Many teen treatment centers offer Dialectical Behavior Therapy (DBT). But some treatment centers specify that they are “Comprehensive,” while others note that they are “DBT-informed.” What’s the difference?
When Dr. Marsha Linehan developed Dialectical Behavior Therapy in the 1980s, she delineated four components of treatment.
These four treatment delivery requirements were originally meant to be implemented in the standard outpatient setting. However, since then, many residential treatment centers and intensive outpatients have adapted them to fit the needs and constraints of their specific settings, and have usually received formal training to do so. (At Behavioral Tech, the premier DBT training institute for clinicians, this training requires weeks of intense coaching and instruction.)
Below are the four components of DBT treatment, as delineated by Dr. Linehan. A DBT-comprehensive teen treatment center includes all four of the aforementioned standard treatment components. A DBT-informed program includes only one, two, or three from the list.
Four Requirements of Comprehensive DBT Treatment Centers
1. Individual therapy
The teen rehabilitation center should offer weekly individual (and family) DBT therapy sessions. In these 1:1 sessions, therapists use Dialectical Behavior Therapy as the primary (or exclusive) therapeutic modality. In between sessions, the therapist will instruct clients to track their own emotions and behavior (for example, using Daily Diary Cards).
2. Skills training
The teen treatment center should offer DBT skills-training groups. In these groups, clients learn the five core modules of DBT together with peers. Each group session focuses on one of the five modules. After each session, the facilitator will give homework. This homework usually consists of practicing and applying a certain DBT skill independently before the next class.
3. Skills coaching
The teen treatment center should offer DBT skills-coaching between sessions. When a client needs immediate help, they should be able to contact their therapist at any given time – night or day – and receive relatively instant coaching. This is especially beneficial when a client has an urge to engage in negative behaviors or needs help implementing a coping skill. The coaching may include instructing the client to problem-solve, for example, by using a Behavior Chain Analysis (a major DBT tool.)
4. Therapists’ consultation teams
Every week, all DBT-trained staff should meet to evaluate their treatment administration and their clients’ progress. The primary goals of the Consultation Team are to enhance the motivation and capabilities of the DBT providers. Dialectical Behavior Therapy believes that the relationship between therapist and patient is an equal one. Therapists practice DBT skills in their own lives so they are able to authentically model them for the clients they are treating.
DBT-Informed Teen Treatment Centers
Not all teen rehab DBT centers have the resources to offer all these four components of “comprehensive DBT.” Many DBT residential treatment programs (RTC), intensive outpatients (IOP) and partial hospitalization programs (PHP) are actually DBT-informed programs, meaning they utilize only one, two, or three aspects of DBT.
Typically, these programs choose to include the skills-training groups component. Research has shown that even DBT skills-groups by itself has been shown to reduce patients’ suicidality, self-harming behavior, depression, and anxiety.
It is important to keep in mind that every DBT program is unique. Every teen is unique. No one rehab center can claim to be “the best” for “every” teen. For example, a comprehensive DBT program may not be appropriate for all teens. Other patients may require a different therapy approach altogether. Others may benefit from a more flexible DBT-informed program that offers DBT skills-groups in addition to other therapeutic modalities. All DBT programs, however, aim to do the same thing. They help struggling clients overcome their negative, ineffective actions and thoughts in order to create “lives worth living.”
If you liked this article, check out: DBT: 20 Ways for Teens to De-Stress and Keep Calm On-the-Go