CClinicalTrials.gg
RecruitingNCT05627492DB2Updated Oct 1, 2026

Pragmatic Patient-oriented Extension Study of Dialectical Behavior Therapy Booster Sessions for Youth With and/or at Familial Risk for Bipolar Disorder

An interventional study of Dialectical behavioral therapy in Bipolar Disorder, sponsored by Centre for Addiction and Mental Health. Recruiting at 1 site in Canada. Open to participants aged 14 Years to 25 Years. Per ClinicalTrials.gov, last updated 2026-10-01.

Sponsored by Centre for Addiction and Mental Health · Not applicable, Interventional, and Treatment

From the registry’s dates

  • Started Nov 2022; still recruiting 3 years 10 months later.
Phase
Not applicable
Study type
Interventional
Enrollment
120
Allocation
Not applicable
Ages
14 Years to 25 Years
Sex
All
01

Study summary

The study intervention is DBT adapted for youth with and/or at familial risk for bipolar disorder. Participants will have completed one full year of DBT in a previous study. This study is examining use of booster sessions. It is delivered in the form of individual sessions and skills sessions, based on the preference of the study participant. The study participant may also receive skills coaching via phone. There is no standard reference therapy/comparator against which the study intervention is being compared.

Read the detailed description

The study intervention is DBT adapted for youth with and/or at familial risk for bipolar disorder. Participants will have completed one full year of DBT in a previous study. This study is examining use of booster sessions. It is delivered in the form of individual sessions and skills sessions, based on the preference of the study participant. The study participant may also receive skills coaching via phone. DBT consists of four components: individual therapy sessions, skills sessions, skills coaching via phone, and consultation team. Given this study is an extension of an existing study of full DBT, the proposed intervention is not prescriptive; that is, we have opted not to dictate how many sessions participants will receive and/or when. Instead, we have opted to leave this decision for participants and their treatment providers to reach collaboratively. Participants, in consultation with their study therapist, will select the frequency of their booster sessions. This may include individual and/or skills sessions in addition to phone coaching for those who attend individual sessions at least once per month. DBT consultation will also remain a component of the treatment. This level of intervention seems appropriate, given that participants have completed a full year of DBT and thus may require a less intensive treatment for continued care. Moreover, it is important to give youth autonomy in treatment options to model health decision making for other life choices.

02

Conditions studied

  • Bipolar Disorder

Keywords

  • Youth
  • Dialectical Behavior Therapy (DBT)
  • Suicide
  • Psychotherapy
03

In context

Bipolar Disorder

1,601 studies on the registry are indexed under Bipolar Disorder; 254 are open to participants now.

This study's planned enrollment of 120 is above the median of 64 across 1,223 interventional studies indexed under Bipolar Disorder.

Browse Bipolar Disorder studies →

Lead sponsor

Centre for Addiction and Mental Health is the lead sponsor of 327 studies on the registry; 51 are open to participants now.

Counted across the registry records on this site, refreshed daily.

04

Who can participate

Ages eligible
14 Years to 25 Years
Sexes eligible
All
Accepts healthy volunteers
No

Inclusion criteria

The participant must meet all of the inclusion criteria to eligible for this clinical trial:

  1. Has completed participation in the DB1 study (049-2021) or the DB3 study (009-2021);
  2. English speaking;
  3. Age 14 years, 0 months to 26 years, 11 months;
  4. Meets diagnostic criteria for bipolar disorder by KSADS-PL(\< 20 years of age) OR SCID-5-RV (≥ 20 years of age) OR have a biological parent/sibling with BD (type I or II) confirmed via KSADS-PL or SCID-5-RV;
  5. Followed by a psychiatrist who provides ongoing care;
  6. If BD-I, taking ≥1 mood stabilizing medication (i.e., antimanic anticonvulsant, antipsychotic, and/or lithium);
  7. Able and willing to give informed consent/assent to participate.

