Evaluation of Dialectical Behavior Therapy – Skills Training for Emotional Problem Solving for Adolescents (DBT STEPS-A) in Aotearoa New Zealand: Protocol of a Mixed-methods Evaluation of the Pilot Roll-out

Abstract

Background: Dialectical Behavior Therapy – Skills Training for Emotional Problem Solving for Adolescents (DBT STEPS-A) is a 30-week program adapted from the comprehensive DBT protocol for adolescents, to be delivered in schools, by school staff. This novel approach takes a preventative position wherein adolescents (aged 11–18) are taught social and emotional skills from DBT to equip them to navigate challenging situations with the premise that this may prevent the development of more severe psychological difficulties. Few studies exist evaluating the “real world delivery” of STEPS-A, and less so outside the United States of America. This protocol outlines the planned evaluation of the effectiveness of the STEPS-A program, as delivered by Marinoto Child and Adolescent Mental Health Service (Health New Zealand|Te Whatu Ora - Waitematā) in Aotearoa New Zealand. Method: This research will use a mixed-methods approach. Specifically, the evaluation of the program will be based on: (i) completed psychometrics pre- and post- program completion, (ii) perceived acceptability as expressed by participants, their families and the schools running the STEPS-A program during semi-structured interviews and focus groups, and (iii) the feasibility of the STEPS-A program in terms of the ability of participating schools to deliver it in an ongoing manner and (iv) any adaptations required to run the program in New Zealand in a culturally responsive manner. The proposed protocol has been peer reviewed by two independent academics and approved by a national health and disability ethics committee. A power analysis has also indicated that the estimated number of program participants will likely yield a sample that will be adequately powered for data analysis. Discussion: This research will evaluate the effectiveness, acceptability and feasibility of the STEPS-A program. Findings will highlight the challenges of implementation in a public health system and the suitability for use with an indigenous population.