Although many middle school adolescents consider the middle school grades to be an exhilarating time of momentous change in their lives, others struggle not only with academic challenges but also with the inability to handle negative emotional states. Middle school adolescents often seek ways to cope with the distress they experience. Evidence indicates that adolescents are rarely adequately equipped with the necessary skills to deal with these stressful situations. Moreover, studies indicate that their distress tolerance, defined as the ability to persist in goal directed activity while experiencing emotional distress, is associated with increased risk behavior.

Given preliminary evidence that low distress tolerance is associated with risky health behavior amongst adolescents, the overall goal of this study was to develop an adolescent appropriate intervention for improving distress tolerance skills, drawing on techniques from Dialectical Behavior therapy, with four main objectives: (1) to enable adolescents to understand the relationship between their emotions and behavior; (2) to educate adolescents on how to identify and label their emotions; (3) to teach skills to adolescents that will enable them to cope with their difficult emotions; and (4) to provide adolescents with skills that will enable them to avoid engaging in later risk behavior.

To aide in the development of this intervention, a multi-method approach was employed using focus groups (n=20), in depth interviews (n=15) and a 3 round Delphi method (n=12). Results from this study were used to develop, modify and finalize a distress tolerance intervention (EASE- Empowering Adolescents to deal with Stress and Emotions) for middle school adolescents.