Meeting the Needs of Neurodivergent Teens for Dialectical Behaviour Therapy: Challenges and Adaptation Strategies From Clinicians, Teens With Fetal Alcohol Spectrum Disorders and Caregivers.

PURPOSE: Neurodivergent teens experience elevated emotion dysregulation yet are excluded from treatment trials designed to address these challenges. Guided by implementation science, social model of disability and Dialectical Behaviour Therapy (DBT)'s biosocial model, this study explores the fit of DBT for neurodivergent youth, focusing on teens with fetal alcohol spectrum disorder (FASD). METHODS: A needs assessment was conducted with teens with FASD, their caregivers, and DBT clinicians. The survey assessed fit of DBT, barriers/facilitators and adaptation priorities. Data analysis employed RADaR (rigorous and accelerated data reduction) and thematic narrative analysis. RESULTS: Community members viewed DBT as promising for teens with FASD. They identified key barriers, including material complexity and a lack of neurodiversity-affirming practices. Clinicians reported limited training in FASD and offered concrete adaptation suggestions. DISCUSSION: Findings highlight the value of living experience in informing inclusive intervention design and provide a foundation for adapting DBT to better support neurodivergent adolescents.