Comprehensive Dialectical Behavioral Therapy (DBT) at Evolve
Evolve offers comprehensive DBT programs for teens of all genders, ages 12 to 17. When it opened in 2016, Evolve was the first residential comprehensive DBT program for teens in California and remains one of the few in the country today.
Evolve Comprehensive DBT Residential Programs
At Evolve’s comprehensive DBT Residential Treatment Centers, our goal is to provide a safe, highly structured environment with 24/7 clinical support for teens who need a higher level of care. Through evidence-based DBT, we focus on stabilizing safety concerns, reducing behaviors that interfere with treatment, and helping teens build the skills they need to create a more balanced and meaningful life.
Max 6 Clients
45 - 60 Days
24/7 Supervision
What is Dialectical Behavioral Therapy (DBT)?
Dialectical behavior therapy (DBT) is an evidence-based treatment designed to treat emotional dysregulation, suicidal thoughts and behaviors, self-harm, and other mental health and/or behavioral issues. It is a structured, skills-based approach that helps people reach their goals and create a life that is experienced as worth living.
Evidence shows DBT works for adolescents. Teens who participate in DBT programs learn actionable, practical skills to improve their lives. DBT for teens includes five core modules: mindfulness, emotion regulation, interpersonal effectiveness, distress tolerance, and the middle path.
In the decades since its development, research has shown DBT’s efficacy in treating a variety of populations and presenting problems, including teens with suicidal behaviors, self-harm, substance use, and eating disorders. While many teens with thoughts of suicide, depression, and/or anxiety may benefit from DBT skills training alone, some teens require a more comprehensive approach that applies all aspects of the DBT treatment model.
What Does Comprehensive DBT Mean?
The full DBT treatment model includes the four components below. While there is benefit in utilizing some aspects of DBT on their own (for example, standalone skills training), a program is not truly providing DBT unless all four essential treatment components are implemented adherently.
DBT Skills Training
A core component of comprehensive DBT is DBT skills training, which must be delivered in a very specific, structured way. These skills groups follow the original skills training format developed by Marsha Linehan, PhD, the founder of DBT, to ensure fidelity to the model and the best possible outcomes for teens.
Clients at Evolve participate in four DBT skills groups weekly.
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The overall goal of DBT skills training is to help teens learn how to change behaviors, emotions, and thought patterns that contribute to distress and interfere with everyday life. Through repeated practice and support, teens build healthier coping strategies and greater emotional stability.
Clients at Evolve participate in four DBT skills groups weekly, one for each skill module (Core Mindfulness, Interpersonal Effectiveness, Emotion Regulation, and Distress Tolerance). Over an 8-week curriculum, teens learn all core DBT skills from intensively trained DBT therapists. Each group follows the standardized DBT structure to help teens not only learn the skills, but practice them consistently and apply them in real-life situations.
Skills Group Structure
Each DBT skills group follows the same proven format:
- Mindfulness practice
Helps teens build awareness and focus in the present moment - Homework review
Discusses how skills learned in the previous group were used between sessions and what worked or felt challenging - New skill lesson
Introduces and teaches new DBT skills - Homework assignment
Assigns homework that provides opportunities to practice and strengthen the skill they learned outside of group - Check-out
Helps teens reflect and transition out of group
DBT Individual & Family Therapy
Another essential component of comprehensive DBT is the use of DBT as the primary therapeutic approach in both individual and family therapy. This ensures that teens are consistently supported in applying DBT skills across all areas of treatment.
Evolve therapists are specially trained in DBT and use it as the primary therapeutic approach.
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At Evolve’s comprehensive DBT programs, primary therapists are specially trained in DBT and use it as the primary therapeutic approach. Therapists balance acceptance and change strategies so teens feel understood and supported while learning how to make meaningful behavioral and emotional changes. Sessions incorporate core DBT strategies such as skill reinforcement, reshaping unhelpful thought patterns, behavior shaping, and building tolerance for difficult emotions. Therapists also use tools like DBT Diary Cards to help teens track target behaviors, identify patterns, and monitor skill use.
DBT is also central to family therapy. In Evolve’s comprehensive DBT programs, parents are introduced to DBT early in treatment and provided with resources to learn the skills alongside their teen. Parents participate in their own weekly virtual DBT skills training group with other parents in the program. This shared learning helps parents support skill use at home and creates consistency between treatment and daily life.
DBT Skills Coaching
Another essential component of comprehensive DBT is DBT skills coaching, which follows the structured, step-by-step approach developed by DBT’s founder, Marsha Linehan, PhD. In traditional outpatient DBT, skills coaching often happens by phone between sessions when a client needs support.
