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Dialectical behavior therapy (DBT) is an evidence-based psychotherapy. DBT stems from and includes many components of the cognitive behavioral therapy (CBT) approach. It was developed by Marsha M. Linehan in the late 1980s, as a means to more effectively treat chronically suicidal individuals diagnosed with borderline personality disorder (BPD). DBT combines standard CBT techniques for emotional regulation and reality testing with concepts derived from Buddhist meditative practice such as awareness, mindfulness, and attentiveness to current situations and emotional experiences to focus on the psychosocial aspect of treatment.

What Can It Treat?

Preliminary research has found that DBT can be effective in “treating adolescents, likely because many adolescents struggle with symptoms that mirror those found with borderline personality disorder, including non-suicidal self-injury, suicide attempts, dichotomous thinking, impulsive behaviors, labile moods, and unstable interpersonal relationships.” As such, the Child Mind Institute asserts that the DBT approach can be beneficial for adolescents struggling with:

  • Drugs and/ or alcohol abuse 
  • Substance use disorder
  • Anxiety/ generalized anxiety disorder (GAD)
  • Impulsive and/ or disruptive behaviors
  • Attention-deficit/ hyperactivity disorder (ADHD)
  • Frequent mood swings
  • Bipolar disorder
  • Self-injuring behaviors
  • Depression/ major depressive disorder (including treatment-resistant major depression and/ or chronic depression)
  • Suicidal behaviors
  • Poor coping skills
  • Anger outbursts
  • Eating disorder behaviors/ bulimia/ binge-eating disorder/ anorexia 
  • Family and/ or peer conflict
  • Post-traumatic stress disorder (PTSD)

Further, DBT is helpful in treating issues related to emotional dysregulation. Emotional dysregulation is a term used within the mental health field to denote irrational, poorly modulated emotional responses, which is highly common amongst adolescents.

DBT Format

Dialectical behavior therapy is a multifaceted approach that is carried out in three distinct therapeutic settings, which are weekly individual psychotherapy sessions, weekly DBT skills training group sessions, and as-needed phone coaching. DBT is divided into four main areas, commonly referred to as the four modules of DBT, to teach adolescents’ skills that help with effectively changing their behaviors. The four modules are introduced during the weekly group DBT skills training sessions, and include: 

  • Core mindfulness: focusing skills; the practice of remaining fully present in the moment at any given time.
  • Distress tolerance: crisis survival skills; learning to increase one’s ability to tolerate pain in challenging situations rather than attempting to escape or avoid experiencing negative emotions.
  • Emotion regulation: de-escalation skills; decreasing emotional impulsivity by learning skills to help manage and shift intense emotion without reacting instinctively to them.
  • Interpersonal effectiveness: relationship/ people skills; increasing one’s self-awareness and authentically advocating for one’s own wants and needs in a relationship in a way that is both self-respecting and non-damaging.

Individual therapy sessions provide one-on-one attention to help the adolescent go over skills learned in the group sessions. Open access to phone coaching provides additional support between weekly individual and group sessions. The entire DBT program generally lasts about six months long, as six weeks are allocated to focusing on each of the four DBT skills modules. Dialectical behavior therapy can help adolescents cultivate healthy coping mechanisms and useful techniques for managing stress, regulating emotions, and improving relationships with others.

The information above is provided for the use of informational purposes only. The above content is not to be substituted for professional advice, diagnosis, or treatment, as in no way is it intended as an attempt to practice medicine, give specific medical advice, including, without limitation, advice concerning the topic of mental health. As such, please do not use any material provided above to disregard professional advice or delay seeking treatment.

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