberty; b) nutrition and dimensions of health; c) cyber safety; d) drug education and learning to manage risks. Participants in the control condition did not have contact with the research team outside of data collection.”

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    • IMO:

      It changed over time: too much self confidence, too little of it, too many spanks, to much school violence, too much crying, too little of it. Fashion trends in child rearing started apparently by Dr. or Mr. Spok’s writings.

      In addition to the descent of old morality/religion. The change in rules of what is right and what is wrong.

      And importantly in today’s progressive discourse: the need for minors to acquire skills to fill job positions in the spectrum between “serving fries” and inventing the first home use quantum computer.

      So, I guess sumarizing: a change in social values and the requirements, euphemistically called needs, of modern job markets.

      Along with a big decline in buying power for generations after the baby boomer one, and some analogous outside the US. In great part by competition from foreing, “emerging”, markets like South Korea, Germany, Japan and now China and India.

      As an example: Calculus was required for some bachelor degrees, even if it was taught to all if not most high school students. A few years ago there was an article that cited the requirement of mastering calculus, as diferential equations which is a bachelor topic not a highschool one, for doing customized tools by a company in the US that could only hire high schools graduates, given it could not pay a bachelor graduate for said job.

      And for all the rhetoric kids are seldom aware of the larger world around them, from my experience they are more aware, cognizant and even savants of what the world is expecting from them, and what to expect from it. Like little prescient rascals, of the great kind.

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        • But then neoliberalism might render whatever complement/insight science does on spirituality moot.

          And the briefly monopolar world did no good either:

          It lasted from 1991 to 2001. A decade.

          Around fifteen years after that, other forms of radicalism and “natiolism” made any progress in scientific philosphy and non-pernicious spirituality moot.

          Now, one is either with some or against some. Regardless of one’s intentions, acts and deeds.

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  11. Not a fan of dbt or anything else the industry offers in general. An acquaintance is a good outcome dbt case. My take? They helped her adapt her raw emotions while climbing the ladder. Now she has more resources free time and freedom in general, and those factors are vital not so much dbt. As for the kids…

    Poor kids. Poor parents too. Psychology and psychiatry are damaging to families often with tragic consequences. Szasz delves into this if I recall.

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  12. It is because they are trying to TEACH IT. That is the same as any other kind of force. They WANT the kids to learn something THEY want to happen or see change in the child or teen. The emotions are bothersome for the teachers, parents, & adults so they want to TEACH them what THEY the ADULT wants them to learn. Any force fails. They don’t need TAUGHT these things. It needs to be a collaborative problem solving method between the child & the adult(s). The child should ALWAYS have a say. Do theu even WANT to talk or hear what we have to say?? That is the forst question. Because they may just need some time to calm down. Many times they need space. Do they need to cry? Allow the cry. Let them know it is ok to cry & they can cry as long as they need to. They are angry? If they are not hurting people or property with physical movements, ALLOW the anger & if it is yelling, try to move to another room with them. Let them know when THEY are ready you will be here for them to talk & you will listen. If they are able to talk or when they are ready to- ASK THEM what may be helpful to THEM. Do they have any ideas? The fact that you are allowing them to talk without barking some “breathing” orders or whatever else adults think will “fix” them many times calms them down sooner because we are truly listening to them & hearing them, who they are, how they feel, their opinions, & how THEY would like to try solving their own problems. If they have no ideas or are just barking at you to fix the problem let them know you will stay by their side if they would like to go speak to the person they are upset with or need to say something to. Tell them you will support them with using their own voice to respectfully speak to another person about the problem that has occurred. This is only an example if a student or child is having trouble with another person.

    Thes kids don’t need “fixed” as both positive & negative emotions are part of the human condition with some of us experiencing much more of the negative than the positive. As long as we keep coming up with methods to try to “fix” and change their behaviors we will fail.

