Leveling Up Dialectical Behavior Therapy for Autistic Individuals with Emotion Dysregulation: Clinical and Personal Insights

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Keenan, E. G., Gurba, A., Mahaffey, B., Kappenberg, C. F., & Lerner, M. D. (2023). Leveling Up Dialectical Behavior Therapy for Autistic Individuals with Emotion Dysregulation: Clinical and Personal Insights. Autism in Adulthood, 6(1), 1-8. https://doi.org/10.1089/aut.2022.0011

Publication date: 26 Jun 2023 Added to AutiHub: 5 Jul 2026 Type: Article Article language: English
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Authors

Publication authors
5
Publication authors identified as autistic
2 / 5 (40.0%)
  1. Elliot Gavin Keenan *
  2. Ava Gurba *
  3. Brittain Mahaffey
  4. Catherine Faith Kappenberg
  5. Matthew D Lerner

Abstract

Autistic people may experience high emotion and sensory sensitivities and a slow return to baseline emotional state. Dialectical behavior therapy (DBT) was developed to address reactivity, impulsivity, and mood dysregulation in individuals with mood and personality disorders. DBT may be therapeutically beneficial to autistic individuals struggling with these or similar emotional and sensory challenges. This article is a synthesis of the first author's experiences of DBT as an autistic person and professional insights from all authors. We provide an overview of the development of DBT, its foundational components, and adaptations. Using this basis, the first author describes the benefits DBT has had, the modifications that have helped him, and how those modifications may enhance DBT for autistic people. Modifications include visuals, graphics, and a gaming format that target the client's personal interests. The essence of these alterations is to transform life skills and DBT skills into something meaningful and functional. Receptivity of the therapist to the modifications and neurodivergent problem solving may be foundational to therapeutic success. Client-initiated contributions in collaborative therapy may improve autistic participants' understanding, validation, and adherence with DBT. The authors suggest expanding work on DBT modifications for autism in the areas of daily self-monitoring, assessing for preferred visual and gaming formats, and utilizing personal interests.

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These indicators describe the cited bibliography imported for this publication. Cited-reference metrics use the cited-reference total as denominator. Cited-author metrics state whether they use all cited-author occurrences or only occurrences linked to authors already integrated in the AutiHub database. They use cached links between cited authors and authors integrated in the AutiHub database. Last computed: 16 Aug 2026 11:30.

Cited references
50
Total cited references integrated for this publication.
Cited references with an identified autistic author
2 / 50 (4.0%)
Cited author occurrences identified as autistic
3 / 193 (1.6%)
Among occurrences linked to AutiHub author records: 3 / 32 (9.4%). Distinct cited authors identified as autistic: 3 / 187 (1.6%).
Cited author occurrences linked to AutiHub author records
32 / 193 (16.6%)
Distinct linked cited authors: 30 / 187 (16.0%)
Linked cited-author occurrences not identified as autistic
29 / 32 (90.6%)
Among linked cited-author occurrences only. Across all cited-author occurrences: 29 / 193 (15.0%). Distinct linked cited authors not identified as autistic: 27 / 30 (90.0%).
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