Exclusion criteria

Exclusion Criteria

An individual who meets any of the following criteria will be excluded from participation in this clinical trial:

  1. A life-threatening medical condition requiring immediate treatment;
  2. Current victim of sexual or physical abuse;
  3. Current substance use disorder other than mild cannabis or alcohol use disorder;
  4. Evidence of mental retardation, moderate to severe autism spectrum disorder, or organic central nervous system disorder by the K-SADS-PL, parent report, medical history, or school records that would interfere with active participation in DBT.
05

Study design

Phase
Not applicable
Primary purpose
Treatment
Allocation
Not applicable
Intervention model
Single group
Masking
None (open label)
Enrollment
120 participants (estimated)

Study arms

  • Experimental
    Youth with and/or at familial risk for bipolar disorder

    120 youth aged 14 to 26 with bipolar disorder (type I, type II, not otherwise specified/NOS via KSADS-PL or SCID-5-RV) OR at high-risk for bipolar disorder (parent or sibling with bipolar disorder type I or II via KSADS-PL or SCID-5-RV) will be enrolled in the dialectical behavioral therapy booster session intervention.

    Behavioral: Dialectical behavioral therapy

Interventions

  • BehavioralDialectical behavioral therapy

    DBT will be conducted over 1 year. Participants and their treatment providers will decide on the frequency of sessions collaboratively. This may include individual and/or skills sessions in addition to phone coaching for those who attend individual sessions at least once per month. DBT consultation will also remain a component of the treatment. Participants may choose skills training, conducted in approximately 60 minute meetings, and individual therapy conducted in approximately 60 minute sessions. Family participation in skills training is highly encouraged. Skills training may include: psychoeducation, mindfulness skills, emotion regulation skills, distress tolerance skills, interpersonal skills, and walking the middle path skills. Individual therapy sessions aim to aid the youth in applying skills in their daily lives. We adopt the standard DBT hierarchy of treatment targets.

    Also known as: DBT

06

What researchers measure

Primary outcomes

  1. Total number of DBT sessions used during the study interval measured using the Therapy Tracking Form

    The Therapy Tracking Form will be used to document the date of the therapy session, type of session, session duration, content, and scheduled date for next therapy visit. This form will be completed by the study therapist after each therapy session.

    Time frame: At the end of study completion (five years)

  2. Number of unscheduled/expedited DBT sessions that are required measured using the Therapy

    The Therapy Tracking Form will be used to document if the session was a scheduled session or an unscheduled/expedited session. This form will be completed by the study therapist after each therapy session.

    Time frame: At the end of study completion (five years)

  3. Frequencies of different factors/circumstances leading to the need for unscheduled/expedited DBT sessions measured using the Therapy

    The Therapy Tracking Form will be used to document the reason for the unscheduled/expedited DBT session. This form will be completed by the study therapist after each therapy session.

    Time frame: At the end of study completion (five years)

Secondary outcomes

  1. Adherence score for DBT booster sessions measured using a modified version of the Dialectical Behavior Therapy Adherence Checklist - Individual Therapy

    Video recordings will be rated for adherence using a modified version of the Dialectical Behavior Therapy Adherence Checklist - Individual Therapy (DBT AC-I) \[54\]. The 12 DBT strategy domains will be rated as yes/no: 1) structural strategies; 2) problem assessment strategies; 3) problem solving strategies; 4) contingency management strategies; 5) exposure strategies; 6) cognitive modification strategies; 7) validation strategies; 8) reciprocal communication strategies; 9) irreverent communication strategies; 10) dialectical strategies; 11) case management strategies; 12) protocols.

    Time frame: At the end of study completion (five years)

  2. Frequencies of specific DBT components (individual sessions, skills session, phone coaching) measured using the Therapy Tracking Form

    The Therapy Tracking Form will be used to document the type of therapy session and phone coaching use. This form will be completed by the study therapist after each therapy session.

    Time frame: At the end of study completion (five years)

  3. Change in symptoms using the Structured Interview for DSM-IV Personality Disorders (SIDP-IV): Borderline Personality Disorder

    Borderline and antisocial personality symptoms will be assessed using the Structured Interview for DSM-IV Personality. The SID-P uses a semi structured interview format to assess for symptoms of personality disorders. Scores one each item range from 0 to 3 and high scores indicate symptoms of borderline personality disorder and levels of impairment.

