Adolescents with chronic kidney disease often engage in nonadherent behaviors and have poorer outcomes. Dialectical behavior therapy (DBT) promotes quality-of-life improvement, with specific focus on “treatment-interfering behaviors” such as nonadherence. DBT has demonstrated effectiveness with patients who are otherwise difficult to reach, treat, and manage in outpatient settings. This study describes a DBT adaptation for improving adherence in adolescent patients with end-stage renal disease (ESRD). Seven adolescents with ESRD were enrolled in a 9-session DBT program. Process (illness acceptance) and outcome (quality of life, depression) measures were conducted pre- and posttreatment. Transplant team reports of adherence and health improvements were conducted at pre-, mid-, and posttreatment. Significant improvements were evident at posttreatment for depression and adherence. Findings suggest that DBT may promote adherence in difficult-to-treat youth with chronic illness.
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