What You Need to Know About DBT for Adolescents

Dialectical Behavior Therapy for Adolescents (DBT-A) is the treatment of choice for teens presenting with multiple, serious behavioral concerns, including problems like self-harm, eating disorders, substance use, high-risk sexual behaviors, oppositional behavior, and suicidal ideation or actions. DBT can also be helpful with problematic but less severe issues like interpersonal difficulties, moodiness, anxiety, anger dyscontrol, and school avoidance.

At Columbus Park, we use a form of DBT-A that has been formally adopted to treat the needs of teens with eating disorders. Because DBT-A is structured to effectively target multiple concerns at the same time, this treatment is ideal for patients with eating disorders and other co-occurring emotional or behavioral difficulties.

Learn More About DBT for Adolescents

Dialectical Behavior Therapy is a comprehensive therapeutic intervention grounded in science-based principles of behavior change. Extensive research on DBT in both adults and adolescents has demonstrated its efficacy in treating a wide range of difficulties, as mentioned above.

DBT is based on the understanding that difficulty managing emotions can lead to impulsive actions, poor decision-making, and destructive behaviors. These behaviors may serve to relieve distress in the short-term. However, in the long-term, they can be damaging to physical health, self-esteem, relationships, and overall quality of life.

DBT focuses on teaching a broad range of skills for coping that replace familiar, but ultimately damaging, behaviors that negatively impact the quality of life. With treatment, the patient gains a broader repertory of resources to help themselves, not hurt themselves, when challenges arise.

Parents Serve as a Resource for Teens

In DBT, there is recognition of the interplay between the individual and their environment and acknowledgment that there may be ways that environmental factors reinforce dysfunctional behaviors. For youth struggling with emotional and behavioral challenges, a strength of DBT is that it acknowledges the important role of family, a central part of the teen’s environment, in supporting the client through change. Teens are in the midst of a family system and their struggles cannot be addressed in isolation. The system must work together to repair and improve communication and respect and establish an appropriate structure of parental support.

DBT for Adolescents calls for parental involvement, including parent skills training. The goal is for the family system to share the same “language” and work towards change together. With this purpose, parents learn the same skills that the teen is learning. 

Parents also have access to a “Parent Coach” who guides them in strategies to validate and support their teen, improve communication, set limits, and bolster their teen’s implementation of new skills. The Parent Coach is available between sessions to troubleshoot challenging moments and reinforce skillful interactions in real-time. The teen has their own separate therapist so they can feel a sense of privacy and separation from parents. Still, at the same time, the team is working together in the service of creating harmony and health within the family unit as a whole.

What is “True” DBT?

Over the last two decades, DBT has increased in popularity. It’s a “hot” treatment with a lot of buzz and positive references in the field. Many providers integrate elements of DBT as part of a broader treatment alongside other techniques. It’s essential to note that this “light” version of DBT can be helpful in some cases, but it is not consistent with how DBT is intended to be delivered. It shouldn’t be the course for patients with serious or chronic emotional and behavioral concerns.

Adherent DBT (the “full dose”) incorporates individual therapy, skills training, and between-session coaching (for both the patient and parents), and it should be delivered by clinicians with intensive training who are part of a DBT Team. The therapist meets weekly with their team with the intention of collaborating and working together in service of delivering the treatment at the highest level.

Core Components of Comprehensive DBT-A

  • Skills Training Sessions: Here, teens and parents learn dozens of skills for improved emotion regulation, distress management, interpersonal effectiveness, and increased emotional awareness.
  • Individual Therapy: In these meetings, the teen works one-on-one with a therapist to track behaviors and progress, build emotional awareness, fine-tune skills, and gain support in generalizing the skills in real life.
  • Phone Coaching: Phone coaching allows the patient and parents to troubleshoot challenges that arise between sessions. The parents use phone coaching with the Parent Coach, and the teen uses coaching with their Individual Therapist.
  • Team Consultation: A team consultation serves as a tool for the therapist so that the patient/family benefits from the input of other DBT experts. Team support reinforces the efficacy of this type of treatment.

Is DBT Right for Your Family?

If you are wondering if this is right for your teen/family, we encourage you to call us here at Columbus Park. After an initial phone intake, we can decide together if it makes sense to move forward with a full assessment. The assessment involves obtaining a full history and a clear snapshot of the current challenges. We will provide a diagnosis and will outline the targets of treatment along with a thorough recommendation for a treatment course. We have specific criteria to guide whether DBT-A be the treatment protocol of choice or if another treatment would be more appropriate. An initial assessment will give you a great deal of information about the nature of the problem and the best strategy to address it.


If your teen is struggling emotionally or behaviorally, please contact Columbus Park at info@columbuspark.com to discuss treatment options.