ABSTRACT
This chapter discusses adaptations for dialectical behavioral therapy (DBT) in inpatient hospitalization settings. Implementing DBT on an inpatient unit requires a significant amount of adaptation from the standard DBT model that was designed for outpatient settings. The outpatient therapist is an ancillary treatment team member in this adaptation, and has a unique role. The therapist should be aware the adolescent has been hospitalized, and hopefully has provided helpful information to the inpatient therapist regarding the adolescent's treatment. The Crisis Stabilization Scale was developed to specifically measure adolescent stabilization in acute care settings. The primary inpatient therapist has the traditional role of treatment planning, reviewing diary cards, and committing the client to treatment. The treatment targets for adolescents in inpatient settings are similar to those in standard outpatient DBT. Contingency management on inpatient units is as standardized as possible, so that staff members can respond consistently to problem behaviors.
