Muir Wood therapist, David Laing

Dialectical Behavior Therapy for Adolescents

Dialectical Behavioral Therapy (DBT), is a mode of psychotherapy that addresses patient’s views as compared to other therapeutic interventions included in the CBT classification; it provides patients with a mixture of traditional problem-solving strategies as well as acceptance strategies.

This means that patients are encouraged to accept the issues, situations, or relationships that they define as negative rather than deny that they exist or ignore the problematic issues they present.
This therapeutic method also focuses on helping the patient to understand the thoughts that govern their actions. It is commonly used to treat those suffering from multiple issues or disorders (e.g., substance abuse and behavioral issues like ADHD or mental health disorders like depression, anxiety, eating disorders).

Here at Muir Wood, we include the provision of dialectical behavioral therapy in the treatment plan of patients when it is indicated by their intake evaluation and diagnostic process. Contact us at the phone number listed above to learn more about this and other therapeutic options available to your teen today.

Components of Dialectical Behavioral Therapy

Dialectical behavioral therapy techniques are always centered on certain specific principles; these principles include:

  • Skills training for patients
  • Development of individual behavioral treatment plans
  • Contact with the therapist outside of regularly scheduled appointments
  • “Homework” performed by the patient outside of sessions
  • The inclusion of family members in the treatment process
  • Creation of a structured environment
  • The formation of a therapeutic team

The History of Dialectical Behavioral Therapy

Dialectical behavioral therapy has a long and rich history, one that begins with Marsha Linehan, a psychologist who developed the therapeutic method in an effort to treat those suffering from borderline personality disorder (BPD) with suicidal tendencies, a notoriously difficult diagnosis to address effectively in treatment.

Today, DBT is still commonly used to treat patients diagnosed with BPD, though it has been broadened and developed to treat a wide range of patients living with other conditions and disorders as well. The ability to reach the teen population utilizing DBT has been widely researched and shown to be effective in the care and treatment of a number of diagnosable issues in this group.

Who Can Benefit From Dialectical Behavioral Therapy?

Both teens and adults can benefit from the use of dialectical behavioral therapy in conjunction with other therapeutic methods and treatments. While the issues treated by DBT vary from person to person, some of the more common issues effectively addressed by DBT include:

  • Substance abuse and addiction
  • Emotional dysregulation
  • Depression
  • Suicidal tendencies, ideation, or thoughts

Dialectical Behavior Therapy and Addiction

Dialectical behavior therapy has long been used in the treatment of addiction in a number of different populations. When used for patients suffering from substance abuse disorders, DBT focuses on:

  • Abstinence from all drugs and alcohol
  • The reduction in frequency and severity of relapses
  • The reduction in the negative effects experienced as a result of relapse

DBT for addicted patients includes traditional office sessions, off-site sessions, and active attempts by therapists to locate clients who miss sessions as it may be an indicator of relapse or potential relapse.

Addicted teens who undergo DBT learn to take responsibility for their actions and to gain some control over their addictions and the problems that those addictions can cause.

Dialectical Behavior Therapy and Emotional Dysregulation

Emotional dysregulation can be defined as having great difficulty controlling emotional responses to stimuli. Often patients who experience this phenomenon respond to unwanted change, situations or relationships in unhealthy ways. A person with emotional dysregulation, for example, might respond to feelings of being “too full” by purging his food or engaging in excessive exercise.

When dialectical behavioral therapy is used to treat teens suffering from emotional dysregulation, their negative emotional response is viewed as a controllable, learned response, and the teen is encouraged and guided toward finding acceptable ways to modify the undesired response. Teens are taught to focus on being mindful of the thoughts and feelings that lead up to the undesired behavior so they can ultimately control the emotional reaction they have to any given stimuli.

Dialectical Behavioral Therapy and Depression

Depression is one of the most commonly diagnosed mental illnesses in the United States, and it is particularly common among teenagers. Fortunately, dialectical behavioral therapy has been shown to be very effective in helping patients to cope with and recover from the symptoms associated with depression.

Typically, DBT for depression focuses on helping the patient to learn positive coping mechanisms for dealing with symptoms as they arise. Patients are encouraged to share openly with their therapist during periods of depression in order to gain directed guidance in understanding and combating their depressive symptoms.

Dialectical Behavior Therapy and Suicidal Tendencies

Like depression, suicidal thoughts, behaviors, and attempts are not uncommon among teens. To make matters worse, it is an issue that is often coupled with co-occurring conditions or negative behaviors, including self-mutilation and depression.

