Adapting Dialectical Behavior Therapy for Use in Correctional Settings

  • Michele GaliettaEmail author


Correctional environments often struggle to provide adequate treatment for mentally ill individuals in their care. In particular, individuals who present with personality disorders, chronic suicidality, intentional self-harm, and violence create significant challenges for administrators and care providers. Individuals with high-risk behaviors are difficult and costly to manage. Moreover, systems to ensure the safety of such individuals, in the absence of effective treatment, may inadvertently increase their behavioral problems. Dialectical behavior therapy (DBT) is an empirically supported treatment that has been adapted for correctional settings. DBT is consistent with risk-needs-responsivity, good lives, and trauma-informed correctional care models. This chapter will provide a thorough overview of DBT along with a description of correctional adaptations of DBT. The current research base for DBT in corrections will be reviewed. A rationale for using DBT in corrections will be presented, along with pragmatic suggestions for successful implementation of DBT in such settings.


Adaptation Corrections DBT Self-harm 


  1. Andrews, D. A., Zinger, I., Hoge, R. D., Bonta, J., Gendreau, P., & Cullen, F. T. (1990). Does correctional treatment work? A clinically relevant and psychologically informed meta-analysis. Criminology, 28(3), 369–404. Scholar
  2. Asmand, P., Mami, S., & Valizadeh, R. (2015). The effectiveness of dialectical behavior therapy and rational emotive behavior therapy in irrational believes treatment, anxiety among young male prisoners who have antisocial personality disorder in Ilam prison. International Journal of Health System and Disaster Management, 3(1), 1–7. Scholar
  3. Black, D. W., Blum, N., McCormick, B., & Allen, J. (2013). Systems Training for Emotional Predictability and Problem Solving (STEPPS) group treatment for offenders with borderline personality disorder. The Journal of Nervous and Mental Disease, 201(2), 124–129. Scholar
  4. Black, D. W., Gunter, T., Allen, J., Blum, N., Arndt, S., Wenman, G., & Silieni, B. (2007). Borderline personality disorder in male and female offenders newly committed to prison. Comprehensive Psychiatry, 48(5), 400–405. Scholar
  5. Black, D. W., Gunter, T., Loveless, P., Allen, J., & Sieleni, B. (2010). Antisocial personality disorder in incarcerated offenders: Psychiatric comorbidity and quality of life. Annals of Clinical Psychiatry, 22(2), 113–120. Retrieved from
  6. Blanchette, K., Flight, J., Verbrugge, P., Gobeil, R., & Taylor, K. (2011). Dialectical behaviour therapy within a women’s structured living environment. Ottawa, ON: Correctional Services Canada.Google Scholar
  7. Brown, J. F., Brown, M. Z., & Dibiasio, P. (2013). Treating individuals with intellectual disabilities and challenging behaviors with adapted dialectical behavior therapy. Journal of Mental Health Research in Intellectual Disabilities, 6(4), 280–303. Scholar
  8. Conn, C., Warden, R., Stuewig, J., Kim, E. H., Harty, L., Hastings, M., & Tangney, J. P. (2010). Borderline personality disorder among jail inmates: How common and how distinct? Corrections Compendium, 35(4), 6–13. Retrieved from
  9. Dialectic. (2018). In Merriam-Webster Dictionary. Retrieved from
  10. Dimeff, L., & Linehan, M. (2001). Dialectical behavior therapy in a nutshell. The California Psychologist, 34(3), 10–13. Retrieved from
  11. Douglas, K. S., Nicholls, T. L., & Brink, J. (2017). Interventions for the reduction of violence by persons with serious mental illnesses. In P. M. Kleespies (Ed.), The Oxford handbook of behavioral emergencies and crises (pp. 466–488). New York, NY: Oxford University Press.Google Scholar
  12. Drake, E., & Barnoski, R. (2006). Recidivism findings for the juvenile rehabilitation administration’s dialectical behavior therapy program: Final report (Document No. 06-07-1202). Olympia, WA: The Washington State Institute for Public Policy.Google Scholar
