In the 1980s, Dr. Marsha Linehan worked with adolescents with various mental health disorders, including depression, anxiety, bipolar disorder, borderline personality disorder, and others. She discovered that among adolescent patients who displayed high emotional reactivity, extreme moods, and unpredictable behavior, typical treatment – such as cognitive behavioral therapy (CBT) – was not effective.
For teens with extreme symptoms, Dr. Linehan found that the approaches to treatment she trained to use did not help them manage their intense emotions or enable them to control the life- and treatment-interfering behavioral patterns related to those emotions. To help these teens, she developed a method called dialectical behavior therapy, commonly called by its acronym, DBT.
treatment programs for teens
DBT-trained therapists apply the five core skills of DBT, as developed by Dr. Linehan and her colleagues, as the foundation of DBT for adolescents. These skills are:
- Mindfulness: Increasing awareness and focus in the present moment
- Emotion Regulation: Navigating up-and-down emotions
- Interpersonal Effectiveness: Managing relationships
- Distress tolerance: Tolerating difficult emotions safely, reduce suffering through reality acceptance
- Walking the Middle Path: Learning to apply the root principles of mindfulness to emotions, thoughts, and behavior.
The fifth core skill – Walking the Middle Path – was developed specifically for teens. It combines concepts from mindfulness with concepts from cognitive behavior therapy (CBT) to help teens manage emotions over which they feel they have no control.
What is the Middle Path in Adolescent DBT?
The Middle Path has five components. These five components help teens gain perspective, identify their role in managing their thoughts and emotions, and apply this knowledge to their day-to-day behavior. Over time, the middle path becomes their default tool to help make sense out of the most challenging aspects of their mental health disorder. Teens who receive DBT treatment learn to:
- Accept the world as it is, in the here and now, without judgment, and without trying to change it.
- Understand there is always more than one way to solve a problem or understand a situation.
- Validate differing perspectives and experiences of a particular situation or set of circumstances.
- Validate their own perceptions and experience of a situation or set of circumstances.
- Believe that change comes through action guided by mindful and intentional thought.
DBT therapists help teens learn that with acceptance, understanding, and validation, they can develop the capacity to change how they react internally (thoughts and emotions) and externally (words and actions) to situations and circumstances where they previously thought they had no control and felt they had no personal power or agency.
DBT is effective for teens: therapists with experience working with teens will tell you that. Peer-reviewed evidence will, too: studies show that in many cases, DBT treatment is the only therapy that works for teens with severe emotional dysregulation.
However, as the parent of a teen with a mental health disorder, you should also know there are two types of DBT treatment: DBT-informed treatment and DBT Comprehensive treatment.
There are only a few adolescent treatment centers in the country that offer
What is a Comprehensive Residential DBT Program?
If your teen participates in a Comprehensive DBT program, they’ll engage in a highly structured, systematic therapeutic sequence designed to help them create a life they want to live, based on their personal vision of happiness.
Comprehensive DBT for teens programs include the four core components of DBT:
- Individual therapy. Therapists use DBT as the primary therapeutic modality. In between sessions, therapists instruct teens to track their own emotions and behavior using one of the many practical DBT techniques included in the comprehensive DBT curriculum.
- Skills training: Teens learn the five core modules of DBT – as described above – alongside their peers. Each group session focuses on a core skill. After each session, the therapist assigns recovery homework, which typically consists of practicing and applying a DBT skill independently before the next group session.
- Skills coaching: If a teen needs immediate support, they contact their therapist and receive coaching. This is important when a teen feels the impulse to engage in treatment-interfering behavior or needs help implementing a new core skill. Coaching typically includes helping the teen approach and solve problems with DBT skills they learn in individual and group sessions.
- Consultation teams: At an adolescent DBT treatment center that offers Comprehensive DBT, staff meet weekly to evaluate and discuss the progress their patients make. The primary goal of the consultation teams is to improve the skill of DBT therapists.
Comprehensive residential DBT programs help teens with depression, anxiety, bipolar disorder, and other mood and behavioral issues. In addition, there’s one disorder for which comprehensive DBT is particularly effective: borderline personality disorder (BPD). Experts agree that DBT helps manage BPD symptoms in teens better than any treatment available.
What is a DBT-Informed Program?
DBT-informed programs for teens typically use DBT as their primary treatment modality. However, rather than using all four core components of DBT, they utilize one, two, or three aspects of DBT, depending on the specific needs of the adolescent in treatment. Research shows that DBT skills groups aloe can reduce suicidality, self-harming behavior, and help teens manage the symptoms of depression and anxiety.
Why Residential DBT for Teens?
In closing, we’ll summarize the reasons adolescent residential DBT is a good treatment alternative for teens with severe emotional dysregulation:
- It was designed specifically for teens.
- Teens learn skills they can apply immediately.
- DBT-trained therapists understand DBT skills and how to communicate those skills effectively to the adolescent population.
- Teens learn skills alongside peers and can practice the skills they learn with recovery peers before returning home.
- The mindfulness skills of DBT are modular and durable. This means that once a teen learns a mindfulness skill, they can adapt to virtually any situation they encounter over the course of their lifetime.
DBT works because it empowers teens to create – in the words of its founder and creator, Dr. Marsha Linehan – “a life worth living.”
Ready to Get Help for Your Child?Evolve offers CARF and Joint Commission accredited treatment for teens with mental health disorders and/or substance abuse. Your child will receive the highest caliber of care in our comfortable, home-like residential treatment centers. We offer a full continuum of care, including residential, partial hospitalization/day (PHP), and intensive outpatient treatment (IOP).
Angus is a writer from Atlanta, GA who writes about behavioral health, adolescent development, education, and mindfulness practices like yoga, tai chi, and meditation.