    Until we start respecting the individual child as a human being of their own individualism & how they want/need to deal with their problems/upsets/struggles we will continue beating our heads against walls.

    When they have no ideas? And we have gone through all these respectful steps with them THEN we can suggest some things IF theuly would like to hear it. If they don’t want to hear what we are trying to teach them it will NEVER work because we don’t have that kind of control nomatter how much we think our solutions will work- they are allowed to shut down their brain to us at any moment & I promise when we try to force all this & TEACH it they are shutting down their ears & their brains because this is NOT a respectful way to approach another human being noma WHAT AGE they are.

    There are a million tools out here we can all learn in respectful caregiving. They are all over the internet & have been studied & proven to have great outcomes if we would just start seeking them instead of continuing to use power & control of what WE WANT.

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    • As a complement: Teaching and learning by example.

      Many kids, I hope, from my and previous generations learned a lot from some of our exemplary teachers and, for me, above all, my exemplary mates.

      In my deluded imagination I did graduate summa cum laude from kindergardenn, in knowing, appreciating and respecting my peers. And therefore myself. Just like Barbra sang: “The way we were”. No addons or false explanations, plain simple naturalistic interaction and observation.

      Which at least in child peers, in todays world, particularly postpandemic, playing, arguing, agreeing, disagreeing and even fighting does not happen. Simplifying.

      Therefor the lessons, teaching and learning of “normal” or at least tradidional peer learning is severely lacking for kids below 22yrs of age. Late teens and young adults didn’t finish their traditional learning…

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  13. As a teen who went too two programs and learned DBT skills it is truly beneficial. I don’t understand these studies here, but it did improve my relationships as I was learning to communicate and ask for I want with Dearman, and used activity skill when I need a break or something from a meltdown but was able to help communicate as I got older. I actually suggested it should be applied in the schools ask kids don’t know the names of their emotions and that’s all DBT skills is, are names and skills to be able to handle and knowing when we are reacting emotionally, rationally for logically.
    Not telling someone how to act, but showing them how to better respond and understanding to a situation as a child needs guidance and understand of their emotions.
    DBT skills are even great for adults. Not only children and teenagers can take use of it. It is especially fun when you can put the skills into your daily life, and as a group it was a good ice breaker to make friends because you had to come up with situation you would or could use it in. As the boys who lived next door through the programs them seemed to enjoy them during group times but then again we were also teenage girls. I also hear I am like unacquired taste so maybe what works for one person doesn’t another, but I hope to be more involved with the schools these year as all my kids are at school, and school basically raises kids having them 6+ hours a day 10 months a year. Hearing children stabbing children because they don’t understand their emotions. Sometimes you have to be there and see it to understand it. Sometimes it’s easier said than done.

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    • Not casting doubt, but from my analytical point of view enjoying something comunal brings a sense of well being even if its pernicious.

      Acknowledging pernicious does not seem to apply to your case and your peers, but there are examples of groups of people feeling good, returning to the ideas, beliefs and practices that made them feel good, AND causing great harms to other people.

      Victims generally labeled as inferior, defective, ignorant, unskilled sick or different…

      Which by the way is my impression from victims of DBT commenting/posting here at MIA: they felt aggresion, not care.

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  14. So, did the WISE kids also get physica ed during that day, or did the DBT stuff replace that class? If so, how can the control group be called a control group? Even if it is just 1x per week, that seems a bit questionable. In addition, is 1x a week, for 8 weeks enough time to get an accurate outcome. That is a lot of if experience to unlearn for the kids who have not been brought up that way.

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  15. Outcomes improved in the control group in both cases, then fell at the six month mark. Whereas in the study groups outcomes worsened, then worsened more at six months.

    It looks like something else is impacting these relationships. I’m personally skeptical about DBT but I don’t think this study really shows much of anything.

