---
title: "PPRNet Clinical summary: DBT as a Universal Intervention Has a Negative Impact on Adolescent Well-Being"
description: The director of the Psychotherapy Practice Research Network (PPRNet) is Dr. Giorgio Tasca. Dr. Tasca is an Associate Professor with the School of Psychology, in the Faculty of Social, University of Ottawa. His research focus is on psychotherapy process, mechanisms of change, and outcomes, as well as eating disorders.
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# PPRNet Clinical summary: DBT as a Universal Intervention Has a Negative Impact on Adolescent Well-Being

[Dr. Giorgio Tasca](https://collabzium.com/en/articles/author/dr-giorgio-tasca)

calendar icon Feb 05, 2025 · Reading time 2 min read

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Research has focused on early intervention to allow adolescents to realize the best possible outcomes when it comes to mental health. One way to deliver preventive interventions is through the school system, where adolescents spend much of their days. Outcomes of preventive mental health interventions in schools have been mixed, and some studies have shown [adverse effects](https://mentalhealth.bmj.com/content/25/3/117?utm_source=hs_email&utm_medium=email&utm_content=2&_hsenc=p2ANqtz-9Lg7K_PytEFNh5CK1b-siVmtBdVSaEckzErb0bU0lJItZsYt7paNQ09zTIhOHxe4GtkFBnbNyt8MiFkuOrSYVPJ6vk1A&_hsmi=2) of such interventions. It is possible, for example, that translating interventions from one context (patients in the therapy office) to another (a general student population in schools) may have unintended consequences. In this study, Harvey and colleagues introduced a dialectical behaviour therapy (DBT) skills program within the school curriculum. Almost 1100 students were allocated to groups within schools to receive the intervention or to a control condition. The students were in grades 8 and 9, with an average age of 13.48 (SD = 0.70). The “Wise Teens” intervention consisted of 8-weekly 50-minute sessions with a manualized protocol of four DBT training modules: mindfulness, emotion regulation, distress tolerance, and interpersonal effectiveness. Students were encouraged to practice at home and review the homework practice at the subsequent session. The sessions were led by one or two experienced facilitators who were post-graduate trainee clinical psychologists (doctoral or master level). Adolescent participants in the control condition attended their usual Health and Physical Education classes. Immediately post-intervention, contrary to predictions, participants in the “Wise Teens” condition reported significantly worse total difficulties, (t(2485.65) = -2.70, p = .007; d = -0.12; 95% CI -0.26, -0.02), significantly poorer quality of mother-child relationships, (t(1813.16) = 3.18, p = .002; d = 0.15; 95% CI 0.01, 0.30), and significantly poorer quality of father-child relationships (t(1640.99) = 3.15, p = .002; d = 0.16; 95% CI = 0.01, 0.32). Those who received the “Wise Teens” intervention also reported increases in depression, anxiety, and emotional dysregulation, and lower emotional awareness and quality of life compared to the control group. The effect sizes in most cases tended to be small, and most differences disappeared at the six-months follow-up except for the quality of the relationship with mother and father. Only 30% of adolescents undertook the home practice throughout the intervention. 

## Practice Implications

This study and others like it demonstrate how complicated it is to take psychological therapy principles and apply them as a preventive measure to the general population of adolescents. The findings raise concerns about the potential harm of such universal interventions. Universally applied interventions should consider the participants' developmental needs and the school system's needs. 

> Harvey, L.J., White, F.A., Hunt, C., Abbott, M. (2023). Investigating the efficacy of a Dialectical behaviour therapy-based universal intervention on adolescent social and emotional well-being outcomes. Behaviour Research and Therapy, 169. [https://doi.org/10.1016/j.brat.2023.104408.](https://www.sciencedirect.com/science/article/pii/S0005796723001560?via%3Dihub&utm_source=hs_email&utm_medium=email&utm_content=2&_hsenc=p2ANqtz-9Lg7K_PytEFNh5CK1b-siVmtBdVSaEckzErb0bU0lJItZsYt7paNQ09zTIhOHxe4GtkFBnbNyt8MiFkuOrSYVPJ6vk1A&_hsmi=2)

calendar icon Feb 05, 2025 · Reading time 2 min read

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---

<https://collabzium.com/en/articles/author/dr-giorgio-tasca>

### [By Dr. Giorgio Tasca](https://collabzium.com/en/articles/author/dr-giorgio-tasca)

The director of the Psychotherapy Practice Research Network (PPRNet) is Dr. Giorgio Tasca. Dr. Tasca is an Associate Professor with the School of Psychology, in the Faculty of Social Sciences at the University of Ottawa. His research is centered around psychotherapy process, mechanisms of change, and outcomes, as well as eating disorders.

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- [PPRNet Clinical summary: The Therapeutic Alliance in Internet-Based Interventions](https://collabzium.com/en/articles/pprnet-clinical-summary-1.-the-therapeutic-alliance-in-internet-based-interventions)
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