| Sumario: | 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. Summary: Dialectical Behaviour Therapy (DBT) is perceived as highly relevant but not fully accessible for many neurodivergent adolescents, including those with intellectual and developmental disabilities, due to cognitive, language, pacing and environmental demands that exceed typical service adaptations.Teens with FASD, caregivers and clinicians identified concrete, modifiable barriers to engagement (e.g., abstract language, fast session pace, high working‐memory load), alongside specific adaptation strategies that improve comprehension, participation and emotional safety without altering DBT's core principles.Findings highlight that limited inclusion of youth with developmental disabilities in mental health intervention research reflects structural accessibility barriers rather than lack of clinical need or treatment fit, reinforcing the importance of disability‐affirming, developmentally responsive intervention design.This study provides an empirically grounded roadmap for adapting evidence‐based psychotherapies for youth with IDD, advancing the research community's capacity to move beyond exclusionary trial criteria towards equitable, real‐world implementation.
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