Does Insurance Matter? Implementing Dialectical Behavior Therapy with Two Groups of Youth Engaged in Deliberate Self-harm

• Published in: Administration and policy in mental health and mental health services research Vol. 42; no. 4; pp. 449 - 461
• Main Authors: James, Sigrid, Freeman, Kim R., Mayo, Danessa, Riggs, Matt L., Morgan, Joshua P., Schaepper, Mary Ann, Montgomery, Susanne B.
• Format: Journal Article
• Language: English
• Published: New York Springer US 01.07.2015; Springer Nature B.V
• Subjects: Adolescent; Ambulatory Care; Behavior modification; Behavior Therapy; Child; Clinical outcomes; Clinical Psychology; Female; Financing, Organized; Health Administration; Health Informatics; High risk; Humans; Insurance; Insurance, Health - statistics & numerical data; Male; Medicine; Medicine & Public Health; Original Article; Outpatient treatment; Psychiatry; Public Health; Risk factors; Self destructive behavior; Self injury; Self-Injurious Behavior - therapy; Treatment Outcome; Youth; Deliberate self-harm; Adolescents; Insurance type; Implementation; DBT
• ISSN: 0894-587X; 1573-3289; 1573-3289
• DOI: 10.1007/s10488-014-0588-7

This paper presents the outcomes of a Dialectical Behavior Treatment (DBT) program, implemented in intensive outpatient care with two groups of adolescents ( n  = 55 and n  = 45), ages 12–18, who engaged in deliberate self-harm (DSH) but had different insurance/funding sources and risk backgrounds. This pre-post study examined variability in clinical functioning and treatment utilization between the two groups and investigated moderating risk factors. Findings support DBT’s effectiveness in improving clinical functioning for youth with DSH regardless of insurance type. However, lower rates of treatment completion among youth without private insurance call for extra engagement efforts to retain high-risk youth in DBT.