Dialectical behavior therapy (DBT) has been hailed by celebrities recently, including Maisie Williams, Selena Gomez, and Lady Gaga. However, recently endorsed by these celebrities, DBT has been around for some time. So, what exactly is DBT? When was it invented? Why is it currently so popular? And finally, how is it beneficial for teens, especially for residential treatments?
What is DBT?
Dialectical behavior therapy for teens (DBT) refers to talk therapy based on cognitive behavioral therapy specially designed for people who experience intense emotions. DBT treats issues resulting from unhealthy or problematic, intense, negative emotions by teaching them healthier coping methods. These issues include borderline personality disorder, post-traumatic stress, suicidal behavior, eating disorders, anxiety, depression, and substance use disorder.
Overview and History of DBT
Marsha M. Linehan developed DBT in the 1980s. Linehan combined behavioral science and Zen principles to create a treatment that would help individuals with chronic thoughts of suicide and individuals diagnosed with borderline personality disorder (BPD). She noticed other therapy methods, especially teen cognitive behavioral therapy, did not work for people with borderline personality disorder. People with BPD often experience very intense emotions that can prove to be difficult for them to manage. Their typical reactions include crying, passive-aggressive behaviors, and bursts of anger.
Theoretical Underpinnings of DBT
There are three theories that inform DBT. These are dialectics, Zen Buddhism, and biosocial theory.
- Dialectics are defined as systematic reasoning, exposition, or arguments of any kind that contradictory ideas in a manner seeking to resolve their conflict. In DBT, dialectics are applied in a way that the patient is taught two seemingly opposite concepts: acceptance and change. The patient is taught and encouraged to accept that their behaviors and experiences are legitimate. At the same time, they are also taught about making positive changes to have control of their emotions and move forward.
- Zen Buddhism emphasizes the use of meditation to awaken one’s inner nature, compassion, and wisdom. In DBT, Zen Buddhism is applied in teaching patients various skills that help them be more mindful and self-aware. The skills learned to help the patient manage their emotions and control their thoughts and actions.
- The biosocial theory states that biological dysfunction in emotion regulation coupled with an invalidating environment results in pervasive emotional dysregulation. In DBT, the theory aids the therapist and the patient in identifying and dealing with the causes of emotional dysregulation in the patient.
Components of DBT
DBT highly focuses on skill training to achieve the desired results of making the patient able to manage their emotions and control their behavior. There are four main skills taught in DBT. These are;
- Mindfulness refers to the practice of having full awareness and focusing on the present instead of being worried about the past or future.
- Emotion regulation involves understanding and being more aware of your emotions and having control over them.
- Distress tolerance entails understanding and managing your emotions in stressful or difficult situations without reacting to harmful behaviors.
- Interpersonal effectiveness entails understanding how to ask for what you want and need while setting boundaries and maintaining respect for yourself and others.
Why is DBT Effective for Teenagers in Residential Treatment?
If you are a parent or guardian dealing with a teen and do not have a clue on what to do to help them manage their mental health, thank the heavens for DBT. For adolescents having mental health issues, especially those with disruptive mood dysregulation disorder (DMDD), DBT would be of great benefit in helping them regulate their emotions and have them under control. When used in residential treatment, DBT can be highly effective. This is due to the following reasons;
- DBT therapists in residential treatment are not judgemental and have an accepting attitude. Therefore, they are likely to be welcomed by teenagers struggling with self-acceptance.
- Through DBT, teenagers learn various skills that help them understand, manage and control their emotions and actions.
- DBT helps identify and treat various mental health problems teenagers deal with. These include but are not limited to anxiety, depression, ADHD, BPD, and disruptive behavior disorders.
The Relationship between DBT and Adolescent Development
DBT teaches adolescents skills that help them to acknowledge their emotions without feeling judged, after which they can learn the skills and techniques required to manage their emotions. In this way, adolescent can improve their lives and emotional well-being.
DBT is designed to meet the developmental needs of adolescents. Adolescence is a time of intense emotional, physical, and cognitive development. It is when teenagers develop their identity, learn how to regulate their emotions, and navigate complex social relationships. DBT helps teenagers build the skills required to manage their thoughts, emotions, and relationships healthily.
