Researchers Explore How Cognitive Behaviourial Therapy Can Give Street Youth New Lease on Life

by May 5, 2011

TORONTO, May 4, 2011 — Life as a teenager or young adult isn’t easy. But for youth who live on the street, it can be even more difficult: they often experience significant mental health issues, with suicide being the leading cause of death. Dialectical Behaviour Therapy (DBT) which has been found to be effective in helping people manage their emotions, is one approach that may help street youth navigate a successful transition to adulthood, said Elizabeth McCay, Research Chair in Urban Health in the Ryerson University Daphne Cockwell School of Nursing.

McCay is the lead investigator of a three-year national study that is evaluating the effectiveness of DBT with street youth. The study, Enhancement of Transitional Housing Programmes for Street-involved Youth through the Application of Dialectical Behaviour Therapy to Strengthen Resilience, involves research partners at universities and community agencies across Canada.

“When emotions are overwhelming, it can be difficult to manage stressful situations,” said McCay. “DBT teaches youth to regulate their emotions – something that these youth may not have had the opportunity to learn.”

DBT combines cognitive-behavioral techniques and eastern mindfulness practices with concepts of acceptance, tolerance for distress, emotional regulation and interpersonal effectiveness.

Many homeless youth have experienced severe challenges associated with life on the street, as well as physical and sexual trauma. Encouraging mindful awareness and self-acceptance, DBT is a promising treatment for various mental health problems, including depression, anxiety and self-harm behaviour.

Developed by U.S.-based psychologist Marsha Linehan, DBT is unique in that it acknowledges the pain of past traumas and present challenges, while emphasizing the need to move forward, set goals and adopt new ways to cope with future challenges. As a result, participants learn how to withstand emotional distress, strengthen their resilience and behave more effectively in interpersonal relationships.

With project sites in Toronto, Calgary and Halifax, McCay’s study is being conducted in transitional housing programs – group residences where street youth learn to lead independent lives. During the first phase of the project, staff members at the transitional homes completed training to become DBT facilitators. Throughout the study, staff will continue to participate in consultation sessions to support the implementation of the intervention. Over the course of the study, the staff members’ level of skill acquisition will also be assessed.

During the project’s second phase, 75 to 100 youth across the study sites will be recruited to participate in a 12-week DBT program. The participants, ranging in age from 16 to 24, will attend two types of weekly sessions: individual meetings that address specific concerns and group sessions that build emotion regulation skills.

They will complete a range of questionnaires before and after the intervention to assess the effectiveness of DBT to alleviate mental health challenges, and to build coping skills, social connectedness and resilience. The participants will also be asked how to improve access to DBT programs among street youth.

“The longer youth stay on the street, the more likely they are to engage in risky behaviour,” said McCay. “We need to create a path to help youth leave the street. Transitional housing is a critical juncture for youth and earlier intervention provides an opportunity to make a difference in their lives.”

The study has been funded by the Canadian Institutes of Health Research and the Mental Health Commission of Canada. The project involves co-investigators and community partners at Ryerson (Heather Beanlands, Linda Cooper and Souraya Sidani, Daphne Cockwell School of Nursing); Covenant House, Toronto (Carol Howes); the Centre for Addiction and Mental Health, Toronto (Shelley McMain, Addictions Section, and Susan Quesnel, Child Psychiatry); St. Michael’s Hospital, Toronto (Stephen Hwang and John Langley, Keenan Research Centre); the Universities of Calgary (Bruce MacLaurin) and Victoria (Catherine Worthington); Wood’s Homes, Calgary (Jane Matheson, Madelyn McDonald and Bjorn Johansson); and Laing House, Halifax (Maureen McLaughlin).

Ryerson University is Canada’s leader in innovative, career-oriented education and a university clearly on the move. With a mission to serve societal need, and a long-standing commitment to engaging its community, Ryerson offers more than 100 undergraduate and graduate programs. Distinctly urban, culturally diverse and inclusive, the university is home to 28,000 students, including 2,000 master’s and PhD students, nearly 2,700 tenured and tenure-track faculty and staff, and more than 130,000 alumni worldwide. Research at Ryerson is on a trajectory of success and growth: externally funded research has doubled in the past four years. The G. Raymond Chang School of Continuing Education is Canada’s leading provider of university-based adult education. For more information, visit

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