Rising suicide rates among adolescents is a serious public health concern. The frequency of self-injurious thoughts and behaviors drastically increases in the transition from childhood to adolescence (Nock et al., 2008; Nock et al., 2013). Suicide was the third highest cause of death between 1999-2006 for adolescents between the ages of 12 and 19, following unintentional deaths and homicide (Miniño, 2010). Despite the growing problem of adolescent suicide, treatments that meet Level One criteria, the highest level of research support for therapy as defined by the American Psychological Association (APA, 2006), are lacking. Dialectical Behavioral Therapy for Adolescents (DBT-A), a treatment adapted from Dialectical Behavioral Therapy (DBT) for adults who engage in suicidal and self-harm behaviors (Miller et al., 2007), has been examined with studies finding promising results with reducing self-injurious thoughts and behavior (Freeman et al., 2016; Rathus & Miller, 2002). There is also a need for treatments addressing self-injurious thoughts and behaviors that are designed to work with the unique needs and systemic factors of adolescents. Studies have shown that effective treatment of self-injurious thoughts and behaviors include varying elements of family involvement with DBT-A. The aim of this treatment manual is to combine evidence supported family integration to DBT-A treatment in order to more comprehensively address the needs of self-injurious adolescents and improve outcomes. Specifically, this treatment manual is designed to establish a systemic and robust family therapy component to an existing adolescent recovery program, Stage 2 Outpatient Adolescent Recovery (SOAR), with the family therapy sessions conducted using Structural Family Therapy (SFT) interventions.

LLU Discipline





School of Behavioral Health

First Advisor

Kendal C. Boyd

Second Advisor

Bryan M. Cafferky

Degree Name

Doctor of Psychology (PsyD)

Degree Level


Year Degree Awarded


Date (Title Page)




Library of Congress/MESH Subject Headings

Counseling Effectiveness; Dialectical Behavior Therapy; Family Therapy; Self-Injurious Behavior psychology; Adolescence (13-17 yrs)


Doctoral Project

Page Count

51 p.

Digital Format


Digital Publisher

Loma Linda University Libraries

Usage Rights

This title appears here courtesy of the author, who has granted Loma Linda University a limited, non-exclusive right to make this publication available to the public. The author retains all other copyrights.


Loma Linda University Electronic Theses and Dissertations

Collection Website



Loma Linda University. Del E. Webb Memorial Library. University Archives