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Teen DBT Program
Dialectical Behavior Therapy (DBT) is a specialized approach for treating emotional dysregulation. It is an evidence-based treatment, meaning its effectiveness has been examined and verified through research. To provide DBT at Village Counseling and Wellness, our therapists undergo extensive training and are part of a DBT consultation team.
DBT for Teens treats:
- Chaotic relationships with peers
- Family conflict
- Confusion about self
- Impulsive behaviors
- All-or-nothing thinking
- Suicidal thoughts or actions
- Self-harming behaviors (cutting, hair pulling, skin picking, etc.)
- Alcohol or drug use/abuse
- Violence towards self or others
- DBT for teens includes four essential parts
- Individual therapy
- Skills training
- Coaching calls
- Therapist participation in a consultation team
If even one of these 4 parts is missing, DBT treatment is no longer evidence-based or as effective as it can be. Therefore, the Village Counseling and Wellness DBT for Teens program requires participants to:
- Commit to at least 20 weeks of treatment
- Attend weekly, 50-minute, individual therapy
- Attend weekly, 90-minute, multi-family skills group
- Teens make appropriate use of phone calls to their assigned therapist for help in using new skills
- Parents make appropriate use of phone calls to assigned therapist for help using/reinforcing new skills
- Weekly Individual Therapy
A brief parent check-in usually occurs. Family therapy sessions may be scheduled as needed. Sessions start by reviewing a weekly Diary Card, where the adolescent has monitored daily emotions, urges, treatment compliance, etc. This method of treatment clarifies the cause-and-effect role between thoughts, feelings, and behaviors. Alternatives to unsafe/ineffective behaviors are reviewed and practiced.
Weekly Skills Training Class
Each teen, plus at least one parent/guardian, is required to attend weekly Skills Training. This is where DBT skills are taught, reviewed, practiced, and reinforced in a class setting. This is not a traditional therapy group, where people get together to discuss problems. This is a class where skills are taught. Parents are required to attend because, with adolescents, it is critical that a guardian learn, know, practice, and reinforce the adolescent’s new skills. There is much to learn on the family’s part. It is difficult for a teenager in a family to change behaviors, if everyone else stays in the same old patterns. There are 5 modules that are taught over the course of the program.
Mindfulness helps people accept and tolerate powerful emotions. The concept of mindfulness is derived from traditional Buddhist practice, though the version taught in DBT does not involve any religious or metaphysical concepts. Within DBT it is being able to pay attention—non-judgmentally—to the present moment. Mindfulness is living in the moment, experiencing one’s emotions and senses fully, yet with the detachment that allows perspective.
Emotion Regulation is experiencing and expressing emotions without resorting to inappropriate or ineffective behavior. Young people who have difficulty regulating emotions express themselves volatilely, such as screaming, lashing out verbally or physically, and acting aggressively toward themselves and others. These behaviors make it difficult for others to enjoy being around them, and then social problems get even worse. Emotionally dysregulated youngsters are more at risk of being excluded from social groups.
Life happens, including tough situations. Learning how to tolerate distressing emotions and events is important. It is important to learn to deal with negative events or situations without resorting to behaviors that make things even worse. Distress tolerance is managing unpleasant feelings and situations by using effective skills. It is often not possible to change circumstances, but it is possible get through difficult situations in a skillful manner.
Healthy relationships are equitable and balanced. Appropriate boundaries are important, including how to balance one’s priorities and demands with the other persons priorities and demands. It means knowing when and how to ask for help. It means knowing when to say “yes” to someone and when to say “no.” It is about getting one’s needs met, but not at the expense of another person’s needs.
Walking the Middle Path
Walking the Middle Path is about avoiding extremes. It is seeing the truth in both sides of the story. Two things that seem like opposites can both be true. For example, these opposite statements are viewed as both true: (A) The teenager is doing the best he/she can, and B) The teenager can do better. Parents can be firm AND gentle. Teenagers are independent AND dependent. Moving away from either/or thinking to both and thinking improves the foundation from which parents and teens communicate.
The purpose of these calls is to coach teens or their parents—during stressful moments—to use DBT skills instead of resorting to ineffective behaviors. The calls are short—no more than 10-15 minutes, but are very helpful in moving the skills out of the therapy office and into real life.
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