DBT for Adolescents
What is DBT for Adolescents?
Dialectical Behavior Therapy for Adolescents (DBT-A) is a treatment that can be effective for a wide range of teenage challenges. First, DBT-A is the treatment of choice for teens presenting with multiple, serious behavioral concerns – problems like self-harm, eating disorders, substance use, high-risk sexual behaviors, impulsive or oppositional behavior, and suicidal ideation or actions. DBT can also be helpful with problematic but less severe issues like interpersonal difficulties, moodiness, depression, anxiety, anger dyscontrol, and school avoidance.
Of note, at Columbus Park, we use a form of DBT-A that has been formally adopted to treat the needs of teens with eating disorders. This treatment is ideal for patients with eating disorders and other co-occurring emotional or behavioral difficulties like any of those mentioned above. DBT-A is structured to effectively target multiple concerns at the same time.
DBT is a comprehensive therapeutic intervention grounded in science-based principles of behavior change. 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, but 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, rather than hurt themselves, when challenges arise.
Parents 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 needs to work together to repair and improve communication, create a relationship of mutual respect, and establish an appropriate structure of parental support.
DBT-A calls for parental involvement, including parent skills training, so that the family system can share the same “language” and work towards change together most effectively. 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, but at the same time, the team is working together in the service of creating harmony and health within the family unit as a whole.
Comprehensive DBT-A Core Components:
Skills Training Sessions where teens and parents learn dozens of skills for improved emotion regulation, distress management, interpersonal effectiveness, and increased emotional awareness.
Individual Therapy where 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 for the patient and parent[s] to troubleshoot challenges that arise between sessions. The parent[s] use phone coaching with the Parent Coach, and the teen uses coaching with their Individual Therapist.
DBT 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 DBT treatment.
Is DBT-A Right for Your Family?
If you are wondering if DBT 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 will 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.