Dialectical Behavior Therapy for Adolescents

Acceptance and change toward your life worth living

What is DBT-A?

DBT is a type of CBT, meaning we’ll look at how your thoughts and behaviors are impacting how you feel. DBT adds the nuance of dialectics, the concept that two things that seem opposite can both be true.

Some common dialectics are “therapy is helpful AND it’s hard work”, “I want to do well in school AND it can be hard to focus”, “I am a wonderful parent AND I make mistakes”.

The main dialectic in DBT is acceptance and change:

“I accept myself exactly as I am AND I am working toward change.”

DBT-A is very similar to DBT – just adapted for teens:

It has one more module than typical in DBT skills group that addresses family conflict.
At least one parent joins the group as a full participant, and all family members are invited to come as often as they can, if the teen agrees.
Phone coaching is only for the teen.
Family and parent sessions are added as appropriate.

Who is DBT for?

Your teen might be struggling with things like

Feeling like they’re on an emotional roller coaster
Fighting with loved ones
Feeling numbed out, empty, or disconnected
Not having a sense of self

Your teen might even have turned to things like

Reckless driving
Self-harm
Unhealthy eating patterns
Thinking about suicide
Threatening suicide

If your teen is experiencing any of the above symptoms, for any reason, we can help.

The common thread for people who benefit from DBT is emotion dysregulation. Emotion regulation is when we are managing, controlling, and influencing our emotions. Emotion dysregulation is the opposite.

A note about borderline personality disorder:

BPD is the most treatable personality disorder. BPD unfortunately doesn’t have the best reputation; DBT is a treatment that works in treating BPD.

However, lots of people who benefit from DBT do not have BPD.

Why was DBT created? What purpose does it fill?

Marsha Linehan, PhD, the developer of DBT, wanted to create a treatment that would actually work for clients who weren’t getting better.

She initially tried behavior therapy, and clients pushed back, saying “you don’t understand how hard it is, how much pain we’re in.”

Then she tried a person-centered, humanistic approach, and still received pushback: “it’s nice to feel validated, and we have real problems and need real help!”

This led to the development of a third set of strategies: dialectical strategies. With the combination of acceptance and change, clients were able to get movement and flow in sessions, and actually reach their life worth living.

What are the parts of DBT that make it work?

Each of the 4 components, or modes, of the treatment directly map onto the problems people come to DBT with.

Group is where you and your teen will learn skills to become more mindful, improve interpersonal effectiveness, tolerate distress, and learn to manage and control emotions.

Phone coaching moves her from skills in her head to skills in her life. It also gives her a chance to learn to observe, communicate, and respect limits in relationships.

Individual DBT helps her recognize patterns that get her stuck and figure out ways to move forward.

DBT team makes sure your teen's therapist doesn’t burn out and does a great job at doing DBT with her.

A note about doing only “part” of DBT

Without all 4 modes, it is NOT comprehensive DBT.

Many times people think they have “done DBT” and have only received one part. This would be called DBT-informed treatment, or therapy that is informed by aspects of DBT.

For people who need full DBT it’s vital that it be done according to the way it was developed and tested because that’s the way we know that it works!

Recent research shows that many people can benefit from DBT skills group alone. This is a decision that is made together with your individual therapist and is not appropriate for everyone.

Let's start your path toward mental health.

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Call, Text or WhatsApp: 201-688-0722
Call: 02-376-4719

I’d like for my daughter to join your next DBT skills group - how do I do that?

Your family (meaning the teen and the parent who will be fully attending group) would need to have an intake prior to starting a DBT group. That’s a 90-minute session for us to get to know you and decide with you what your goals are and whether this is an appropriate addition to your current treatment or whether full DBT is recommended.
We speak to your teen's current therapist and decide together with our team about taking her for group only, or whether we’re only comfortable having her for full DBT (which, as mentioned above, would be group, individual therapy, family therapy if needed, and phone coaching).

If you’re ready to start, you can click here to schedule with our client care coordinator or call us at 201-688-0722 (US) or 02-376-4719 (Israel).

What is the difference between CBT and DBT?

CBT is a general umbrella term for cognitive behavioral therapies, meaning treatments that target thoughts and behaviors to affect how people feel. There are many types of CBT treatments – DBT is one of them.

What exactly does Borderline Personality Disorder mean?

Borderline Personality Disorder (BPD) is a personality disorder, which means that the problems are chronic, as opposed to other mental health conditions, where the problems change or fluctuate. BPD had 9 criteria – people who meet at least five “qualify” for the diagnosis:

Chaotic relationships
Fear of abandonment
Frequent mood swings
Anger outbursts
Impulsivity and risky behiviors in areas such as gambling or food
Suicidality or nonsuicidal self-harm
Lack of sense of self
Feeling empty
Dissociation or paranoia

Typically, teens should not be receiving a diagnosis of bpd, and will likely be receiving multiple diagnoses, such as depression, anxiety, PTSD, disordered eating, and more. When emotion dysregulation is the root of the problem, teens will typically be struggling with multiple problems at a time.

In DBT we don’t focus much on the diagnosis. Instead we focus on helping the person with their emotional dysregulation which a lot of these symptoms stem from. That being said, since DBT is such an effective treatment for BPD (see note above on BPD and DBT), we wanted to clear up confusion around this disorder.

Is there such a thing as a DBT approach to parenting?

DBT-C is a combination of parent management training and DBT; see our DBT-C page to learn more!

Can my teen take medication while she is in therapy?

If you are already working with a prescriber and your teen is taking medication for her symptoms, we’d like her to continue with that treatment exactly until she starts to feel better.

Once she starts feeling better or having symptom relief in therapy, we may have a conversation together with your prescriber about lowering the dosage or going off medication entirely, depending on her and your preference and current level of symptoms.

Many of our clients do choose to go off medication once they have eliminated their diagnosis and symptoms and find that they don’t need it anymore.

There is one important exception to the above policy:

If your teen is taking an as-needed anxiety medication, she might find that it will interfere with treatment. We actually WANT her to feel all the feelings fully in this moment. So medication that interrupts those feelings is going to teach her brain the things we’re trying to undo. Because of this we would likely discuss with you, her, and the prescriber not taking that medication on treatment days or during the treatment period.

Again, that would be in discussion with both you and the prescriber, and any decision we would come to would be together for your teen's best long-term success.

FAQs

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