Dialectical behavioral therapy can help teens recognize why they are having suicidal thoughts, how to cope with and eventually change those thoughts, and most importantly, how to keep those thoughts from turning into life-threatening actions. When suicidal tendencies are coupled with other mental health disorders or symptoms, DBT can be successful at targeting both conditions effectively.

Benefits of Dialectical Behavioral Therapy

While many of today’s therapeutic techniques treat those who are diagnosed with substance abuse and co-occurring disorders as powerless victims, dialectical behavior therapy empowers patients with their ability to effect positive change in their own lives. By altering their harmful thought patterns and attitudes, they can take back control over their emotions and behaviors and ultimately regain positive power in their relationships with themselves and others.

To accomplish this, DBT focuses on teaching patients the practical skills they need to function healthfully on a day-to-day basis and overcome the mental and emotional pain that blocks them from moving forward. Though the specifics will vary based on the patient’s experience and goals for recovery, some of these practical skills may include:

  • The ability to observe their environment and realistically determine the reality of that environment and the impact that it has or could potentially have on their ability to function
  • The ability to describe their environmental observations and related or unrelated feelings and thoughts accurately and honestly
  • The ability to honestly assess their responses and behaviors and to clearly see and understand what they are doing and why
  • The ability to make nonjudgmental, factual decisions about and observations of their experience
  • The ability to be mindful and focused on any one given thing
  • The ability to find coping and reaction strategies that work and to use and stick to those strategies to further their health and happiness

The Goals and Outcomes of Dialectical Behavior Therapy

One of the most beneficial aspects of dialectical behavior therapy is that it’s easy to tell when it is working. In addition to developing the above skills, patients who have had a successful experience in DBT should also enjoy:

  • Decreased frequency and severity of undesired behaviors
  • Increased motivation to change undesired thoughts, feelings and actions
  • Increased ability to cope with situations without resorting to the undesired behavior
  • An understanding and acceptance of their personal strengths and abilities
  • A positive relationship with the therapist
  • Improved relationships with self and others

Dialectical Behavioral Therapy and Self-Distraction

To some patients, the goals of dialectical behavioral therapy may sound unattainable, but it is important to note that not all DBT techniques require the patient to resort to altering their underlying thought processes or undertaking other extreme measures in order to overcome the undesired behavior.

In some cases, simpler techniques can be effective in helping patients to manage their undesired behaviors as they work toward creating long-term change: techniques of self-distraction.

Practical and actionable solutions, self-distraction techniques can be a stepping stone to sustainable healing and can greatly increase the patient’s chances of establishing permanent sobriety from the undesired behavior. Some of the distraction techniques offered in DBT include:

  • Engaging in enjoyable activities instead of in the undesired behavior
  • Shifting one’s focus from self to others
  • Comparison of the self to others in worse conditions or to one’s self in worse conditions
  • Taking specific action that changes one’s emotions from negative to positive
  • Purposefully thinking about other things
  • Engaging in an intense but non-self-destructive experience, such as eating spicy food or going skydiving

By actively and specifically redirecting one’s attention from the negative stimuli, it can improve the patient’s ability to control their quality of life and day-to-day experience.

Why Dialectical Behavior Therapy Is Successful

Dialectical behavior therapy has very high success rates when it comes to greatly decreasing or completely stopping an undesired behavior among teens. This may be due in part to the provision of multiple strategies and techniques for combating unwanted thoughts, feelings and behaviors, as compared to other therapies that provide patients with a single coping mechanism or overall combative strategy.

It makes sense that the more options a person has for resisting an undesired behavior, the more likely it is he will be able to resist that behavior and learn how to continually avoid the self destructive behaviors. If one technique doesn’t work, the patient can try another until he hits on a solution that works for him.

Finding Help

If your teen is suffering from self-destructive behaviors and related negative effects, dialectical behavior therapy may very well be a strong choice for inclusion in his therapeutic treatment plan. A comprehensive and individualized treatment program is encouraged for teens who struggle with substance abuse as well as other co-occurring behavioral and mental health issues. DBT can augment the efficacies of other therapies (e.g., family therapy sessions, peer group sessions) and improve your son’s abilities to handle frustrations in other aspects of his life (e.g., academics, job skills).

You can discuss whether or not DBT will be a positive fit for your teen here at Muir Wood when you contact us today. Each patient’s situation is unique, and not all therapy options are recommended in every case. Learn more about our intensive diagnostic evaluation process when you call the number above or download our admissions packet today.