Dialectical Behavior Therapy (DBT) Treatment for Adolescents in Atlanta

What Is DBT?

What Is DBT?

Dialectical behavior therapy (DBT) is a unique and specialized form of cognitive behavioral therapy used to help people suffering from mental disorders 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 changing ineffective behaviors and thoughts. DBT focuses on changing problematic thought patterns and teaching helpful skills so clients can effectively manage emotional extremes.

How 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.

The 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.

stages of dbt treatment

4 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 spiritual fulfillment work on moving from a sense of incompleteness to a connection with the greater whole.

4 Hierarchal DBT Treatment Targets

There are also four 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-interfering behaviors and skills acquisition.

1. Decreasing Life-Threatening Behaviors

  • Life-threatening thoughts
  • Life-threatening threats
  • Life-threatening attempts
  • Self-injurious behaviors

2. Decreasing Therapy-Interfering Behaviors

  • Missing or coming late to sessions
  • Remaining silent in sessions

3. Decreasing Quality of Life-Interfering Behaviors

  • Physical aggression
  • Electronic dependence
  • Trouble in school
  • Relationship conflict
  • Excessive worry over school/life’s demands

4. Increasing Coping Skills

  • Learning to relate to and 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

Benefits of Dialectical Behavior Therapy

One benefit is that Hillside® uses DBT treatment for depression. As a comprehensive treatment, DBT is proven to help decrease self-injurious behaviors, impulsive behaviors, mood instability and chaotic relationships. 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 and 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?

Originally developed by Dr. Marsha Linehan, a researcher at the University of Washington, DBT is an evolution of cognitive behavioral therapy (CBT) for adults diagnosed with borderline personality disorder. CBT acts as a cornerstone of DBT, but DBT has an emphasis on mindfulness and emotion regulation, not just cognitive distortions. As an evidence-based treatment, DBT is proven to be effective with multiple population, DBT has added specialized treatment protocols to meet specific needs, including the needs of specific age groups.

Dialectical Behavior Therapy for Adolescents (DBT-A)

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-A protocol is the adaptation of the DBT model for adolescents and their families, based on Dialectical behavior therapy adapted for suicidal adolescents by Jill Rathus and Alec Miller. DBT-A involves the same principles and processes as traditional comprehensive DBT. However, DBT-A tailors its approach to suit the unique needs of individuals on the brink of adulthood. It is an effective modality that helps teens manage their extreme emotions and  foster better relationships with themselves and those around them.

When emotional dysregulation and intolerance to life’s discomforts are taking their toll on you or a teen in your family, DBT-A can be a powerful resource to help them build self-confidence and learn valuable coping mechanisms that allow them to thrive.

In addition to helping adolescents harness a greater understanding of their emotions, DBT-A also involves additional instruction and insight for families looking to support the teen in their lives.

Family Skills Training

DBT-A includes family DBT skills training. This can benefit loved ones looking to provide as much support and love for the client as well as help caregivers regulate their own emotions. Family Skills training can be done through a multi-family skills group or a separate caregivers skills groups. Either format has its own pros and cons but has been proven to both be effective. The primary objectives of family skills training include:

  • Helping caregivers or the client’s support system understand the language and skills taught in DBT in order to utilize and model self-regulation for the client
  • Increase knowledge of behavioral management concepts in order to help manage behaviors and environmental contingency 
  • Increase ability to think dialectically and use dialectics 
  • Increase validation and self-validation skills to facilitate healthy relationships with others and with oneself.

Family skills training typically consists of the traditional 4 skills modules with an additional 5th module called “Walking the Middle Path.” Skills training enables client’s support system to better able to provide care and guidance without inadvertently enabling harmful behavior.

The following are the 4 primary DBT skills module:

  • Mindfulness 
  • Emotional regulation
  • Interpersonal
  • Distress tolerance

Walking the Middle Path

Walking the middle path refers to a core concept of DBT that involves striking a balance between two extremes. The use of dialectics and dialectical thinking, the skill of validation, and the overview of behavioral principles for behavior changes are covered in this module.

Skills and principles covered in Walking the Middle Path module helps to do the following:

  • Find common ground
  • Establish more meaningful connections
  • Accept different perspectives
  • Manage intense or extreme emotions
  • Utilize effective behavioral management principles to affect long term change

Families and support systems, along with the teens, learn DBT skills to become more mindful, increase ability to tolerate distress, build a life that is not constantly jumping from one emotional extremes to the other, and foster a healthy way to communicate and maintain good relationships. Ultimately, the family skills training increases the ability to use effective skills in order to create a healthier and more peaceful life.

DBT-A include the reality that adolescents are still functioning in a family system with reliance on support from parents are caregivers. The family skills component helps family acquire additional skills for supporting their teens and help families create a safe and validating space for their beloved adolescents. 

Disorders DBT Can Help

DBT changes the thought patterns that produce frequent emotional extremes. This reduction in emotionality can be useful in treating multiple disorders, including:

In addition to DBT-A. DBT also has other specific protocols, such as DBT-Prolonged Exposure (DBT-PE), DBT for substance use disorder (DBT-SUD) or DBT or posttraumatic stress disorder (DBT-PTSD), that can be used to help clients dealing with a whole range of issues.

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. 
  • 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 get through emotional crisis without making the situation worse. Teens learn how to acknowledge their current painful circumstances and develop a healthy response versus tampering with their feelings or lashing out.
  • Themiddle path skills for families: The 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.

Benefits of DBT-A

With dialectal behavioral therapy, adolescents gain skills to:

  • understand and create a lifestyle to regulate their emotions 
  • manager their feelings, urges, and behaviors
  • become more aware of the present moment
  • communicate effectively

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 life-threatening 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 behaviors: 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 modality is designed to help teens, preteens and their families adjust to change and emotional distress. Our DBT treatment services below emphasize mindfulness and improving your 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 enhancing 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 worries or anxiety.

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 DBT and the first residential treatment program to be recognized by the Linehan Board of Certification as a DBT-Certified Program. Along with our intensively trained therapists, Hillside® staff at all levels complete DBT education upon orientation. The campus is saturated in DBT, and it remains part of our day, every day.

In addition to residential dialectical behavior therapy, Hillside® offers DBT treatment at a Partial Hospitalization Program level of care for clients in our Experience DBT- Day Treatment and Intensive Outpatient programs. The strategies that DBT teaches — interpersonal effectiveness, mindfulness, emotional regulation and distress tolerance — are useful skills for living in any situation. 

By offering DBT therapy in our Day Treatment and Intensive Outpatient, we can involve clients and their families without out-of-home placement. These programs can be utilize to prevent hospitalizations or as they transition from hospitalizations or residential program back home. 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.

Contact Hillside® for More Information About Our Comprehensive DBT-A Treatment Modalities

If your teen is struggling with their behavioral and mental health, turn to the treatment experts at Hillside®. Our DBT for adolescents treatment is designed to help each client develop the coping skills needed to thrive in everyday life. We offer various options to suit your unique needs and situation.

Hillside® can help your family see the light at the end of the tunnel and assist you in transforming destructive thought patterns, behaviors and mental health. You are not alone, and our team is focused on meeting your clinical needs so you can enjoy more of what life has to offer and help your teen build a life worth living.

Contact Hillside® to learn more about admissions and our DBT-A treatment today.

Contact Hillside® for More Information About Our Comprehensive DBT-A Treatment Modalities