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    • I think it showed that administering group DBT training doesn’t lead to improved outcomes. If I’m a school administrator, that should be enough for me to think, “Well, we’ve got only so much time in the day, why waste time on something that doesn’t have a significantly positive effect?” An intervention doesn’t have to be proven harmful to be avoided. It just needs to be shown not to be significantly helpful.

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    • Well, even at the six months mark, as you note, parent conflict for those who received the intervention continued to get worse, while those in the control group returned to baseline. That seems pretty clear: those in the intervention group were worse off afterward, even six months later. Why do you think that doesn’t show much of anything?

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      • I’m not answering for Sam H., but, lack of causal explanation?.

        I mean it does sound suspicious that the experts doing da research don’t come out clear with their strong suspicions.

        But maybe they didn’t consider narcicisstic/pyschopatic parent agression against a “suddenly more” mature, assertive, perceptive and accurate teenager. Which I am not saying they were either!.

        But on a question to PS, eupehmistically: did they become “better” teenagers beyond the “pathology”.

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  16. This study showed that kids who were *required* to attend emotional regulation skills training, in co-ed groups run by a therapist, at age 13-14, got worse afterwards. More anxious and depressed, worse family relationships, worse quality of life. This was especially true for boys who liked the intervention less than girls. Note that almost all therapists were women. The authors didn’t have much to say about why their intervention might have made kids worse, especially boys. Perhaps forcing kids (especially boys) at that awkward age to discuss their feelings and learn “skills” for managing them in front of peers is actively harmful? What might be the reasons why? THIS is in my view the conversation that needs to be had. This study is not the first major school-based study to show that teaching kids emotion regulation skills (e.g., mindfulness) makes them worse. Perhaps researchers need to take a step back and examine the wisdom of this entire enterprise.

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    • I would say also that doing reseach in humans without knowing enough of the dangers of the intervention is at least unethical.

      In medicine there are exmaples of that that came impune, most antihypertensives used before 2010, with the exception of one cuasi-class of medications, caused more deaths than saved them!.

      But in this case, the rationale in psychological terms for deducing benefit for DBT, for just 8hrs, is unclear to me. And, given the bad outcomes, very likely also to the researchers.

      To me, it points to a failure not just of the research, but of the incorrectly called theoretical research framework of the study.

      And to me, it points, personally, further backwards, since the framework for DBT might depend on previous theories of psychology. So the whole thing might be bogus in the sense that it does not predict the outcomes of experiments with accuracy, and if time after time, that points to a lack of a theory, not just flaws in research implementation.

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  17. Please click on the actual study and read it. The over view of the 24 page meta-analysis states clearly: “ Results endorsed that, compared to control conditions, students who participate in USB SEL interventions experienced significantly improved skills, attitudes, behaviors, school climate and safety, peer relationships, school functioning, and academic achievement.” Shame on you for warping and twisting this to your whim.

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    • Hi Kate, I don’t see that quote in the study at all. And the pdf I have is 13 pages, not 24. Can you say more about where you found that quote? It does not seem consistent with any of the data I saw in the study, or the researchers’ own conclusions. Thanks!

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    • I think that meta-analysis is not the research reviewed here, but it seems to be the support for deciding/justifying the study. But I must admit I am confused if it was published before enough the present study.

      But if I remember correctly at least one author is on both “papers”.

