Hot off the press: DBT for Adolescents is the only “well established” treatment for reducing teen suicidal ideation, suicide attempts, and self-harm

When the stakes are high, we all want to know that our loved ones are getting the very best treatment they possibly can. If your mom needs heart surgery, you find the best heart surgeon, even if it means driving several hours away several times in a row. If your spouse needs a specialized treatment for a rare condition, you get on a plane and fly to where the treatment is available. And, if your child is struggling with suicidal behavior, of course you want to know that their treatment team is using the best treatment available. 

So, what is the best treatment for helping suicidal teens? We’re so glad you asked, because it just so happens that our very own Erika C. Esposito, PhD, Director of Research & Program Evaluation at DBT Works, along with a number of colleagues, just released a comprehensive update summarizing the research on this very topic. 

The 2026 study: Check out the full article here!

The update was published in early February 2026 in the Journal of Clinical Child and Adolescent Psychology on behalf of the Society of Clinical Child and Adolescent Psychology. Erika and her colleagues combed through nearly 6,000 unique research articles that were published between 2018 and 2024 (the period since the last comprehensive update on this topic). 

Erika and her team evaluated these thousands of studies to see: (1) whether they used the “gold standard” research design for treatment evaluation: a randomized controlled trial, and (2) whether they were effective in reducing self-injurious thoughts and behaviors. Then, the authors took the results and used them to classify each type of psychotherapy as: Level 1: Well-established, Level 2: Probably efficacious, Level 3: Possibly efficacious, Level 4: Experimental, and Level 5: Questionable efficacy. 

What did the prior update say? 

The last update was published in 2019 and found that DBT for Adolescents was “Level 1: Well-established” for reducing deliberate self-harm and suicide ideation in teens (Glenn et al., 2019). But, at that time, DBT for Adolescents was classified as “Level 2: Probably efficacious” for reducing teen suicide attempts since only one study looked at treatment effects on suicide attempts (McCauley et al., 2018). In other words, DBT for Adolescents had the highest level of evidence for reducing teen self-harm and suicidal thoughts… but didn’t have quite as much evidence for teen reducing suicide attempts. 

What’s new in this update? 

This is the big news: The new update concluded that DBT for Adolescents now has the highest level of evidence (Level 1: Well-established) for reducing suicide attempts, in addition to reducing self-harm and suicidal ideation. This was based on a second research study showing that DBT for Adolescents reduced suicide attempts in the year during DBT and in the year following DBT (Goldstein et al., 2024). It probably goes without saying why having the highest level of evidence for reducing suicide attempts is a big deal, but it’s an even bigger deal when you think about the fact that so far, DBT for Adolescents is the only treatment that is “Well-established” for addressing any type of adolescent self-injurious behavior (self-harm, suicidal ideation, or suicide attempts).  

So, is DBT-A the only treatment option worth considering for adolescent self-injurious thoughts and behaviors?

Nope! While this update does emphasize that DBT for Adolescents has the strongest research support to-date, there are several other promising treatment families. For example, treatments like integrated family therapy are classified as Level 2: Probably efficacious, and still others, like Adjunctive/Booster Safety Plan Interventions, are classified as Level 3: Possibly efficacious. Only treatment families categorized in Level 5: Questionable efficacy are potentially harmful. Treatment families classified in Levels 2 and 3 generally mean we just need more research to know for sure how efficacious they are. 

TLDR; DBT for Adolescents has the highest level of evidence for reducing adolescent deliberate self-harm, suicide ideation, and suicide attempts. 

Want to read more? Check out the full article here!