The Importance of Validating and Accepting Teenagers' Experiences
Everybody, including teenagers, should be validated for their feelings, perceptions, and experiences. Validation is not the same as approval. Rather, it is the recognition of a person’s experiences as being real and valid. Validation has several benefits for the person being validated, especially teenagers. These benefits include;
- It models healthy ways for teenagers to talk about their emotions. When you validate a teenager’s experience, you present them with a conducive environment for opening up and talking about their emotions without feeling like they are going to be judged.
- It builds a teenager’s self-confidence and trust. When you validate a teenager, you tell them you love them as they are, including their feelings, and that they are trustworthy. This will boost their self-confidence and build their trust.
- It reaffirms to teenagers that feelings are not a negative thing. By validating your teenager, you are telling them that feelings are normal and it is okay to have them. You destroy the notion that having emotions is a negative thing. Once teenagers know of this, they easily open up, allowing themselves to be helped to correct emotions and behaviors.
Benefits of DBT for Teens
In case you are wondering why DBT is highly recommended for teens, well, there is a simple answer: DBT has several benefits for teens. These benefits include the following;
- DBT allows teens to learn various skills that help them to be more accepting, less judgmental, and capable of thinking logically. DBT therapists guide teens to make more balanced, effective, and less impulsive decisions.
- DBT is a proven mode of therapy that helps its patients deal with anxiety, depression, trauma, and stress, among other mental health issues. It is, therefore, very important for teens struggling with their emotions or facing mental health issues.
- Through DBT, a patient, in this case, a teen, can learn skills such as mindfulness, distress tolerance, emotional regulation, and interpersonal effectiveness that are essential for dealing with the turbulence of adolescence. This also improves teens’ self-worth and self-respect.
- DBT makes teens intentional about therapy. Teens go to group treatment knowing that they are being supported. When teens who have undergone DBT therapy get to their group sessions, they check in with the genuine intention to share and learn interpersonal skills. Furthermore, being part of DBT, the group sessions provide the teens with the required peer experience that offers real motivation and connects them.
- Through group sessions, teens learn to be responsible, they learn how to solve problems. DBT teaches teens that things do go wrong in life and it is okay when they do. This is reinforced in the stories of others as they share in the group. Once they know this, they can reach out to each other amid pain and confusion while applying the DBT skills they have learned.
Teen Treatment Program Facilitating DBT
Residential Treatment
This is a structured, live-in program undertaken at a licensed treatment facility for patients struggling with addiction. In inpatient treatment for teens, your teen is put under 24-hour care and support by the therapists, nurses, and other healthcare providers in their facility. They are looked after as they undergo treatment while at the facility. Their time in the facility depends on the time the therapist or doctor recommends.
The teen residential treatment aims to support the patient’s efforts to overcome substance use disorder. Services offered in residential treatment include a comprehensive assessment of a patient’s substance use over time, crisis and family counseling, individual and group therapy, and education on substance use and abuse.
Partial Hospitalization Program (PHP)
A partial hospitalization program (PHP) is a structured outpatient psychiatric services program. It is specially structured to be intensive to be a suitable alternative to inpatient treatment for patients requiring a high level of care. A teen in PHP receives treatment during the day and leaves in the evening. They do not have to spend the night at the facility where they receive treatment.
Intensive Outpatient Program (IOP)
This treatment program is used to treat addictions, eating disorders, depression, or other dependencies that do not involve detoxification or 24-hour supervision. Unlike other outpatient programs, intensive outpatient programs allow teens to continue their daily activities.
An intensive outpatient program for teens may sometimes be combined with in-patient programs to help clients reintegrate with their families and communities smoothly. They are structured in a manner that helps with relapse management, establishes support mechanisms, and provides coping mechanisms.
Treatment Modalities Used in Teen Residential Treatment
Treatment modalities in therapy refer to the therapeutic techniques, processes, or approaches used to help treat and improve a patient’s emotional, psychological and social well-being. The most commonly used treatment modalities in teen residential treatment include family, group, individual, mindfulness-based, psychodynamic, and trauma-focused therapies, which are discussed below.
Family Therapy
Family therapy plays a huge role in the treatment of your teen. But not just that, it also helps improve the well-being of your entire family. During this therapy, your entire family recovers from the issues that had developed as a result of your teen’s mental health problems or addiction. Through teen family therapy, your entire family understands your teen’s issues, improves communication, and learns how to create a conducive and supportive environment for your teen’s recovery. This modality helps to improve communication amongst your family members, build healthy relationships, and promote recovery.
