DBT-A may be an effective intervention to reduce self-harm, suicidal ideation, and depression in adolescents with repetitive self-harming behavior. Clinical trial registration information-Treatment for Adolescents With Deliberate Self Harm; http://ClinicalTrials.gov/; NCT00675129.

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Abstract. Both musicians and non-musicians can often be seen making sound-producing gestures in the air without touching any real instruments. Such "air playing" can be regarded as an expression of how people perceive and imagine music, and studying the relationships between these gestures and sound might contribute to our knowledge of how gestures help structure our experience of music.

Background Knowledge is lacking on the long‐term outcomes of treatment for adolescents with repetitive suicidal and self‐harming behavior. Furthermore, the pathways through which treatment effects may operate are poorly understood. Our aims were to investigate enduring treatment effects of dialectical behavior therapy adapted for adolescents (DBT‐A) compared to enhanced usual care (EUC) through a prospective 3‐year follow‐up and to analyze possible mediators of treatment effects. Methods Interview and self‐report data covering the follow‐up interval were collected from 92% of the adolescents who participated in the original randomized trial. Trial registration number: NCT01593202 (http://www.ClinicalTrials.gov). Results At the 3‐year follow‐up DBT‐A remained superior to EUC in reducing the frequency of self‐harm, whereas for suicidal ideation, hopelessness and depressive and borderline symptoms and global level of functioning there were no inter‐group differences, with no sign of symptom relapse in either of the participant groups. A substantial proportion (70.8%) of the effect of DBT‐A on self‐harm frequency over the long‐term was mediated through a reduction in participants’ experience of hopelessness during the trial treatment phase. Receiving more than 3 months follow‐up treatment after completion of the trial treatment was associated with further enhanced outcomes in patients who had received DBT‐A. Conclusions There were on average no between‐group differences at the 3‐year follow‐up in clinical outcomes such as suicidal ideation, hopelessness, depressive and borderline symptoms. The significantly and consistently larger long‐term reduction in self‐harm behavior for adolescents having received DBT‐A compared with enhanced usual care, however, suggests that DBT‐A may be a favorable treatment alternative for adolescents with repetitive self‐harming behavior.

We evaluated the feasibility of DBT training, adherence, and retention preparing for a randomized controlled trial of Dialectical Behavior Therapy (DBT) adapted for Norwegian adolescents engaging in self-harming behavior and diagnosed with features of borderline personality disorder. Therapists were intensively trained and evaluated for adherence. Adherence scores, treatment retention, and present and previous self-harm were assessed. Twenty-seven patients were included (mean age 15.7 years), all of them with recent self-harming behaviors and at least 3 features of Borderline Personality Disorder. Therapists were adherent and 21 (78%) patients completed the whole treatment. Three subjects reported self-harm at the end of treatment, and urges to self-harm decreased. At follow up, 7 of 10 subjects reported no self-harm. DBT was found to be well accepted and feasible. Randomized controlled trials are required to test the effectiveness of DBT for adolescents.