What Is DBT?
DBT is a unique and specialized form of cognitive behavioral therapy used to help people suffering from mental disorders to reduce their emotional extremes. With certain mental disorders, the accompanying emotional highs and lows add an extra layer of complexity and make it difficult for the client to concentrate on the core issue. DBT focus on changing problematic thought patterns and teaching helpful skill so clients can effectively manage emotional extremes.
How Dialectical Behavior Therapy (DBT) Works
DBT combines skills for staying grounded in the present moment and coping skills for tolerating the stressors of internal and external conflicts. DBT focuses on developing new skills and behaviors to help with understanding and relaxing emotions, tolerating when life does not go as planned, navigating relationships/conflict with others, improving parent-child interactions and increasing contentment with the present moment.
Development of these DBT skills motivates preteens and adolescents to create a healthy balance of acceptance and change. This empowers them to overcome challenges like peer pressure, bullying and social media.
Four Stages of DBT Treatment
There are four stages of treatment in DBT following a pre-treatment stage where the goals for therapy are set. Each stage has specific targets in treatment and helps move the clients from “feeling miserable and being out of control” to becoming more aware and having the ability to regulate their feelings and behaviors. In the first stage of DBT, the focus is to help our clients move from being out of control of their behavior to being in control.
Once their behaviors stabilize the clients move into stage II, where they work on fully experiencing their emotions. In stage III, clients focus on building a healthy lifestyle and developing self-reliance. For some, a fourth stage is needed. In stage IV, clients who seek deeper meaning through a spiritual fulfillment work on moving from a sense of incompleteness to connection with a greater whole.
4 Hierarchal DBT Treatment Targets
There are also 4 hierarchy of treatment targets in DBT which help determine what needs to be addressed as a priority. These targets include Life-Threatening Behaviors, Therapy Interfering Behaviors, Quality of Life Behaviors, and Skills Acquisition.
Decreasing life-threatening behaviors
- Suicidal thoughts
- Suicidal threats
- Suicide attempts
- Self-injurious behaviors (helping teens who cut)
Decreasing therapy-interfering behaviors
- Missing or coming late to sessions
- Remaining silent in sessions
Decreasing quality-of-life interfering behaviors
- Physical aggression
- Electronic dependence
- Trouble in school
- Relationship conflict
- Excessive worry over school/life’s demands
Increasing coping skills
- Learning to relate to & communicate better with others
- Learning to understand and tolerate different emotions
- Improving acceptance of one’s self
- Skills for being able to enjoy the present moment more fully
Benefits of Dialectical Behavior Therapy (DBT)
One benefit is that Hillside uses DBT treatment for depression. As a comprehensive treatment, DBT has been successfully proven to help decrease self-injurious behaviors, mood instability, chaotic relationships, anger and impulsive behaviors. Also, DBT helps improve the understanding of personal boundaries and relationships, and how to better deal with conflicting or painful emotions. The aim is to decrease disruptive and potentially life-threatening behaviors.
DBT Therapy for Anxiety & Moodiness
DBT benefits individuals and families struggling with moodiness and anxiety, as well as relationships – be they peer or familial. It also encourages participants to find interests and motivations outside of social media, which in turn prepares them to handle ALL of life’s ups and downs, not just the digital ones.
What Ages Are Best For DBT Treatment?
It was once believed that DBT was not appropriate for anyone under 18, but many professionals now think DBT does benefit some adolescents – currently, 8% of pre-teens and teens ages 12 to 17. Appropriate therapy improves emotional stability and behavioral symptoms seen in teens with eating disorders, bipolar disorder, ADHD and anxiety.
Teens ages 12 through 17 are best suited for dialectal behavior therapy because they’re more emotionally equipped to handle treatment. Children younger than 12 typically lack the necessary cognitive skills needed for effective treatment. Today, there is a modified form of treatment for children younger than 12.
DBT-C for Children
A modification of DBT, called DBT-C, can now address the treatment needs of children ages 6 to 12. It focuses on the same principles as DBT, but does not include group therapy and instead adds a caregiver element that focuses on the individual. If a child shows trouble with emotion regulation and harmful behavior patterns, DBT-C could be an effective treatment option. Parents can also consider DBT-C treatment for children who are regularly irritable and angry, and it could help prevent anxiety and depression later in life.
Dialectical Behavioral Therapy (DBT) for Teens
For parents, their child’s teenage years can be stressful, marked by emotional ups and downs. But if your child shows signs of behavioral problems or emotional instability like depression, anxiety, anger or emotional distress, it’s important to consider that your teen might not be experiencing normal teen moodiness. Depending on their situation, they may benefit from dialectal behavioral therapy (DBT).
DBT is a unique form of therapy helping adolescents ages 12 through 17. Developed by Dr. Marsha Linehan, a researcher at the University of Washington, this program is an evolution of cognitive behavioral therapy (CBT). CBT acts as a cornerstone to DBT, but DBT has an emphasis on mindfulness, not just emotional regulation.
Dialectical Behavior Therapy Coping Skills for Teens
DBT was designed to treat and help adolescents with extreme emotional instability and help them manage their emotions and understand them without judgment. This therapy is designed to teach teens to accept their feelings and change behaviors to make their lives better.
