Table of Contents

Foreword, Charles R. Swenson
Introduction
1. Suicidal Behaviors in Adolescents: Who Is Most at Risk?
2. What Do We Know about Effective Treatments for Suicidal Adolescents?
3. Dialectical Behavior Therapy: Treatment Stages, Primary Targets, and Strategies
4. DBT Program Structure: Functions and Modes
5. Dialectical Dilemmas for Adolescents: Addressing Secondary Targets
6. Assessing Adolescents: Suicide Risk, Diagnosis, and Treatment Feasibility
7. Orienting Adolescents and Families to Treatment and Obtaining Commitment
8. Individual Therapy with Adolescents
9. Including Families in Treatment
10. Skills Training with Adolescents
11. Assessing Progress, Running a Graduate Group, and Terminating Treatment
12. Program Issues
Appendix A. Mindfulness Exercises for Adolescents
Appendix B. Walking the Middle Path Skills: Lecture and Discussion Points
Appendix C. Handouts for Walking the Middle Path Skills

About the Author

Alec L. Miller, PsyD, is Cofounder and Clinical Director of Cognitive and Behavioral Consultants, White Plains and New York, New York, and Clinical Professor of Psychiatry and Behavioral Sciences at Montefiore Medical Center/Albert Einstein College of Medicine, Bronx, New York. Dr. Miller served for over 20 years as Professor of Clinical Psychiatry and Behavioral Sciences, Chief of Child and Adolescent Psychology, Director of the Adolescent Depression and Suicide Program, and Associate Director of Psychology Training at Montefiore Medical Center. He is a scientific advisor to the American Foundation of Suicide Prevention and the National Educational Alliance of Borderline Personality Disorder, a Fellow of the American Psychological Association, and past Chair of the International Society for the Improvement and Training of DBT. He has published numerous peer-reviewed journal articles, book chapters, and books on topics including DBT, adolescent suicide, childhood maltreatment, and borderline personality disorder. He is the coauthor of DBT Skills in Schools, DBT Skills Manual for Adolescents, and Dialectical Behavior Therapy with Suicidal Adolescents. He has conducted over 400 lectures and workshops around the world, training thousands of mental health professionals in DBT.

Jill H. Rathus, PhD, is Professor of Psychology at Long Island University Post, where she directs the DBT scientist-practitioner training program within the clinical psychology doctoral program. She is also Co-Director and Co-Founder of Cognitive Behavioral Associates, a group private practice in Great Neck, New York, specializing in DBT and cognitive-behavioral therapy (CBT). Her clinical and research interests include DBT, CBT, adolescent suicidality, intimate partner violence, anxiety disorders, and assessment. Dr. Rathus has developed and conducted programs in DBT for adolescents and adults as well as males referred for intimate partner violence, and has received foundation and university funding to study, adapt, and develop assessment tools for DBT. She has published numerous peer-reviewed articles and chapters on DBT, adolescent suicide, couple therapy, intimate partner violence, personality disorders, assessment, and anxiety disorders. She is the coauthor of books including DBT Skills in Schools, DBT Skills Manual for Adolescents, and Dialectical Behavior Therapy with Suicidal Adolescents.

Marsha M. Linehan, PhD, ABPP, the developer of dialectical behavior therapy (DBT), is Professor Emeritus of Psychology and Director Emeritus of the Behavioral Research and Therapy Clinics at the University of Washington. Before retiring in 2019, she devoted her career to developing and evaluating evidence-based treatments for populations with high suicide risk and multiple, severe mental disorders. Dr. Linehan is the 2025 recipient of the Lifetime Achievement Award from the American Foundation for Suicide Prevention. Her contributions to suicide research and clinical psychology research have also been recognized with the University of Louisville Grawemeyer Award for Psychology, the Career/Lifetime Achievement Award from the Association for Behavioral and Cognitive Therapies, the Gold Medal Award for Life Achievement in the Application of Psychology from the American Psychological Foundation, and the James McKeen Cattell Award from the Association for Psychological Science. In her honor, the American Association of Suicidology created the Marsha Linehan Award for Outstanding Research in the Treatment of Suicidal Behavior. Dr. Linehan was featured in Time magazine's "Great Scientists: The Geniuses and Visionaries Who Transformed Our World." She is founder of the Linehan Institute and a Zen master.

Reviews

'This outstanding book represents a major contribution to the prevention of adolescent suicide. It is extensively detailed to inform clinicians about the applications of this effective psychosocial treatment for adolescents who present with specific risk factors. Written by pioneering developers of dialectical behavior therapy (DBT), this book is essential reading for mental health professionals at every level of experience and training.' - "Cynthia R. Pfeffer, MD, Department of Psychiatry, Weill Medical College of Cornell University, USA" 'This book is extremely relevant for therapists working with adolescents who engage in suicidal and other high-risk behaviors. In addition to providing an efficacious and easily understood manualized approach for this population, it offers many valuable tips for building a strong therapeutic alliance with this challenging population.' - "Lynn Ponton, MD, Department of Psychiatry, University of California, San Francisco, USA" 'An excellent, practical book on a very difficult-to-treat and neglected population... This book is recommended for students, psychologists, social workers, psychiatric residents, psychiatrists, and other professionals dealing with mental health issues in teenagers. Also, this book is an outstanding resource for researchers evaluating the efficacy of DBT for teenagers.' - "Boris Birmaher, MD, Department of Psychiatry, University of Pittsburgh Medical Center, USA" 'A humane, practical, and erudite guide. The authors, through their dialectical approach, provide a theoretical framework that allows for an efficient, realistic, and parsimonious approach to the core difficulties in multiple health-risk behaviors in youth. Most important, they provide clear guidelines as to how therapists should conduct themselves to be maximally effective with these challenging adolescents, and how to cope with the emotional demands of work with this population. What the reader will learn is that DBT is more than a set of skills and techniques/m-/it is a way of understanding and conceptualizing human behavior. This book should be read by every professional who works with multiproblem teens.' - "David A. Brent, MD, Division of Child and Adolescent Psychiatry and Services for Teens at Risk, University of Pittsburgh School of Medicine, USA"