    Time frame: 12 months to 18 months

  4. Change in symptoms using the Structured Interview for DSM-IV Personality Disorders (SIDP-IV): Borderline Personality Disorder

    Borderline and antisocial personality symptoms will be assessed using the Structured Interview for DSM-IV Personality. The SID-P uses a semi structured interview format to assess for symptoms of personality disorders. Scores one each item range from 0 to 3 and high scores indicate symptoms of borderline personality disorder and levels of impairment.

    Time frame: 18 months to 24 months

  5. Change in suicidality using the Suicidal Ideation Questionnaire (SIQ)

    Youth participants will complete the self-report Suicidal Ideation (SIQ), which is intended to identify participants whose level of suicidal ideation is severe enough to warrant further intervention. Each item is rated on a 7-point Likert-type scale (0= "I never had this thought" to 6="almost every day") and is used to indicate the frequency with which the participant experiences each thought.

    Time frame: 12 months to 15 months

  6. Change in suicidality using the Suicidal Ideation Questionnaire (SIQ)

    Youth participants will complete the self-report Suicidal Ideation (SIQ), which is intended to identify participants whose level of suicidal ideation is severe enough to warrant further intervention. Each item is rated on a 7-point Likert-type scale (0= "I never had this thought" to 6="almost every day") and is used to indicate the frequency with which the participant experiences each thought.

    Time frame: 15 months to 18 months

  7. Change in suicidality using the Suicidal Ideation Questionnaire (SIQ)

    Youth participants will complete the self-report Suicidal Ideation (SIQ), which is intended to identify participants whose level of suicidal ideation is severe enough to warrant further intervention. Each item is rated on a 7-point Likert-type scale (0= "I never had this thought" to 6="almost every day") and is used to indicate the frequency with which the participant experiences each thought.

    Time frame: 18 months to 21 months

  8. Change in suicidality using the Suicidal Ideation Questionnaire (SIQ)

    Youth participants will complete the self-report Suicidal Ideation (SIQ), which is intended to identify participants whose level of suicidal ideation is severe enough to warrant further intervention. Each item is rated on a 7-point Likert-type scale (0= "I never had this thought" to 6="almost every day") and is used to indicate the frequency with which the participant experiences each thought.

    Time frame: 21 months to 24 months

  9. Change in symptoms using the Adolescent Longitudinal Interval Follow-up Evaluation (ALIFE)

    The Longitudinal Interval Follow-up Evaluation (LIFE) will provide a comprehensive cross-sectional and longitudinal picture of the symptomatic and psychosocial course and outcome of all participants in this study. Scores range from 0-3 on certain disorders and 0-6 for other disorders. High scores indicate high level of symptom impairment.

    Time frame: 12 months to 18 months

  10. Change in symptoms using the Adolescent Longitudinal Interval Follow-up Evaluation (ALIFE)

    The Longitudinal Interval Follow-up Evaluation (LIFE) will provide a comprehensive cross-sectional and longitudinal picture of the symptomatic and psychosocial course and outcome of all participants in this study. Scores range from 0-3 on certain disorders and 0-6 for other disorders. High scores indicate high level of symptom impairment.

    Time frame: 18 months to 24 months

  11. Change in suicidality using the Columbia-Suicide Severity Rating Scale (C-SSRS)

    Suicidal events (past and over follow-up) will be assessed with the Pediatric Version of the Columbia-Suicide Severity Rating Scale (C-SSRS). The C-SSRS has sound psychometric properties, yields ratings of widely accepted definitions of youth suicidal events, and was used in other pediatric treatment trials yielding standardized outcomes to compare across studies. This is a semi-structured interview that includes yes/no questions as well as narrative. It captures number of suicidal events as well as type and severity.