DBT is a unique form of therapy that helps teens stay grounded and learn coping skills to tolerate stressors of internal and external conflicts. In dialectal behavioral therapy, adolescents learn five skills:
- Mindfulness: This area of therapy focuses on being present in the moment and knowing the signs of unregulated emotions and behavioral patterns. Teens learn to improve their self-awareness skills and identify impulse thoughts and behaviors.
- Emotional Regulation: Adolescents use emotional regulation skills to cope with stressful situations by creating pleasant and soothing experiences to protect against emotional extremes. This skill is mostly based on the program DBT was derived from, cognitive behavioral therapy (CBT).
- Interpersonal Effectiveness: With interpersonal effectiveness skills, your child will be able to interact with others appropriately and allow them to feel more supported by their peers. Teens learn how to communicate their wants and needs with others, as well as how to share their ideas. They can develop healthy boundaries, feel comfortable around others and learn how to ask for help.
- Distress Tolerance: Distress tolerance skills teach kids how to react appropriately to stressors and define their emotional reactions while recognizing urges to do dangerous things like hurting themselves. Teens learn how to calmly acknowledge their current painful circumstances and develop a healthy response versus tampering with their feelings or lashing out.
- Middle Path – Skills for Families: Middle path is a skill where kids and parents learn to validate each other, negotiate and compromise and see the other person’s side of a situation.
What Children Benefit Most From DBT Treatment
With dialectal behavioral therapy, adolescents learn two things:
- To accept their feelings
- How to change these feelings
For adolescents, the shift from dependent child to independent adult can be scary and overwhelming with pressure to live up to a specific image, have stellar academics and maintain interpersonal relationships. DBT is a practical solution for teens and focuses on developing new skills and behaviors, tolerating when life doesn’t go as planned, navigating interpersonal relationships and improving child and parent interactions.
At Hillside, we motivate teens to focus on creating balance and acceptance in their lives and change as they face new challenges and pressures. Our treatment goals focus on:
- Life-Threatening Behaviors: During dialectical behavior therapy, we focus on decreasing self-injury-related behaviors and suicidal thoughts, threats and attempts.
- Therapy-Interfering Behaviors: To get the most from treatment, we work on decreasing behaviors that will inhibit therapy effectiveness including missing or arriving late or remaining silent during sessions.
- Quality of Life-Interfering Behavior: Aggression, electronic dependence, academic trouble, related conflicts and excessive worry are all aspects of your teen’s life that dialectical behavior therapy can improve. By curbing these effects, your child can have an improved quality of life.
- Increasing Coping Skills: With DBT, your child can relate and communicate with others more effectively, understand different emotions and learn to accept themselves and enjoy the present moment.
Empowering Teens at Hillside
At Hillside, our DBT program is designed to help teens, pre-teens and their families adjust to change and emotional distress. Our DBT treatment services below emphasize mindfulness and improving you and your family’s quality of life:
- Individual and Family Psychotherapy: We offer personalized DBT therapy so clients can learn DBT emotional regulation exercises and how to apply these skills to their day-to-day lives. Our therapists are also trained in family therapy to help improve relationships between children and their parents and how to incorporate DBT into their daily routines.
- Skill Group Training: There are both groups for teens and parents with an emphasis on improving problem-solving skills, learning to achieve goals and enhance communication skills. During these sessions, we’ll focus on the five training modules outlined above.
- Additional Therapy: Our trained therapists can help clients on an individual basis with daily mindfulness practices and strategies to reduce the impact of common daily stressors like school, work, social issues or anxiety.
Disorders DBT Can Help
Dialectical Behavior Therapy changes the thought patterns that produce frequent emotional extremes. This reduction in emotionality can be useful in treating multiple disorders, including:
As a cognitive behavioral therapy, DBT can be used in conjunction with other treatment modalities to help clients suffering from a whole range of emotion-based disorders.
Arrange DBT Treatment in Atlanta
Pioneering the use of dialectical behavior therapy in Atlanta, Georgia, Hillside is one of the first residential facilities in the southeast that has therapists who are intensively trained in Dialectical Behavior Therapy. Along with our intensively trained therapists, Hillside staff at all levels complete DBT education upon orientation and renew this training annually. Indeed, Hillside is recognized in the field for its DBT residential treatment programs. The campus is saturated in DBT and it remains part of our day, every day.
We are proud to have the first and currently only DBT-Linehan Board Certification, Certified Clinician™ through the Linehan Institute in the state of Georgia.
The certification is a rigorous, multi-year process. There are currently 138 DBT-Linehan Board of Certification, Certified Clinician™ worldwide and our own clinician, Dr. Kimberly Vay, Ed.D, LPC has earned her place among this elite group of clinicians. Dr. Vay’s fellow clinicians at Hillside are also seeking certification as Hillside strives to be one of the first residential treatment facilities in the nation to be recognized by the DBT-LBC.
In addition to residential dialectical behavior therapy, Hillside offers DBT treatment for clients in our Day Treatment and Intensive Outpatient. The strategies that DBT teaches – interpersonal effectiveness, mindfulness, emotional regulation and distress tolerance – are useful skills for living in any situation. Learning these skills through DBT therapy, in conjunction with any other treatment modalities, is an asset to overall mental health.
By extending DBT therapy to our Day Treatment and Intensive Outpatient, we can involve clients and their families, either as they transition from the residential program back home or as part of an outpatient program. Our desire is to teach children and families the DBT skills they need to cope with behaviors together, so the child returns home and remains in the home.