DBT Therapy for Adults
Adult Program (ages 18+)
Dialectical Behavior Therapy (DBT) is a cognitive behavioral treatment developed by Marsha Linehan, PhD. It emphasizes individual psychotherapy and group skills training classes to help people learn and use new skills and strategies to develop a life that they experience as worth living. DBT skills include skills for mindfulness, emotion regulation, distress tolerance, and interpersonal effectiveness.
SoCal DBT’s comprehensive DBT program for adults can help those that struggle regulating their emotions and tolerating distress in their lives. DBT has been proven helpful for adults struggling with self harm, suicidal ideation or gestures, depression, anxiety, labile emotions, substance use disorder, anger, eating disorders, avoidance, isolation, procrastination and relationship problems, among other things.
To admit to our adult program, we will first have you see one of our therapists for an assessment. After we meet you, we will then assign you to a therapist. Pre treatment for DBT consists of four sessions, and by the fourth session, we ask you to commit to our program, and we commit to you in return. (You don’t just sign our contract, we sign a contract committing to you as well!). There is an initial six month commitment to our program, and after that you can extend by 3 or 6 months at a time. This is because it takes six months to get through the skills one time. Research shows that DBT is most effective if done for 12-24 months total, and we think six months can give you and us a good idea of if DBT is working for you. All adults in our program are in individual therapy, skills class (we can do these individually if there is a scheduling conflict, and we sometimes do them in addition to group as well), and have access to 24/7 skills coaching with either 2 or 3 therapists.
DBT for Adolescents (DBT-A)
Adolescent Program (ages 13-17)
DBT is appropriate for many adolescents, and our program can help when adolescents are feeling overwhelmed by their emotions and are struggling to cope with the world around them. DBT has been clinically proven to be effective in adolescents with Borderline and related personality disorders, as well as a range of other mental health issues. Our program also works with parents, who sometimes don’t know where to turn for help.
One of the fundamental principles of DBT is the balance of acceptance and change. Our adolescent program provides the structure to help adolescents acquire the skills they need to reduce or eliminate behaviors that are dangerous or are preventing self-growth and healthy functioning. Adolescents in our comprehensive program are learning skills from Rathus and Miller’s DBT Skills Manual for Adolescents. In this protocol, the teens learn the following modules: Mindfulness, Emotion Regulation, Distress tolerance, Interpersonal Effectiveness, and Walking the Middle Path.
Our DBT trained clinicians use validation strategies and cognitive behavioral interventions to help teens stay committed to treatment as they attempt the challenge of changing well-established behaviors they may have relied on for long periods of time. We are also available to teens and parents involved in the family aspect of our program for coaching 24 hours a day, 7 days a week.
Our adolescent program consists of individual sessions, adolescent skills group (90 minutes once per week), and attendance by parents at parent skills sessions (45 minutes per week for 26 weeks on an individual basis). At times we recommend family therapy when indicated and appropriate. The program has a minimum 6 month commitment. Parents and their teens are learning the skills at the same time together, and the focus of adolescent DBT is to help teens and their parents navigate through this challenging time to adulthood mindfully. Parents must be willing to participate in weekly parent skills sessions for 26 weeks. These sessions include access to 24/7 coaching in order to learn and reinforce the skills at home. Without parent participation, it isn’t comprehensive DBT-A, and will be less effective.
Common behaviors we treat in adolescents are:
- Relationship Difficulty
- Problems Communicating
- Suicidal ideation
- Self Harm
- Physical aggression
- Verbal aggression
- Eating disorders
- Drug abuse
- Alcohol abuse
DBT for Children (DBT-C)
Pre Adolescent Program (ages 6-12)
SoCal DBT’s DBT for Children program runs 26-32 weeks, and consists of multiple sessions per week. Both children and parents (and sometimes siblings) must participate.
DBT for Children (DBT-C) was developed to address treatment needs of children dealing with high emotional sensitivity and impulsive emotional behavior. These children experience emotions on a different level, and much stronger than their peers. Little things irritate them, and emotions may be so overwhelming that verbal or physical aggression occurs. The main goals of DBT-C are to teach these children adaptive coping skills and effective problem-solving and to teach their parents how to reinforce effective behaviors at home.
DBT-C is appropriate for children experiencing any of the following:
- High emotional sensitivity
- High reactivity
- High Intensity Feelings with a slow return to baseline
- Suicidal ideation or behaviors
- Non suicidal Self Injury (NSSI)
- Impulsive behaviors
- Frequent Temper Outbursts with verbal or physical aggression
DBT-C has three components:
1. Parent training, which helps parents and families change problematic behaviors by encouraging more desirable behaviors. A child’s volatile behaviors are often the best way they know how to deal with their intense emotions. Further, these behaviors may continue because they are frequently reinforced (e.g., attention from adults and peers, getting their way when parents finally give in, reduction in the intensity of emotional arousal). The environment may not be ready to effectively manage the challenges such children present, and “good-enough parenting” may not be sufficient to meet these demands. As a child’s needs cannot be adequately met by the environment, the environment frequently invalidates these needs, and destabilizes the child further. A more destabilized child continues to stretch an environment’s ability to respond adequately, which leads to further invalidation, and so forth. IN DBT-C, parents are integral to treatment, as we see them before we see the children, to ready the environment for change. DBT-C teaches parents everything their child learns (e.g., coping skills, problem-solving, didactics on emotions), plus effective contingency management techniques. DBT-C maintains that parental modeling of adaptive behaviors, reinforcement of a child’s skills use, ignoring of maladaptive responses, validation, and acceptance are key to achieving lasting changes in a child’s emotional and behavioral regulation.
2. Individual therapy for the child. DBT-C retains the theoretical model, principles, and therapeutic strategies of standard DBT and incorporates almost all of the adult DBT skills and didactics into the curriculum. However, the presentation and packaging of the information are considerably different to accommodate for the developmental and cognitive levels of pre-adolescent children.
3. Skills Training as a family. This allows the whole family to learn skills together to reinforce skills at home. Parents and children will attend individual skills classes together, and learn the skills with one another.
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