    Time frame: 12 months to 18 months

  12. Change in suicidality using the Columbia-Suicide Severity Rating Scale (C-SSRS)

    Suicidal events (past and over follow-up) will be assessed with the Pediatric Version of the Columbia-Suicide Severity Rating Scale (C-SSRS). The C-SSRS has sound psychometric properties, yields ratings of widely accepted definitions of youth suicidal events, and was used in other pediatric treatment trials yielding standardized outcomes to compare across studies. This is a semi-structured interview that includes yes/no questions as well as narrative. It captures number of suicidal events as well as type and severity.

    Time frame: 18 months to 24 months

  13. Change in emotion regulation using the Difficulties in Emotion Regulation Scale (DERS)

    Youth participants will complete the Difficulties in Emotion Regulation (DERS), a 36-item questionnaire assessing emotional dysregulation. Participants indicate how often each item applies to them on a scale from 1="almost never; 0-10 percent" to 5= "almost always; 91-100 percent".

    Time frame: 12 months to 15 months

  14. Change in emotion regulation using the Difficulties in Emotion Regulation Scale (DERS)

    Youth participants will complete the Difficulties in Emotion Regulation (DERS), a 36-item questionnaire assessing emotional dysregulation. Participants indicate how often each item applies to them on a scale from 1="almost never; 0-10 percent" to 5= "almost always; 91-100 percent".

    Time frame: 15 months to 18 months

  15. Change in emotion regulation using the Difficulties in Emotion Regulation Scale (DERS)

    Youth participants will complete the Difficulties in Emotion Regulation (DERS), a 36-item questionnaire assessing emotional dysregulation. Participants indicate how often each item applies to them on a scale from 1="almost never; 0-10 percent" to 5= "almost always; 91-100 percent".

    Time frame: 18 months to 21 months

  16. Change in emotion regulation using the Difficulties in Emotion Regulation Scale (DERS)

    Youth participants will complete the Difficulties in Emotion Regulation (DERS), a 36-item questionnaire assessing emotional dysregulation. Participants indicate how often each item applies to them on a scale from 1="almost never; 0-10 percent" to 5= "almost always; 91-100 percent".

    Time frame: 21 months to 24 months

  17. Treatment Satisfaction Questionnaire (18-item)

    During follow-up visits, participants, parents, and/or siblings who are participating in therapy sessions will complete an 18-item Treatment Satisfaction Questionnaire. This assesses clients' satisfaction of the service (responses range from quite dissatisfied to very satisfied) as well as whether or not the service addressed the clients' needs.

    Time frame: 15 months

  18. Treatment Satisfaction Questionnaire (18-item)

    During follow-up visits, participants, parents, and/or siblings who are participating in therapy sessions will complete an 18-item Treatment Satisfaction Questionnaire. This assesses clients' satisfaction of the service (responses range from quite dissatisfied to very satisfied) as well as whether or not the service addressed the clients' needs.

    Time frame: 18 months

  19. Treatment Satisfaction Questionnaire (18-item)

    During follow-up visits, participants, parents, and/or siblings who are participating in therapy sessions will complete an 18-item Treatment Satisfaction Questionnaire. This assesses clients' satisfaction of the service (responses range from quite dissatisfied to very satisfied) as well as whether or not the service addressed the clients' needs.

    Time frame: 21 months

  20. Treatment Satisfaction Questionnaire (18-item)

    During follow-up visits, participants, parents, and/or siblings who are participating in therapy sessions will complete an 18-item Treatment Satisfaction Questionnaire. This assesses clients' satisfaction of the service (responses range from quite dissatisfied to very satisfied) as well as whether or not the service addressed the clients' needs.

    Time frame: 24 months

  21. Change in use of DBT skills with the DBT Ways of Coping Checklist (DBT-WCCL)

    Youth participants will complete the DBT-WCCL, a 59-item questionnaire assessing the use of DBT skills and coping strategies. Participants indicate how often they engaged in the thought/behavior from 0= "never used" to 3= "regularly used".

