Comprehensive DBT Program
for Adolescents & Young Adults
What is DBT?
Dialectical Behavioral Therapy (DBT) is a comprehensive and evidenced-based intervention that has been shown to decrease emotional dysregulation (reactivity) and a wide range of crisis oriented impulsive behaviors such as suicidal ideation, self-harm, and avoidance behaviors significantly impacting functioning. “Dialectical” means there are two opposing truths that are accepted and addressed at the same time. The fundamental “dialectic” in DBT is the concept that we are both accepting what is happening now and working to change it. DBT is a type of psychotherapy that emphasizes both cognitive and behavioral strategies and relies on learning a new set of skills to replace ineffective coping behaviors that create secondary problems.
This intervention was developed by Marsha Linehan in the 1980s and was originally designed to treat people with borderline personality disorder. Over the years and more recently, it has been utilized with a wide variety of populations who struggle with a high emotional sensitivity and reactivity and need ways to be more effective in managing their emotions and relationships. It has been found to work well with both adolescent and adult groups and there are skills curriculums designed for each. It is also important for parents to learn DBT skills.
Raising children who experience their emotions intensely can be very challenging. Typical parenting strategies tend not to work very well with this population, who require more thoughtful, deliberate, and directed approaches. It is as important for parents to learn DBT philosophy and skills as it is for the client.
When all parties in the home environment are utilizing common language and skill sets, it allows the environment to become a safe and validating place for practice and integration of the DBT skills, which can significantly improve functioning and relationships.
What will comprehensive DBT look like if my family chooses this treatment?
There will be pre-treatment first.
Before beginning skills training, clients engage in 4-6 sessions of pre-treatment. During this time the therapist establishes a relationship with the client and conducts a thorough assessment (including a parent interview session), establishes goals, orients the client to the process and tools of DBT, and addresses any barriers that may interfere with the client engaging successfully in the treatment.
Clients are asked to demonstrate a willingness and commitment to the DBT process and tasks and to give the intervention an honest chance by agreeing to maintain safety and commit to creating a life worth living.
There are DBT skills modules.
Core Mindfulness: Skills to live in the present moment by accepting what is, not judging things and exhibiting compassion.
Emotion Regulation: Skills to be more in touch with the experience of emotion and take care of ourselves regularly to limit vulnerabilities that can make us more susceptible to our emotions.
Distress Tolerance: Skills to tolerate difficult and uncomfortable emotions and body sensations associated with intense emotions.
Interpersonal Effectiveness: Skills to communicate effectively that help to develop and maintain relationships.
Walk the Middle Path: Skills that move us away from all or nothing patterns of thinking and allow for greater choices, compromise, and consideration of others’ perspectives.
There are essential DBT components.
In order for DBT to be adherent to the evidence-based model it must have the following:
Skills Training Group
DBT Consultation Team
How does the "DBT Skills Group" work?
Each module is taught in 5 weeks with core mindfulness taught for 1 week in between each of the other modules. There are 4 modules plus the core mindfulness sessions = 24 sessions per cycle. Parent skills groups may meet for fewer total sessions though cover all the same skills. A full round of skills training takes approximately 24 weeks (give or take). It is common for clients to repeat a second cycle or more of skills training if skills are not yet integrated and goals not yet met. The team will consult with clients and families on progress toward treatment goals and the recommendation for continued skills group training beyond one cycle.
It has been our experience that due to the focus on safety and stability for most clients during the first cycle, this is a time when skills are introduced though are not yet absorbed. Once greater stabilization has been achieved, a second cycle helps to integrate and apply the skills with greater awareness and thoughtful deliberation. DBT can take anywhere from 6-24 months to achieve best and lasting results.
Due to the intense nature of this intervention there are very few weeks that are cancelled for holidays or vacations. Please see our attendance policy.
Once skills training is complete, a graduate DBT group is available to help clients continue to utilize skills in their daily lives and access support and coaching in session from peers. Parents do not attend a parent group once their adolescent is in graduate group.