  13. Fazel, S., Hayes, A. J., Bartellas, K., Clerici, M., & Trestman, R. (2016). Mental health of prisoners: Prevalence, adverse outcomes, and interventions. Lancet Psychiatry, 3(9), 871–881. Scholar
  14. Fazel, S., & Seewald, K. (2012). Severe mental illness in 33,588 prisoners worldwide: Systematic review and meta-regression analysis. The British Journal of Psychiatry, 200(5), 364–373. Scholar
  15. Fellner, J. (2004, February 12). Prisons no place for the mentally ill. The San Diego Union Tribune. Retrieved from
  16. Ferreira, C. C. (2012). The effects of a modified dialectical behavior therapy program on male inmates’ coping skills (Doctoral dissertation, Pacific School of Professional Psychology, Forest Grove, OR).Google Scholar
  17. Ford, M. (2015, June 8). America’s largest mental hospital is a jail. The Atlantic. Retrieved from
  18. Frazier, S. N., & Vela, J. (2014). Dialectical behavior therapy for the treatment of anger and aggressive behavior: A review. Aggression and Violent Behavior, 19(2), 156–163. Scholar
  19. Galietta, M., Fineran, V., Fava, J., & Rosenfeld, B. (2010). Antisocial and psychopathic individuals. In D. McKay, J. S. Abramowitz, & S. Taylor (Eds.), Cognitive-behavioral therapy for refractory cases: Turning failure into success (pp. 385–405). Washington, DC: American Psychological Association.CrossRefGoogle Scholar
  20. Galietta, M., & Rosenfeld, B. (2012). Adapting dialectical behavior therapy (DBT) for the treatment of psychopathy. International Journal of Forensic Mental Health, 11(4), 325–335. Scholar
  21. Galietta, M., Rosenfeld, B., & Ivanoff, A. (2003, April). Treating difficult-to-treat forensic patients: Applying DBT to forensic settings. Symposium presented at the International Association of Forensic Mental Health Services Conference, Miami, FL.Google Scholar
  22. Gee, J., & Reed, S. (2013). The HoST programme: A pilot evaluation of modified dialectical behaviour therapy with female offenders diagnosed with borderline personality disorder. European Journal of Psychotherapy & Counselling, 15(3), 233–252. Scholar
  23. Goodman, P. R., Page, J., & Phelps, M. (2017). Breaking the pendulum: The long struggle over criminal justice. New York, NY: Oxford University Press.CrossRefGoogle Scholar
  24. Gunderson, J. G., Weinberg, I., & Choi-Kain, L. (2013). Borderline personality disorder. Focus, 11(2), 129–145. Scholar
  25. Lemmon, G. (2008). Impact of a modified Dialectical Behavior Therapy treatment on coping methods and impulsiveness in female inmates (Doctoral dissertation, Pacific University, Forest Grove, OR).Google Scholar
  26. Linehan, M. M. (1993). Cognitive behavior therapy for borderline personality disorder. New York, NY: The Guilford Press.Google Scholar
  27. Linehan, M. M. (2013). What psychiatrists should know about dialectical behavior therapy. Psychiatric Annals, 43(4), 148. Scholar
  28. Linehan, M. M. (2015a). DBT skills training manual (2nd ed.). New York, NY: The Guilford Press.Google Scholar
  29. Linehan, M. M. (2015b). DBT skills training handouts and worksheets (2nd ed.). New York, NY: The Guilford Press.Google Scholar
  30. Linehan, M. M., Armstrong, H. E., Suarez, A., Allmon, D., & Heard, H. L. (1991). Cognitive-behavioral treatment of chronically parasuicidal borderline patients. Archives of General Psychiatry, 48(12), 1060–1064.CrossRefGoogle Scholar
  31. Manning, S. Y. (2007). Dialectical behaviour therapy. In C. Freeman & M. Powers (Eds.), The handbook of evidence based psychotherapies (pp. 83–92). West Sussex, UK: Wiley.CrossRefGoogle Scholar
  32. McCann, R. A., Ball, E. M., & Ivanoff, A. (2000). DBT with an inpatient forensic population: The CMHIP forensic model. Cognitive and Behavioral Practice, 7(4), 447–456. Scholar
  33. Miller, N. A., & Najavits, L. M. (2012). Creating trauma-informed correctional care: A balance of goals and environment. European Journal of Psychotraumatology, 3(1), 17246. Scholar
