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Dialectical Behavioral Therapy

Our Expert Therapists Use Dialectical Behavior Therapy (DBT) to Help Troubled Teens

There are several types of psychotherapy that involve different approaches, techniques, and interventions. At times, a combination of different psychotherapy approaches may be helpful. In some cases, a combination of medication with psychotherapy may be more effective.

Dialectical Behavior Therapy (DBT) can be used to treat older adolescents who have chronic suicidal feelings/thoughts, engage in intentionally self-harmful behaviors, or have Borderline Personality Disorder. DBT emphasizes taking responsibility for one’s problems and helps the person examine how they deal with conflict and intense negative emotions. This often involves a combination of group and individual sessions. 

The theory behind the approach is that some people are prone to react in a more intense and out-of-the-ordinary manner toward certain emotional situations, primarily those found in romantic, family and friend relationships. DBT theory suggests that some people’s arousal levels in such situations can increase far more quickly than the average person’s, attain a higher level of emotional stimulation, and take a significant amount of time to return to baseline arousal levels.

  1. Individual weekly psychotherapy sessions that emphasize problem-solving behavior for the past week’s issues and troubles that arose in the person’s life. Self-injurious and suicidal behaviors take first priority, followed by behaviors that may interfere with the therapy process. Quality of life issues and working toward improving life in general may also be discussed. Individual sessions in DBT also focus on decreasing and dealing with post-traumatic stress responses (from previous trauma in the person’s life) and helping enhance their own self-respect and self-image. During individual therapy sessions, the therapist and client work toward learning and improving many basic social skills.
  2. Weekly group therapy sessions, generally 2 1/2 hours a session which is led by a trained DBT therapist. In these weekly group therapy sessions, people learn skills from one of four different modules: interpersonal effectiveness, distress tolerance/reality acceptance skills, emotion regulation, and mindfulness skills are taught.

Components of DBT

  • Support-oriented: It helps a person identify their strengths and builds on them so that the person can feel better about him/herself and their life.
  • Cognitive-based: DBT helps identify thoughts, beliefs, and assumptions that make life harder: “I have to be perfect at everything.” “If I get angry, I’m a terrible person” & helps people to learn different ways of thinking that will make life more bearable: “I don’t need to be perfect at things for people to care about me”, “Everyone gets angry, it’s a normal emotion.
  • Collaborative: It requires constant attention to relationships between clients and staff. In DBT people are encouraged to work out problems in their relationships with their therapist and the therapists to do the same with them. DBT asks people to complete homework assignments, to role-play new ways of interacting with others, and to practice skills such as soothing yourself when upset. These skills, a crucial part of DBT, are taught in weekly lectures, reviewed in weekly homework groups, and referred to in nearly every group. The individual therapist helps the person to learn, apply and master the DBT skills.

The 4 Modules of Dialectical Behavior Therapy

1. Mindfulness

Observe, Describe, and Participate are the core mindfulness “what” skills. They answer the question, “What do I do to practice core mindfulness skills?”

2. Interpersonal Effectiveness

These skills include effective strategies for asking what one needs, how to assertively say ‘no,’ and learning to cope with inevitable interpersonal conflict. The skills taught are intended to maximize the chances that a person’s goals in a specific situation will be met, while at the same time not damaging either the relationship or the person’s self-respect.

3. Distress Tolerance

Distress tolerance skills constitute a natural development from mindfulness skills. They have to do with the ability to accept, in a non-evaluative and nonjudgmental fashion, both oneself and the current situation. Distress tolerance behaviors are concerned with tolerating and surviving crises and with accepting life as it is in the moment. Four sets of crisis survival strategies are taught: distracting, self-soothing, improving the moment, and thinking of pros and cons.

4. Emotion Regulation

Dialectical behavior therapy skills for emotion regulation include:

  • Learning to properly identify and label emotions
  • Identifying obstacles to changing emotions
  • Reducing vulnerability to “emotion mind”
  • Increasing positive emotional events
  • Increasing mindfulness to current emotions
  • Taking opposite action
  • Applying distress tolerance techniques

Since the development of Dialectical Behavior Therapy it has also been used for the treatment of other kinds of mental health disorders. Find out how you and your loved one can learn about DBT treatment at our program.

For more information on this topic, visit American Academy of Child and Adolescent Psychiatry https://psychcentral.com/lib/an-overview-of-dialectical-behavior-therapy/