Dialectical behavior therapy (DBT) is an evidence-based psychotherapy treatment that was originally developed by Marsha M. Linehan, in the late 1980s to better treat chronically suicidal individuals diagnosed with borderline personality disorder (BPD). DBT is based 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. Since its inception, dialectical behavior therapy has not only become and continues to be the gold standard for treating individuals with BPD but has also become known as an effective treatment method for other mental health disorders (e.g., depression, bulimia, binge-eating disorder, bipolar disorder, substance use disorder, etc.). DBT places primary emphasis on the psychosocial aspect of treatment.
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.” 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. Dialectical behavior therapy can help teach adolescents healthy coping mechanisms and useful techniques for managing stress, regulating emotions, and improving relationships with others.
DBT for Adolescents
Dialectical behavior therapy is a multifaceted approach that is carried out in three distinct therapeutic settings, which are weekly individual psychotherapy sessions, weekly group DBT skills 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 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. It also enables a young person the opportunity to further explore and dissect how the processes of implementing DBT skills have been effective throughout the week as well as identify areas that may need further attention. Open access to phone coaching provides additional support between weekly individual and group sessions. The entire DBT program typically lasts about six months long, as six weeks are allocated to focusing on each of the four DBT skills modules.
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.