What Is Dialectical Behavioral Therapy, and Is It Good for My Teen?

By: Jacqueline Anderson, LPC 

“What my son needs are more coping skills so he doesn’t keep going from zero to one hundred.”

“I wish I could stop reacting without thinking all of the time.”

“My daughter could really use something more than weekly counseling. Can she come see you twice a week?”

In my work with teen clients and their families, these are comments that I often hear. So much of our work as counselors is two-fold: We create a space for the client to feel heard and to process what it is that they are going through, while at the same time we aim to impart new skills and new perspectives. The problem is that we only have so much time to do these things in each session. Some clients can benefit from more focused and dedicated time learning and practicing new coping skills that will help them with the day-to-day challenges they face. I draw from Dialectical Behavioral Therapy (DBT) because it helps me bring practical coping skills into my work with teen clients.

What is Dialectical Behavioral Therapy (DBT)?

The world “dialectical” means holding two opposing forces together at the same time. In DBT, the biggest example of this is reconciling the ideas of acceptance and change. Woven throughout the DBT method is an emphasis on change (i.e. changing our approach) while also focusing on acceptance (how can I sit with the discomfort of this situation and accept that there’s nothing I can do right now?).

Dialectical Behavioral Therapy was created by Marsha Linehan, Ph.D., as a treatment for individuals with borderline personality disorder. However, it has now been shown to be effective with individuals experiencing depression, eating disorders, bipolar disorder, post-traumatic stress disorder, substance abuse, and more. I truly believe that all of us as humans can benefit from the skills taught in DBT!  

DBT is broken up into four modules: mindfulness, distress tolerance, emotion regulation, and interpersonal skills. Individuals who benefit from DBT often have difficulty controlling their emotions, want to improve their impulse control, may find themselves stuck in a pattern of rocky relationships, and/or want to be more grounded in the present. A true DBT program involves a few components, including a weekly skills group, weekly individual therapy sessions, and phone coaching. In addition, DBT therapists meet regularly with a consultation group to collaborate and support each other in the work.

DBT Skill Creative Arts Group for Teens

At Sunstone, we run weekly DBT skills groups for adolescents that follow Linehan’s curriculum. Over sixteen weeks, we go through each DBT module, covering at least one skill per session and spending time on a corresponding creative arts activity.

For example, in a recent group, we discussed distress tolerance and how we can self-soothe with each of our five senses when we are trying to get through an emotional crisis moment (examples of soothing with our sense of touch could be wrapping ourselves up in a warm blanket, baking cookies, finger painting, etc.). For our corresponding art activity, we decorated smooth stones that can be reminders of soothing by touch and sight. Group members then took these “self-soothe” stones home to both look at and hold in their hands when they’re feeling distressed.

This group is a great option for adolescents who could benefit from that focus on coping skills in addition to meeting for individual therapy. The arts component serves to reinforce the skills we are learning and it allows the teens to relax in the moment and to express themselves creatively.  If you’re interested in learning more about the group, please contact Jacqueline Anderson, LPC.