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  18. I’m pleasantly surprised to hear some critical thinking in these comments. Sadly, I am also not surprised to see lack of critical thinking skills, and a lot of uneducated individuals, brainwashed by church or the republican party, into believing this nonsense. Anyone with malicious intentions and intelligence can make a graph look real or “statistical data” make something look like science. I happen to have a masters degree and I own my own business. In that masters degree I was taught how to read statistical information and if I wanted to get out my text box and explain it to you all I could. However, I know there are people on this thread that are thinking critically about this article, and that thrills me. I wish where I live, in Oklahoma, DBT was taught, because not only are teachers, but our students, our families are in dire need of this to be publicly funded. They’re actually is scientific evidence that shows the benefit of meditation and mindfulness on a persons well-being. I happen to have learned a lot about DBT and other evidence based treatment modalities, because I also happens to be a mental health clinician. And why are you may think I’m “woke” and hurting people every day, that is not the reality of this industry. There are MANY poorly educated providers in our industry with very good intentions. However, good intentions don’t help people manage mental illness on a daily basis. EVIDENCE BASED TREATMENT MODALITIES and good intentions do. If you’ve ever been hurt, let down, or harmed some way by a therapist please talk to them about it. If they don’t respond the in a manner that is helpful and respectful to you then find another therapist. It’s ok to move around until you find a good fit! Set boundaries, be clear about what your goals are, listen to your therapist, do your homework, and don’t give up. But also don’t blindly believe someone has the best treatment for you because they’re nice and kindhearted, do your research too. If you’re actually hurt and taken advantage of (not just mad you didn’t hear what you wanted to hear) file a complaint with your local board of behavioral health. That’s why they’re there! They certainly don’t have the clinician’s interest at heart. At least not in Oklahoma like they used to, sadly. I love my clients in an ethical manner. I cheer with them, laugh with them, and sometimes I cry with them (or for them at home on my own unpaid time). I’ve never heard of Mad in America, however without looking at any other “news” articles I can tell you this is manipulative propaganda that takes advantage of uneducated or deeply wounded individuals who would have their lives drastically improved if they weren’t too scared or proud to make that call.

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  19. It does seem like trying to fix something that is not obviously broken. Somewhere in the past I remember a song about ‘you’re my favourite waste of time’. There is a great power differential when it comes to kids, and parent’s (or teachers) definitions of the situation tend to rule. They are taken as the credible source of persuasion, the opportunity for kids to speak safely is I think intrinsically compromised, making interventions with them a minefield ‘where angels fear to tread’. But I’m not saying that some may not need to be canvassed for psychological help e.g the development of bed wetting by an 11 year old. But ever so gently and respectfully. With the knowledge that oftentimes they are struggling to manage a toxic environment and they may suffer sanctions or worse for any disclosure of family matters.

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  20. Now that I think it a fourth time, not doing home assignments when it required family cooperation might point tenously, conjecturaly, to narcicissm/pyschopathy in the family.

    But also to: working monoparentals, working bi-parentlas, etc.

    Pity no causality, but only correlation could be infered from this study.

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  21. Wow so inspiring to see so many comments here and also such a quality critique of research findings; discussions etc rather than just applying what therapy is popular in a reactive vs. responsive way.
    DBT and CBT both also are highly intellectual and individualistic approaches which is fine and good for the frontal cortex, however when emotional disregulation is 1. Caused by experience 2. Specifically social experience it is often then social interventions that are needed which in a roundabout way is i think suggested by this article in that family involvement is an important factor in outcomes as is community though. Also experiential and social treatments may be more effective for teens or needed in conjunction with more intellectual approaches because if one’s’ brain is suffering wounds or overloaded in amygdala or other areas that are highly sensitive to environment and experience, while the prefrontal cortex can learn to help regulate those areas’ reactions it is also still dependent upon their health for it to function well. We seem to shy away from labor intensive solutions…maybe when robots are doing much of the custodial and automation work etc we’ll start having more means to have people in jobs that help people?

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  22. Any therapy idea that originates from one person’s style of recovery is likely to fail, simply because it only worked for that individual within their specific context and for their particular issues. Until we discover a more comprehensive approach to addressing human issues, we will continue to wander in the desert, searching for a well. DBT will not be effective for one person within a group if the group is not all engaged in the same approach. In this context, “group” includes a family unit.

    Furthermore, the concept of narcissistic abuse is silly term to use in mental health discourse; it is merely a term used when there is a significant power imbalance between two individuals but it is too long to say that way so we shortened it to “narcissistic abuse” which further obfuscates the reality. Anyone can do narcissistic abuse given a power to gaining something without fairness or equality built in.

