How is DBT Different and How Does it Help?

DBT stands for Dialectical Behavior Therapy and it is a therapeutic approach for treating certain conditions that commonly impact teenagers.  Although it was originally created as a way to help those diagnosed with borderline personality disorder, it is also proving effective at helping teens who are participating in self-harming activities and those who have acknowledged having suicidal thoughts.  It is an approach to treatment that combines several different kinds of therapy and mental health coping mechanisms into a single overarching program.

One of the most important aspects of a DBT program is the type of relationship that the provider strives to achieve with the client.  In some programs and even during individual therapy practices, the practitioner operates in an adversarial capacity, especially in working with teenagers.  However, in DBT programs, the provider’s goal is to build a different kind of relationship, one where the teen feels supported and the provider is their ally rather than another enemy.

The program also pulls from a variety of therapeutic approaches and techniques aimed at treating the whole person as well as the whole problem.  DBT generally include individual cognitive behavioral therapy, group therapy sessions, mindfulness training and activities, reality testing, distress tolerance, and some assertiveness training.  Let’s look at each of these individually.

  • Individual Cognitive Behavioral Therapy Sessions –This type of therapy helps clients address issues with emotional dysfunction and behavior modification.
  • Group Therapy Sessions – This type of therapy works on building the client’s skills in regulating their own emotions, modifying their behaviors, and tolerating stressors in a more productive way.
  • Mindfulness Training – This practice can help with stress reduction, present awareness, relief of anxiety and depression symptoms, and overall wellness.  This is a core part of DBT as it provides the foundation for accepting, enduring, and overcoming the powerful feelings that clients may be using unhealthy behaviors to manage.
  • Reality Testing – This helps clients understand and differentiate between what is happening in their mind and what is happening in the outside world.
  • Distress Tolerance – This approach helps clients learn to tolerate pain and distress in a non-judgmental way so that they can make decisions and react without becoming besieged by the torrent of negative emotions and self-destructive behaviors they have been using to cope.
  • Assertiveness Training – This part of the program helps clients learn to create healthy boundaries, say no, and handle conflict with other people.

The combination of all this components is what makes DBT such an effective form of treatment for teens.  By learning mindfulness techniques, teens can learn to pause before reacting to negative events.  The distress tolerance and reality testing elements build from there, providing teens with new skills to cope with painful circumstances and past stressors while also being able to separate what is happening from their perception of what is happening.  In their individual sessions, they gain a better understanding of themselves and their emotions and learn new skills for challenging and changing their behavior.  Group sessions provide an opportunity to practice the skills they have learned with their peers and improve their interpersonal skills.  Lastly, the assertiveness training gives them a framework for using the things they have learned out in the world.   When you combine all the skills, strategies, techniques, and tools together, clients get the attention they need to work through complex emotional issues while also building a solid skill set that will enable them to self-manage.  This comprehensive approach is what makes DBT so successful at treating maladaptive behaviors like cutting, self-harm, and suicidal tendencies.

DBT helps because it enables teens to develop a more balanced approach to their lives.  For teens that feel overwhelmed or out of control emotionally, this type of program can provide a sense of regaining some control.   By enabling teens to replace unhealthy behaviors with higher distress tolerance and more appropriate coping mechanisms, it enables them to become better self managers now and as they move into the future.  It is most effective at treating teens with the following problems:

If you have a teenager who is experiencing any of these problems, participation in a DBT program may offer real and lasting benefits by providing your teenager with a safe space to work through their emotions and a new set of skills.


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