    Time frame: 12 months to 15 months

  22. Change in use of DBT skills with the DBT Ways of Coping Checklist (DBT-WCCL)

    Youth participants will complete the DBT-WCCL, a 59-item questionnaire assessing the use of DBT skills and coping strategies. Participants indicate how often they engaged in the thought/behavior from 0= "never used" to 3= "regularly used".

    Time frame: 15 months to 18 months

  23. Change in use of DBT skills with the DBT Ways of Coping Checklist (DBT-WCCL)

    Youth participants will complete the DBT-WCCL, a 59-item questionnaire assessing the use of DBT skills and coping strategies. Participants indicate how often they engaged in the thought/behavior from 0= "never used" to 3= "regularly used".

    Time frame: 18 months to 21 months

  24. Change in use of DBT skills with the DBT Ways of Coping Checklist (DBT-WCCL)

    Youth participants will complete the DBT-WCCL, a 59-item questionnaire assessing the use of DBT skills and coping strategies. Participants indicate how often they engaged in the thought/behavior from 0= "never used" to 3= "regularly used".

    Time frame: 21 months to 24 months

  25. Change in temperament using the Conflict Behavior Questionnaire (CBQ)

    The Conflict Behavior Questionnaire (CBQ) is a youth and parent 20-item self-report instrument that taps into conflict and negative communication between parents and their children. Items are rated as "true" or "false". Higher scores indicate greater levels of conflict and negative communication.

    Time frame: 12 months to 15 months

  26. Change in temperament using the Conflict Behavior Questionnaire (CBQ)

    The Conflict Behavior Questionnaire (CBQ) is a youth and parent 20-item self-report instrument that taps into conflict and negative communication between parents and their children. Items are rated as "true" or "false". Higher scores indicate greater levels of conflict and negative communication.

    Time frame: 15 months to 18 months

  27. Change in temperament using the Conflict Behavior Questionnaire (CBQ)

    The Conflict Behavior Questionnaire (CBQ) is a youth and parent 20-item self-report instrument that taps into conflict and negative communication between parents and their children. Items are rated as "true" or "false". Higher scores indicate greater levels of conflict and negative communication.

    Time frame: 18 months to 21 months

  28. Change in temperament using the Conflict Behavior Questionnaire (CBQ)

    The Conflict Behavior Questionnaire (CBQ) is a youth and parent 20-item self-report instrument that taps into conflict and negative communication between parents and their children. Items are rated as "true" or "false". Higher scores indicate greater levels of conflict and negative communication.

    Time frame: 21 months to 24 months

07

Study locations

1 of 1 sites recruiting
  • Centre for Addiction and Mental Health
    Toronto, Ontario M6J 1H4, Canada
    Recruiting
08

Updates

1 registry update since Sep 25, 2026
Minor edits
Nothing that changes what the study is or who can join. Edited: verification date, arm descriptions and secondary outcomes
1 update, last Oct 1, 2026
Show all 1 update
  1. Oct 1, 2026
    Minor edits only
    + 3 other changes: verification date, arm descriptions and secondary outcomes

From the registry record's own update history. This site started tracking changes on Sep 25, 2026; for anything earlier, see the record history on ClinicalTrials.gov ↗

09

Registry details

Key details

Study ID
NCT05627492
Lead sponsor
Centre for Addiction and Mental Health
Responsible party
Benjamin Goldstein (Director of the Centre for Youth Bipolar Disorder, Clinician-Scientist, Professor of Psychiatry, Pharmacology & Toxicology, and Psychological Clinical Science, Centre for Addiction and Mental Health) — Principal investigator
First posted
Nov 25, 2022
Start date
Nov 9, 2022
Primary completion
Nov 30, 2028 (estimated)
Completion
Nov 30, 2028 (estimated)
Last update
Oct 1, 2026

Study contacts

Vanessa Rajamani, MSW
Contact
vanessa.rajamani@camh.ca
416-535-8501 ext. 31761
Amanda Moss, MSW
Contact
amanda.moss@camh.ca
416-535-8501 ext. 33227
Benjamin I Goldstein, MD, PhD
principal investigator · Centre for Addiction and Mental Health

Oversight

Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

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