%0 Journal Article
%T Adapting Dialectical Behavior Therapy for an Adolescent with Neurofibromatosis 1: A Case Study | Insight Medical Publishing
%A Courtney Santucci
%A Joslyn Kenowitz
%A Lesley Michael
%A Michelle Lupkin
%A S
%A ra Pimentel
%J Journal Impact Factor:
%D 2018
%R 10.4172/2472-1786.100077
%X Background: There remains a need for interventions addressing psychopathology in individuals with cognitive and intellectual disability (ID). This case examines the application of Dialectical Behavior Therapy (DBT) in an adolescent with Neurofibromatosis 1 (NF1) and multiple psychiatric diagnoses. Treatment targeted suicidal ideation (SI), non-suicidal self-injury (NSSI) and impulsivity, while addressing cognitive limitations. Case background: The patient met criteria for Major Depressive Disorder, Borderline Personality Disorder, and Attention-Deficit Hyperactivity Disorder. She had a two-year history of NSSI behavior and two prior psychiatric inpatient hospitalizations. At baseline, she presented with deficits in interpersonal relationships, emotional reactivity and maternal conflict. Course of treatment: The treatment plan followed the DBT-A protocol, with modifications made to address the patient¡¯s cognitive limitations. Adaptions included greater reliance on behavioral and visual learning strategies, increased maternal involvement, regular collaboration with the multidisciplinary care team, and shortened sessions to fit the patient¡¯s attentional capability. Treatment outcomes: The patient showed a reduction in NSSI, SI, and did not require further psychiatric hospitalization. Patient and mother evidenced increased skill use. Additional outcomes are discussed. Conclusions: These adaptations offer a preliminary account of DBT-A for an adolescent with cognitive impairments. Important factors for successful modification included a multidisciplinary treatment approach, adapted and targeted teaching methods, and significant reliance on behavioral principles. This case study suggests that DBT is a promising treatment for individuals with ID and cognitive impairments and should be further tested within this population.
%U http://childhood-developmental-disorders.imedpub.com/adapting-dialectical-behavior-therapy-for-an-adolescent-with-neurofibromatosis-1-a-case-study.php?aid=23675