What Is Dialectical Behavior Therapy (DBT)?
Dialectical Behavior Therapy (DBT) is a type of cognitive-behavioral therapy originally developed to help people with borderline personality disorder. It has since been adapted for teens and has proven effective for treating a wide range of emotional and behavioral challenges.
DBT helps teens learn skills to manage intense emotions, improve relationships, reduce self-destructive behaviors, and develop better coping strategies. It's particularly effective for teens who struggle with emotional regulation, self-harm, suicidal thoughts, and difficulty in relationships.
The "dialectical" in DBT refers to the therapy's emphasis on balancing acceptance and change — accepting who you are while also working to make positive changes.
Who Can Benefit from DBT?
DBT can help teens who struggle with:
Emotional Regulation
- • Intense, overwhelming emotions
- • Rapid mood swings
- • Difficulty managing anger
- • Emotional outbursts
Self-Harm Behaviors
- • Cutting or self-injury
- • Suicidal thoughts or behaviors
- • Risky behaviors
- • Impulsive actions
Relationship Problems
- • Conflicts with family and friends
- • Difficulty maintaining relationships
- • Fear of abandonment
- • Boundary issues
Other Challenges
- • Eating disorders
- • Substance abuse
- • Depression and anxiety
- • Post-traumatic stress
Core Components of DBT
DBT typically includes four main components designed to provide comprehensive support:
1. Individual Therapy
One-on-one sessions with a DBT therapist where your teen:
- • Works on specific goals and challenges
- • Addresses self-destructive behaviors
- • Learns to apply DBT skills to their life
- • Receives validation and support
- • Builds motivation for change
2. Skills Training Group
Group sessions where teens learn and practice DBT skills with peers:
- • Mindfulness skills
- • Distress tolerance skills
- • Emotion regulation skills
- • Interpersonal effectiveness skills
- • Practice with peers in a supportive environment
3. Phone Coaching
Access to the therapist between sessions for:
- • Crisis support
- • Guidance on using skills in real-time
- • Help during difficult moments
- • Generalization of skills to daily life
4. Therapist Consultation Team
DBT therapists meet regularly to:
- • Ensure quality of care
- • Provide support to therapists
- • Maintain adherence to DBT principles
- • Problem-solve challenging cases
The Four DBT Skills Modules
DBT teaches four core skill sets that help teens manage their emotions and relationships more effectively:
1. Mindfulness
Learning to be present in the moment, aware of thoughts and feelings without judgment.
- • Paying attention to the present moment
- • Observing thoughts and feelings without judgment
- • Being fully present in activities
- • Reducing reactivity to emotions
- • Building awareness of self and others
2. Distress Tolerance
Learning to tolerate and survive crisis situations without making things worse.
- • Accepting reality as it is
- • Surviving crisis situations without self-harm
- • Using distraction and self-soothing techniques
- • Finding meaning in difficult situations
- • Resisting urges to act impulsively
3. Emotion Regulation
Learning to understand, manage, and change intense emotions that are causing problems.
- • Understanding and naming emotions
- • Reducing emotional vulnerability
- • Increasing positive emotions
- • Changing emotional responses
- • Managing intense emotions effectively
4. Interpersonal Effectiveness
Learning to communicate effectively, maintain relationships, and respect yourself and others.
- • Asking for what you want
- • Saying no effectively
- • Maintaining relationships
- • Building self-respect
- • Balancing priorities and demands
Family Involvement in DBT
Many DBT programs for teens include family involvement, recognizing that family support is crucial for success:
Family Skills Training
- • Parents learn DBT skills alongside their teen
- • Family members practice skills together
- • Improved family communication
- • Better understanding of your teen's challenges
Parent Coaching
- • Guidance on how to support your teen
- • Learning validation techniques
- • Setting appropriate boundaries
- • Managing your own reactions
Family Sessions
- • Joint sessions with your teen and therapist
- • Addressing family conflicts
- • Improving family relationships
- • Creating a supportive home environment
How Effective Is DBT for Teens?
