A study on the effects of combined DBT and STEPPS interventions for adolescents with non-suicidal self-injury: a randomized controlled trial.

OBJECTIVE

To evaluate whether an integrated Dialectical Behavior Therapy and Systems Training for Emotional Predictability and Problem Solving (DBT + STEPPS) programme is more effective than DBT alone or conventional treatment in reducing non-suicidal self-injury (NSSI) and improving emotion regulation, anxiety, and depressive symptoms among adolescents with depression and NSSI.

METHODS

This study recruited 192 adolescent patients with non-suicidal self-injury between March 2024 and February 2025, and they were randomly divided into the Control Group (conventional intervention), Intervention Group A (DBT intervention), and Intervention Group B (DBT combined with STEPPS intervention). Patients' self-harm behaviors, emotional regulation strategy capabilities, and severity of illness were assessed both prior to intervention and within 48 h post-intervention. Data analysis employed one-way analysis of variance (ANOVA), Kruskal-Wallis H test, χ 2 test, or Fisher's exact test.

RESULTS

Intervention Group B exhibited lower NSSI behavior scores than both Intervention Group A and the control group, while Intervention Group A scored lower than the control group (p < 0.05). Regarding emotional regulation capacity, Intervention Group B demonstrated the highest adaptive strategy scores and the lowest maladaptive strategy scores (p < 0.05). This group also recorded the lowest anxiety and depression symptom scores (p < 0.05). All indicators for Intervention Group A were superior to those of the control group (p < 0.05).

CONCLUSION

DBT combined with STEPPS effectively reduces NSSI behaviors, improves emotion regulation, and alleviates anxiety and depression in adolescent non-suicidal self-injurious patients. And the effect of the combined intervention is better than that of the single intervention.

CLINICAL TRIAL REGISTRATION: This study was registered with the Chinese Clinical Trial Registry (https://www.chictr.org.cn/; Registration number: ChiCTR2100043855) on 4 March 2021. The first subject was recruited on February 13, 2025.