  34. Moore, K. E., Folk, J. B., Boren, E. A., Tangney, J. P., Fischer, S., & Schrader, S. W. (2018). Pilot study of a brief dialectical behavior therapy skills group for jail inmates. Psychological Services, 15(1), 98–108. Scholar
  35. Raine, A., & Yang, Y. (2006). Neural foundations to moral reasoning and antisocial behavior. Social Cognitive and Affective Neuroscience, 1(3), 203–213. Scholar
  36. Rosenfeld, B., Byars, K., & Galietta, M. (2011). Conducting psychotherapy outcome research in forensic settings. In B. Rosenfeld & S. D. Penrod (Eds.), Research methods in forensic psychology (pp. 309–324). Hoboken, NJ: Wiley.Google Scholar
  37. Rosenfeld, B., Galietta, M., Ivanoff, A., Garcia-Mansilla, A., Martinez, R., Fava, J., … Green, D. (2007). Dialectical behavior therapy for the treatment of stalking offenders. International Journal of Forensic Mental Health, 6(2), 95–103. Scholar
  38. Sakdalan, J. A., Shaw, J., & Collier, V. (2010). Staying in the here-and-now: A pilot study on the use of dialectical behaviour therapy group skills training for forensic clients with intellectual disability. Journal of Intellectual Disability Research, 54(6), 568–572. Scholar
  39. Sansone, R. A., & Sansone, L. A. (2009). Borderline personality and criminality. Psychiatry (Edgmont), 6(10), 16–20. Retrieved from
  40. Shelton, D., Kesten, K., Zhang, W., & Trestman, R. (2011). Impact of a dialectic behavior therapy-corrections modified (DBT-CM) upon behaviorally challenged incarcerated male adolescents. Journal of Child and Adolescent Psychiatric Nursing, 24(2), 105–113. Scholar
  41. Shelton, D., Sampl, S., Kesten, K. L., Zhang, W., & Trestman, R. L. (2009). Treatment of impulsive aggression in correctional settings. Behavioral Sciences & the Law, 27(5), 787–800. Scholar
  42. Singleton, N., Meltzer, H., & Gatward, R. (1998). Psychiatric morbidity among prisoners in England and Wales: Summary report. London, UK: Office for National Statistics.Google Scholar
  43. Skeem, J. L., Polaschek, D. L. L., Patrick, C. J., & Lilienfeld, S. O. (2011). Psychopathic personality: Bridging the gap between scientific evidence and public policy. Psychological Science in the Public Interest, 12(3), 95–162. Scholar
  44. Stern, S., Galietta, M., Rosenfeld, B., & Curtis, R. (2014, June). Assessing psychotherapy variables in treatment with psychopathic offenders. Paper presented at the International Association of Forensic Mental Health Services 2014 Conference, Toronto, Canada.Google Scholar
  45. Swenson, C. R., Sanderson, C., Dulit, R. A., & Linehan, M. M. (2001). The application of dialectical behavior therapy for patients with borderline personality disorder on inpatient units. Psychiatric Quarterly, 72(4), 307–324. Scholar
  46. Tomlinson, M. F. (2018). A theoretical and empirical review of dialectical behavior therapy within forensic psychiatric and correctional settings worldwide. International Journal of Forensic Mental Health, 17(1), 72–95. Scholar
  47. Trestman, R. (2000). Behind bars: Personality disorders. The Journal of the American Academy of Psychiatry and the Law, 28(2), 232–235. Retrieved from
  48. Wagner, P., & Sawyer, W. (2018, June 14). Mass incarceration: The whole pie 2018. Prison Policy Initiative. Retrieved from
  49. Wahl, C. T. (2011). Evaluation of a dialectical behavior therapy skills group for female inmates who voluntarily seek treatment: A pilot study (Doctoral dissertation). Retrieved from ProQuest Dissertations & Theses Global. (Order No. 3479921).Google Scholar
  50. Ward, T., Melser, J., & Yates, P. M. (2007). Reconstructing the Risk–Need–Responsivity model: A theoretical elaboration and evaluation. Aggression and Violent Behavior, 12(2), 208–228. Scholar
  51. Ward, T., Yates, P. M., & Willis, G. M. (2012). The good lives model and the risk need responsivity model: A critical response to Andrews, Bonta, and Wormith (2011). Criminal Justice and Behavior, 39(1), 94–110. Scholar

Copyright information

© Springer Nature Switzerland AG 2018

Authors and Affiliations

  1. 1.John Jay College of Criminal JusticeNew YorkUSA

Personalised recommendations