Kaylin Miller


Non-suicidal self-harm is a broad term used to describe the intentional injury to oneself. Dialectical Behavior Therapy (DBT) is an evidence-based treatment, originally developed for adults with Borderline Personality Disorder, that has been adapted for use with adolescents to treat self-harm and suicidal ideation (DBT-A). Stage one of DBT, which focuses on teaching skills to replace self-harm behaviors and reduce suicidal ideation, has been researched extensively. However, there is limited research on stage two of DBT, which focuses on treating the underlying psychological causes that lead to self-harm. Loma Linda University’s Behavioral Medicine Center offers intensive outpatient DBT stage one treatment for adolescents. Stage Two Outpatient Recovery Program (SOAR) was developed at Loma Linda University’s Behavioral Health Institute to provide additional support and stage two treatment for adolescents who completed the stage one program. However, based on scores from the Youth Outcome Questionnaire (YOQ) collected each week during SOAR, it appeared that participants’ symptoms were not improving. A qualitative study at Loma Linda University was conducted to examine the opinions and feedback from 28 participants (10 adolescents, 18 parents) from the previous SOAR program. The qualitative study used grounding-theory techniques to code and analyze the information gathered through phone interviews with the participants. The x themes that were discovered through this analysis informed the content and structure of the current treatment manual. This manual is critical for recovery of adolescent self-harm, with a focus on treating the underlying trauma symptoms that influence the onset and maintenance of self-harm behaviors.

LLU Discipline





School of Behavioral Health

First Advisor

Bryan Cafferky

Second Advisor

Cameron Neece

Degree Name

Doctor of Psychology (PsyD)

Year Degree Awarded


Date (Title Page)




Library of Congress/MESH Subject Headings

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


Doctoral Project

Page Count

x; 68 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