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    • No, I strongly disagree:

      1.- There is the assumption, unjustified, that the human mind is understandable, explainable and predictable in scientific terms. It goes against the mathematically proven theorems of black box inner workings inferences, based on empiricism.

      The Chinesse room thought experiment, very clearly narrated in the “The Emperors New Mind” by Roger Penrose, a mathematician, and a christian is clarifying enough. He does believe, AFIU in divinity.

      2.- At least my use of narcicistic does not depend on diagnosis. I use it as a descriptive term for behaviours that are callous, harmfull, careless and are an expression of most commonly a sense, a belief that the person perpetrating said abuses is below their peers.

      In that sense, I claim, since decades ago, narcicism is a mislabel:

      Narcissus was actually beatifull, his belief in his over everyone else beauty can’t be questioned. Most, if not all otherwise labeled narcisists are not Narcissus, they know themselves, and act themselves accordingly to their ingrained belief of their inferiority, not their superiority as Narcissus.

      Freud was, me getting my psychodynamic velvety globes, not a narcicist, but a psychopath. He was exteme in his callousness, lack of empathy, carelessness, agression, violence and criminality, important last point.

      Being narcicistic does not cross the legal, socially, moraly accepted standard, the common ethical ground, is more of an under the table, under the belt, overhanded approach to deal with disagreement otherwise, by limitations, by options not available to the narcicist.

      Explained precisely by incompetence apparent even to the narcicist. That closes the explanatory loop.

      The psychopath, on the other hand, is Raskolnikovian, it justifies it’s criminality with delusions, not only of grandeur, but apptly to psychiatry, of the common good. Way out of way “understood” by the psychopath.

      That’s why some of them can’t see themselves in the social mirror as a narcisist can.

      That’s why narcicism was psychological, psychodynamic. Psychopathy was madness in the organic kind of way. Lombrosian even…

      Aware I might seem to cross into the crappy pappy psycho babble, but be patient with me, be kind with me, I have insight on these things. And even if I am wrong, way wrong, I am not trying to prejudice anyone against someone else.

      And calling psychopathy organic is not a scientific claim, it’s a reminder precisely of psycho babble, a calling card, a red light to engage the rational skeptic brain.

      Just trying to put comments in place. For, at least, the sake of minors, aware IT superficially sounds like the dominant psycho bable, but it is not…

      Not even in fraudians ever was…

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  23. This will probably fall on deaf ears, but anything that increases panopticism – monitoring the “self” (whatever that is) – is a recipe for increased neuroticism. But as most people in the Western world have been raised in a culture of increasing panopticism they have become blind to this. This is going through life looking in the rear-view mirror, constantly monitoring yourself. Better to teach relational responsibility (e.g. Gergen, Levinas, Wittgenstein, etc) – to be more sensitive to the people around you. This will get you looking out, not in, and be a better person for it. Give up trying to know yourself (or see yourself) and most of you will be better off.

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    • You certainly have my attention. Thank you for reminding me of Foucault’s ideas about this internal monitoring that has taken over the entire society. I believe this is precisely why the “trauma discourse” has become fashionable nowadays and it is hard to decipher if it is internal labyrinth or external forces acting on the psyche. It is also really a great fertile growth for fascisms…get busy with your own mind, while we control the external!

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    • ‘This will probably fall on deaf ears, but anything that increases panopticism – monitoring the “self” (whatever that is) – is a recipe for increased neuroticism.’ not when considering mirror neurons related to empathy/sympathy and surviving narcicistic abuse.

      But, otherwise, I totally agree, reformulating, hopefully: loking at one’s inner mind process risks leaving one’s mind open too far, and too wide.

      Saddly, other people kept pushing me, sometimes, to look myself in the mirror, when all I wanted is to look beyond ourselves.