Research has shown that DBT can be highly effective for teens, particularly for:
- • Reducing self-harm and suicidal behaviors
- • Decreasing hospitalizations
- • Improving emotional regulation
- • Enhancing relationships with family and peers
- • Reducing substance use
- • Improving school attendance and performance
- • Decreasing depression and anxiety symptoms
Success in DBT often depends on commitment to the program, regular attendance, and practicing skills outside of therapy sessions.
What to Expect in DBT
Time Commitment
- • DBT is typically a long-term treatment (6 months to 1 year or more)
- • Individual therapy: Usually once per week
- • Skills group: Usually once per week (2-2.5 hours)
- • Phone coaching: Available as needed between sessions
- • Homework: Regular practice of skills outside sessions
The Therapeutic Relationship
- • DBT therapists are validating and supportive
- • They balance acceptance with pushing for change
- • They're direct and honest
- • They help teens solve problems while accepting their current state
Progress and Challenges
- • Progress may be gradual
- • There may be setbacks along the way
- • Teens need to practice skills regularly
- • Success requires commitment and effort
- • Family support is crucial
How Parents Can Support DBT Treatment
1. Encourage Participation
- • Support regular attendance at therapy and group sessions
- • Help with homework and skill practice
- • Be patient with the process
- • Celebrate small victories
2. Learn DBT Skills
- • Participate in family skills training if offered
- • Practice skills yourself
- • Model effective emotion regulation
- • Use DBT skills in family interactions
3. Practice Validation
- • Validate your teen's emotions and experiences
- • Show understanding and acceptance
- • Acknowledge their efforts and progress
- • Balance validation with expectations for change
4. Maintain Boundaries
- • Set clear, consistent boundaries
- • Follow through with consequences
- • Balance support with expectations
- • Don't enable destructive behaviors
5. Take Care of Yourself
- • Get support for yourself
- • Practice self-care
- • Consider therapy or support groups for parents
- • Manage your own stress and emotions
Frequently Asked Questions (FAQs)
Q: How long does DBT treatment take?
A: DBT is typically a long-term treatment, usually lasting 6 months to 1 year or more. The length depends on the teen's needs, severity of symptoms, and commitment to the program. Some teens may need longer treatment, while others may make progress more quickly.
Q: Is DBT only for teens with severe problems?
A: While DBT was originally developed for severe cases, it can benefit teens with a range of emotional and behavioral challenges. DBT skills are useful for anyone who struggles with intense emotions, relationship difficulties, or impulse control. It's not only for the most severe cases.
Q: What if my teen doesn't want to do DBT?
A: This is a common concern. Here are some approaches:
- • Discuss their concerns and fears about therapy
- • Explain what DBT involves and how it can help
- • Consider starting with individual therapy before group
- • Work with the therapist to address resistance
- • Sometimes teens need to experience the benefits before fully committing
Q: How do I find a qualified DBT therapist?
A: Look for:
- • Licensed mental health professionals with DBT training
- • Therapists certified in DBT (if available in your area)
- • Programs that offer comprehensive DBT (all four components)
- • Recommendations from your child's doctor or other mental health professionals
- • DBT treatment programs at hospitals or mental health centers
Q: Will DBT work if my teen also needs medication?
A: Yes, DBT can work very well alongside medication. Many teens in DBT also take medication for depression, anxiety, or other conditions. DBT and medication can complement each other — medication may help stabilize mood, while DBT teaches skills to manage emotions and behaviors. It's important for the therapist and prescribing doctor to coordinate care.
Key Takeaways
Skills-Based
DBT teaches practical skills for managing emotions and relationships
Comprehensive
Includes individual therapy, groups, and family support
Family Support
Family involvement is crucial for success
⚠️ Important Note
This article provides general information and is not intended to replace professional mental health advice. DBT should be provided by qualified, trained mental health professionals. If you're considering DBT for your teen, consult with your child's doctor or a mental health professional to determine if it's appropriate and to find qualified providers in your area.