Redesign of Dialectical Behavior Therapy for Young People on the Autism Spectrum for Use in Community-Based Clinics: Discover Phase Part II: Demonstration Study

Institution: University of Washington

Project Overview

This project proposed a redesign of Dialectical Behavior Therapy (DBT) to better suit autistic young adults, who showed high rates of suicidal thoughts and behaviors (STB) and non-suicidal self-injury (NSSI). DBT had proven effective for borderline personality disorder, and emerging studies suggested its potential for autistic individuals, yet there was a notable gap in systematic, stakeholder-engaged adaptation of the therapy for this group. Utilizing the Discover, Design/Build, Test framework that integrated implementation science with human-centered design, this project aimed to refine DBT to enhance its usability, feasibility, and appropriateness specifically for autistic young adults in community DBT clinics. With the support of the AIR-P Scholars Award for Aim 1b (Discover Part II), the project included two demonstration studies: one sought feedback from a diverse sample of autistic young adults on the intervention redesign, and another ensured treatment fidelity with certified DBT clinicians/clinic leaders. The expected risk was minimal, and the outcome was a clear modification blueprint, created with key stakeholders, to inform the next phase of Design/Build. This endeavor was poised to improve access to effective DBT for autistic individuals, ultimately enhancing health and quality of life.

The overarching goal was to adapt DBT for autistic young adults with STB/NSSI in a way that optimized its delivery within community clinics. This involved a dual-objective approach: firstly, a demonstration study with 15 autistic young adults identified which components and procedures of DBT should be maintained, altered, or removed. Secondly, a follow-up study with 15 certified DBT clinicians and clinic leaders discussed the feasibility and appropriateness of these proposed changes, aiming to ensure they were both practical for clinical settings and effective for the clients they would serve.

Collaborating Institutions

University of Washington

Project Mentors and Contributors

Jill Locke, PhD, Gary Stobbe, MD,  Henry Boeh, PhD, Casey Wilson Adora Du, Samantha Seaver, Rene Niessner, Shannon Schoonover, Amara Brooks, Rachel Kraus