At Evolve, this approach is integrated into the residential setting through milieu-based skills coaching.
Read More
Skills coaching helps teens practice and strengthen the DBT skills they are learning in real time, throughout their day. Specially trained DBT skills coaches are available 24/7 to support teens as challenges arise, helping them apply coping strategies, emotion regulation tools, and communication skills in the moment. All staff receive extensive training in skills coaching, ensuring consistent and effective support across every shift. Over time, teens are gradually encouraged to identify and use skills more independently so they are better prepared to manage challenges after discharge.
For some families, especially when ongoing DBT therapy may not be immediately available in their community after discharge, we teach parents how to provide DBT skills coaching for their teen. When their teen needs coaching during the day, parents can practice providing real-time support with guidance from Evolve staff. This added support is designed to empower parents, build confidence, and help families use DBT skills effectively during moments of distress, supporting a smoother transition and greater success after discharge.
DBT Consultation Team
The final core component of comprehensive DBT is the DBT consultation team. This component focuses on supporting the clinicians and staff providing DBT, ensuring the treatment is delivered consistently, effectively, and with fidelity to the model. DBT recognizes that strong therapist support is essential to successful outcomes, which is why participation in a consultation team is a required component of comprehensive DBT.
At Evolve, the DBT consultation team meets weekly.
Read More
The goal of the consultation team is to strengthen the motivation, skills, and effectiveness of the DBT treatment team. Team members meet regularly to problem-solve clinical challenges, support one another, and maintain empathy in their work. DBT skills are actively used within the consultation team itself, reinforcing the same principles taught to teens and families. At Evolve, the DBT consultation team meets weekly and includes therapists, clinical leadership, DBT skills coaches, and residential counselors, helping ensure coordinated, high-quality care across the program.
DBT Skills Training Groups
A core component of comprehensive DBT is DBT skills training, which must be delivered in a very specific, structured way. These skills groups follow the original skills training format developed by Marsha Linehan, PhD, the founder of DBT, to ensure fidelity to the model and the best possible outcomes for teens.
The overall goal of DBT skills training is to help teens learn how to change behaviors, emotions, and thought patterns that contribute to distress and interfere with everyday life. Through repeated practice and support, teens build healthier coping strategies and greater emotional stability.
Clients at Evolve participate in four DBT skills groups weekly, one for each skill module (Core Mindfulness, Interpersonal Effectiveness, Emotion Regulation, and Distress Tolerance). Over an 8-week curriculum, teens learn all core DBT skills from intensively trained DBT therapists. Each group follows the standardized DBT structure to help teens not only learn the skills, but practice them consistently and apply them in real-life situations.
Skills Group Structure
Each DBT skills group follows the same proven format:
- Mindfulness practice
Helps teens build awareness and focus in the present moment - Homework review
Discusses how skills learned in the previous group were used between sessions and what worked or felt challenging - New skill lesson
Introduces and teaches new DBT skills - Homework assignment
Assigns homework that provides opportunities to practice and strengthen the skill they learned outside of group - Check-out
Helps teens reflect and transition out of group
DBT Individual & Family Therapy
Another essential component of comprehensive DBT is the use of DBT as the primary therapeutic approach in both individual and family therapy. This ensures that teens are consistently supported in applying DBT skills across all areas of treatment.
At Evolve’s comprehensive DBT programs, primary therapists are specially trained in DBT and use it as the primary therapeutic approach. Therapists balance acceptance and change strategies so teens feel understood and supported while learning how to make meaningful behavioral and emotional changes. Sessions incorporate core DBT strategies such as skill reinforcement, reshaping unhelpful thought patterns, behavior shaping, and building tolerance for difficult emotions. Therapists also use tools like DBT Diary Cards to help teens track target behaviors, identify patterns, and monitor skill use.
DBT is also central to family therapy. In Evolve’s comprehensive DBT programs, parents are introduced to DBT early in treatment and provided with resources to learn the skills alongside their teen. Parents participate in their own weekly virtual DBT skills training group with other parents in the program. This shared learning helps parents support skill use at home and creates consistency between treatment and daily life.
DBT Skills Coaching
Another essential component of comprehensive DBT is DBT skills coaching, which follows the structured, step-by-step approach developed by DBT’s founder, Marsha Linehan, PhD. In traditional outpatient DBT, skills coaching often happens by phone between sessions when a client needs support. At Evolve, this approach is integrated into the residential setting through milieu-based skills coaching.
Skills coaching helps teens practice and strengthen the DBT skills they are learning in real time, throughout their day. Specially trained DBT skills coaches are available 24/7 to support teens as challenges arise, helping them apply coping strategies, emotion regulation tools, and communication skills in the moment. All staff receive extensive training in skills coaching, ensuring consistent and effective support across every shift. Over time, teens are gradually encouraged to identify and use skills more independently so they are better prepared to manage challenges after discharge.
