"It's Not Always Named": Critical Perspectives on Antiracist Dialectical Behaviour Therapy with Racialized Youth

Abstract

Dialectical behaviour therapy (DBT) is a respected therapeutic modality that is broadly used in youth mental health care. Yet, there is a paucity of research on its applicability to and effectiveness for racialized clients. DBT is an evidence-based practice that rests on the dominant Eurowestern knowledge base of the mental health disciplines, rendering it a potential tool of domination. Some argue that critical race theory and critical race psychology can be used to develop an antiracist DBT framework, however, this approach is yet to be studied in practice. Using the lenses of critical race theory, critical race psychology, and postcolonial psychiatry, this research explores how critical practitioners account for race in practice and imagine possibilities for an antiracist DBT framework with racialized youth clients. Through semi-structured interviews with practitioners who integrate critical perspectives into their DBT work with racialized youth, this study highlights emerging themes related to critiquing and adapting DBT foundations, the relational foundation of cultural humility, and reimagining DBT through critical justice-oriented frameworks. This research seeks to contribute to the urgent need for therapeutic approaches which attend to race for racialized youth, who face disproportionate vulnerabilities in a mental health care system with an unrepresented dialectic of a fundamentally racist society.