What is Dialectical Behavior Therapy (DBT)?

When most of us think of therapy, we picture a scene similar to the one most commonly portrayed on TV.  There is a wood paneled office featuring a therapist in a chair and a patient on a couch.  In reality, therapy can look very different depending on the kind of therapy that is going on.  There are several types of therapy that can be very beneficial in helping teens overcome their mental health challenges.  DBT, which stands for Dialectical Behavior Therapy, is a specific kind of therapy that can be very beneficial for a variety of issues.

DBT was originally developed as a treatment for borderline personality disorder (BPD).  DBT combines several different therapeutic approaches in an effort to help participants develop more comprehensive and extensive coping mechanisms.  This approach uses individual cognitive behavioral therapy techniques, mindfulness, reality testing, distress tolerance, assertiveness training, and group sessions to facilitate modifications in behavior.

A foundational part of DBT is building a relationship between the mental health practitioner and the teen that focuses on creating an alliance rather than making enemies or acting adversarial.   By offering validation and acceptance, the mental health practitioner creates a safe space for the teenager to express feelings that can then be redirected into healthy behavior changes.

DBT incorporates both individual therapy sessions and group sessions.    This two-pronged approach is part of the reason DBT can be so successful.  The group sessions give teens the skills they need to overcome challenges like regulating emotions, practicing mindfulness, increasing effectiveness, and tolerating distress.   Interacting with others their age also gives them the opportunity to practice utilizing these skills with their peers.  The individual sessions provide time to deal with emotional issues in a one-on-one setting.  By incorporating both types of therapy, DBT ensures that teenagers get the individual attention they need while they build and practice the skills they need to self-manage.

Across the different approaches to therapy, DBT is the approach that puts the most focus on developing coping skills.   DBT has been used for 40 years and in the last decade has become an integral part of most, successful eating disorder treatment programs.   DBT breaks the teen’s life up into four main areas, relationships, thoughts, feelings and behaviors.   Because all of these areas are typically deregulated during the course of the illness, DBT is tailor-made for treating eating disorders.

In addition to helping those dealing with eating disorders, DBT can also help teenagers who are engaging in self-harm and struggling with suicidal thoughts.  This approach helps teens develop the skills they need to regulate their emotions, control their behavior, and become more resilient when faced with difficult situations.   The benefit of taking DBT approach is that troubled teens can get the help they need to overcome maladaptive behaviors.

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