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Dialectical behavior therapy (DBT) is evidence-based psychotherapy. It was developed by Marsha M. Linehan in the late 1980s, intended to be used as a means to better treat chronically suicidal individuals diagnosed with borderline personality disorder (BPD). It is founded on the principles of cognitive-behavioral therapy (CBT) and blends Eastern mindfulness techniques (e.g., awareness, mindfulness, and attentiveness to current situations and emotional experiences) to encourage acceptance and change. DBT emphasizes the psychosocial aspect of treatment. This therapeutic modality is particularly helpful in treating issues related to emotional dysregulation, something many teenagers experiences. Emotional dysregulation is a term used within the mental health field to denote irrational, poorly modulated emotional responses. DBT focuses on teaching skills in four key areas, also referred to as the four modules of DBT, which are: core mindfulness (focusing skills), distress tolerance (crisis survival skills), emotional regulation (de-escalation skills), and interpersonal effectiveness (social/ relationship skills). The entire DBT program takes about six months to complete, as six weeks are allocated to each of the four modules.

DBT Format

DBT is conducted in three therapeutic settings: individual therapy sessions, group DBT skills training sessions, and phone crisis coaching between sessions (if needed). Weekly individual therapy sessions provide a teen and his or her clinician with the opportunity to co-create behavior plans that incorporate long and short-term goals. One-on-one therapy also helps a teen learn skills to improve self-worth, establish self-compassion, acceptance, and a positive self-identity. Weekly DBT group skills sessions are focused on enhancing the capabilities of each participant by teaching behavioral skills. In DBT group skills sessions, adolescents learn and practice implementing DBT skills used to help communication, regulate emotions, improve relationships, enhance moods, and practice effective problem-solving skills. The structure of group therapy sessions affords adolescents the ability to learn important behavioral skills from peers as well as encourage new, healthy ways of interacting with others. Phone coaching is a component of DBT that provides a teen with access to his or her clinician between individual and group therapy sessions. A teenager can call his or her clinician to receive support and guidance for coping with challenging in-the-moment situations.

What Does DBT Treat?

Currently, the DBT approach is often integrated into treatment plans for teenagers in LA struggling with an array of mental health ailments, some of which include the following examples, provided by the Child Mind Institute

  • 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)

Dialectical behavior therapy can help teach teenagers 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.