For some families, especially when ongoing DBT therapy may not be immediately available in their community after discharge, we teach parents how to provide DBT skills coaching for their teen. When their teen needs coaching during the day, parents can practice providing real-time support with guidance from Evolve staff. This added support is designed to empower parents, build confidence, and help families use DBT skills effectively during moments of distress, supporting a smoother transition and greater success after discharge.
DBT Consultation Team
The final core component of comprehensive DBT is the DBT consultation team. This component focuses on supporting the clinicians and staff providing DBT, ensuring the treatment is delivered consistently, effectively, and with fidelity to the model. DBT recognizes that strong therapist support is essential to successful outcomes, which is why participation in a consultation team is a required component of comprehensive DBT.
At Evolve, the DBT consultation team meets weekly.
The goal of the consultation team is to strengthen the motivation, skills, and effectiveness of the DBT treatment team. Team members meet regularly to problem-solve clinical challenges, support one another, and maintain empathy in their work. DBT skills are actively used within the consultation team itself, reinforcing the same principles taught to teens and families. At Evolve, the DBT consultation team meets weekly and includes therapists, clinical leadership, DBT skills coaches, and residential counselors, helping ensure coordinated, high-quality care across the program.
Who is Comprehensive DBT for?
DBT was originally created as an alternative treatment method for chronically suicidal adults. In working with this population, Marsha Linehan found that the primary treatments at the time, Cognitive Behavioral Therapy and Psychoanalytic Therapy, did not seem to fully meet the needs of these clients and that many would drop out of treatment or continue attempting suicide or ending up in psychiatric hospitals. She developed DBT as an alternative to these treatments and went on to demonstrate its efficacy for adults with chronic suicidality, self-harm, and severe emotion dysregulation. Over time, DBT has become the gold standard for evidence-based treatment of borderline personality disorder.
Teens who need comprehensive DBT may identify with one or more of the following:
- High emotion sensitivity (intense emotional reactions to triggers in the environment, difficulty coming back to baseline)
- Severe emotion dysregulation (moods that change rapidly throughout the day)
- Unstable sense of self that is beyond normal identity exploration for a teen
- Chaotic, intense relationships that often involve high conflict and switching from loving others to hating them
- A history of severe and/or chronic self-harm
- A history of multiple suicide attempts and/or chronic thoughts of suicide
- Confirmed or suspected diagnosis of borderline personality disorder
Evolve Clinical Expertise & Staff DBT Training
Evolve’s Comprehensive DBT programs were developed by our Chief Clinical Officer, Alyson Orcena, LMFT. Alyson is intensively trained in DBT through Behavioral Tech, the premier DBT training institute, and has over a decade of clinical experience specializing in the treatment of adolescents with emotion dysregulation and suicidal behaviors. Alyson is committed to implementing best practices in all Evolve programs by ensuring staff have the appropriate training, resources, experience, and mentorship to implement DBT in a way that helps clients most effectively.
At Evolve’s Comprehensive DBT Residential Programs, our Clinical Director and the Primary Therapists have been intensively trained in DBT. All employees (even our chef) receive ongoing training in DBT techniques specific to the Comprehensive DBT model. Our staff are available 24/7 for teens to receive in-the-moment, face-to-face skills coaching whenever they need it.
Many members of Evolves clinical leadership team have also received intensive DBT training through Behavioral Tech, including our CEO, Michelle Gross, LMFT, our Vice President of Operations, Director of Admissions, and our Regional Program Director. This training allows key leadership to provide expert clinical oversight for every teen entering treatment at Evolve and provides ongoing training in techniques specific to DBT and the residential model.
Understanding the Admissions Process
Step 1: Start the Conversation
Call to connect with an Admissions Coordinator who will listen, answer your questions, and walk you through treatment options and insurance coverage
Step 2: Free Clinical Assessment
We’ll get to know your teen and assess what level of care is clinically appropriate, ensuring Evolve is the right fit. If we’re not the right fit, we’ll provide referrals to programs that better meet your teen’s needs.
Step 3: A Safe, Supportive Start
On your teen’s first day, you’ll be welcomed by our team, guided through the intake process, and have a chance to tour the program. Your teen will begin their journey in a safe, nurturing environment surrounded by caring professionals.
Visit our Admissions Page to learn more about what to expect and how to get started.
Or call us today for a free assessment:
📞 1-800-665-4769
Learn More About Comprehensive DBT
Not ready for a call? Contact our admissions team in the form below to learn more or to schedule a free assessment.
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