      And looking at the world, for me not always worked. Looking at the lamaland, the Nirvana, Shangri-la, the beyond, the immaterial impermanent “reality” of spirituality never did work for me either.

      So, all I had was science and epistemics to look for, and at.

      But, overall, I agree with you.

      Neurotic me, but happily, yipeee!. 🙂 , not a disease anymore.

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    • Actually, they do go to therapy for the therapist’s related issues.

      A therapist is supposed to go to therapy with another more senior therapist for the first therapists therapy related emerging issues.

      And that could? lead to extorsions of the I know what you did last summer!. I am after all your therapist therapist. Better be quiet and don’t rock the boat. I am monitoring you.

      That induces conformity, transigence and aquiescence with the oppresive on others outside therapist’s therapy conformance.

      And that is a form of disclosure of private confidential information, rarely now discussed in the discourse.

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  24. Sadly, most people — especially “mental health professionals” — have not yet learned about the Three Principles (3P), which were identified by Sydney Banks in 1973 and which explain how every person’s thoughts create their experience of life, moment by moment. Because no two people think the exact same thoughts, we create and experience separate realities. As 3P Practitioner and Author Jack Pransky said “All we are is peace, love and wisdom and the power to create the illusion that we are not.” Psychology and Psychotherapy erroneously focus on the past and our or others’ behavior, all of which is “downstream from” our thoughts. All over the world, 3P Practitioners use no special techniques or practices but are helping clients understand how to END their mental suffering.

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  25. Out of curiosity, may I ask if anyone knows why this article in particular is showing to have exponentially more views (137567) than other articles on MIA?

    I have tried to come up with a reasonable argument, like maybe it’s the specific topic of kids/schools that would catch a broader audience but other MIA articles regarding kids/schools do not have as nearly as many views. Did this article end up in some social media algorithm where other MIA articles usually don’t?

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    • I guess it might be the intersection between teenagers, the teenager post COVID “crisis”, the self-harm crisis, the social media crisis, the teenager school crisis…

      and the finding that DBT is really pernicious. Just the MIA comments on DBT lived experience…

      And, last but not least, that this paper does show something not always published in clinical psychology:

      Harm by A form of psychotherapy.

      And from researchers that apparently are propagandists/proselitists for DBT. One of them did a review/meta-analysis of DBT before publishing the study reviewed here.

      And it could be, ignorant me, at least because I don’t care that much, that perhaps DBT is perhaps gaining traction among the dozens of psychotherapies. So, it catches an eye if otherwise “trending”…

      But, that last one, I don’t know. Maybe MIA is gaining traction in the obscure ranking social media algos.

      Conspiratorially, for LOLs, maybe some meta-fellow had some one? in DBT? and has an axe to grind…

      There was the plan to take tha family into a secluded place to survive the apocalipse at some point before the pandemic.

      And that showed that surviving in New Zealand, locked up for years/decades with a teenager in distress, several of them even, was not a realistic plan. After the COVID and it’s lock up.

      Before Covid, there was the end of the world uber-rich, ultra high net worth individuals paying for top talks on how to survive any apocalypse.

      That came crashing on one basic trait of humans: psychology.

      But that is just Halloween, “Dia de Muertos”…

      And Lulz…

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  26. Then, I can make up another attempt at explanation narrative:

    Maybe the teenagers who got worse became therapist-like, DBT providers to their families, and that was received with agression/hostility from the family.

    Teens did not have status as DBT providers, their DBTeed behaviour might have appeared as a first aggresion. And when not paired with status, was less than welcomed. Particularly if not asked for. As in why are you therapizing me?.

    Which would suggest, DBT providers, are actually aggressive, and it is the status that hides, covers-up the agression as…therapy…

    Like a teenager Woody Allen character that goes psychoanalyzing his or her relatives, only to be met not with a wow! of improvement, but with the now obvious at least hostility. At least the intromission of analysis feels aggressive.

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