Group Therapy
As the name suggests, group therapy is therapy done in a group. It involves bringing teens experiencing similar issues together to discuss their mental health problems. This therapy mode is used mostly to treat trauma, among other mental health problems and co-occurring disorders. During teen group therapy, teens are taught coping and communication skills. They are given room to share their personal experiences openly and honestly. As they do so, other teens in the group offer nonjudgmental attention and support. The sessions enhance the teenagers’ self-esteem, communication, and coping skills and help them to rebuild their trust after trauma.
Individual Therapy
Individual therapy is a one-on-one treatment experience with a therapist. A teen works through their mental health issues with the help of a therapist in a calm, safe, and confidential setting. During the teen individual therapy sessions, teenagers acquire insight into their problems as they are taught how to manage and cope with their symptoms.
Mindfulness-Based Therapy
Mindfulness means staying aware of the present. Mindfulness-based therapy involves teaching teens awareness and how to accept their situations as they come and go without judgment. Through this therapy, teenagers learn mindfulness techniques, such as meditation and deep breathing, which help them manage stress and regulate their emotions.
Psychodynamic Therapy
This type of therapy assists teenagers in understanding their underlying feelings and thoughts. In this case, the therapist brings the teenager’s unconscious thoughts into the conscious mind. This technique helps teenagers explore their emotions and determine how their unconscious thoughts affect their emotions and contribute to their mental health problems.
Trauma-Focused Therapy
As the name suggests, trauma-focused therapy focuses on trauma. In this type of therapy, a teenager is taught new skills and strategies that help them to understand, cope, and move on from the trauma they faced. The goal of the therapy is to empower teens to be more focused, lead healthier lives free of the trauma they faced, and have the competence to look into their future with hope and vigor.
How Does DBT Compare to Other Therapies Used in Residential Treatment?
Advantages of DBT Over Other Therapies
There are two advantages that DBT has over other types of therapy like ACT and CBD. First and foremost, in DBT therapy, patients are taught acceptance, which enhances their self-esteem and confidence. The other advantage is that teens are taught various skills that help them manage their thoughts and emotions, improve their interpersonal relationships, and be assertive.
Limitations of DBT in Comparison to Other Therapies
Compared to other types of therapy, DBT is very intensive. Although this may not be a disadvantage, it is worth noting that it may not be suitable for all teens and conditions. Unlike other therapies, it requires much commitment from the teen and their families to be effective.
Other than its intensive nature, some people, for religious reasons, may have reservations about it due to the incorporation of Zen Buddhism in DBT.
What Can You Expect from DBT Treatment in a Residential Setting?
The Structure of DBT in a Residential Setting
DBT is a well-structured type of therapy. There are several steps that a patient takes when they enroll for DBT therapy.
Pre-Treatment
This is the first step in DBT therapy the therapist and patient establish a working relationship and are ready for therapy. In this stage, the therapist determines whether therapy can begin or not, depending on the readiness and willingness of the teen patient. It is also in this stage that the therapist breaks down what DBT is to the patient.
Stage One
This is when therapy begins. It is also the most known stage of DBT. In this stage, the therapist focuses on helping the teen patient to control their behavior.
After stage one is completed, the patient is taken through four modes of therapy. These are individual therapy, group skills training, inter-session contact, and peer consultation team meetings.
Individual Therapy
As earlier mentioned, teen individual therapy is a one-on-one treatment experience with a therapist. The patient works through their mental health issues with the help of a therapist in a calm, safe, and confidential setting. These sessions are done weekly and are structured. Normally, the therapist gives the patient homework, including a diary card that the patient should fill out.
Group Skills Training
After individual therapy, the next component is group skills training, a psychoeducational group that takes about two hours weekly. The group normally consists of between three and ten individuals. During this training, the patients are taught various skills, which include mindfulness and interpersonal skills.
Inter-Session Contact
Inter-session contact is another component of DBT therapy. This component involves communication between the therapist and the patient in between the scheduled sessions. It may take various forms, such as telephone coaching or continuous support. This is especially relevant when a patient has an individual therapist in a residential unit. This setup ensures that there is a 24-hour intersession availability.
In the case of individual therapy, patients may have direct communication channels with their therapist. Such channels include personal cell phone numbers for calls, texts, or emails. However, it’s crucial to establish and uphold boundaries in managing this contact.
Peer Consultation Team Meetings
This is the final component of DBT therapy. Weekly meetings between all the patients’ treatment team members take a maximum of two hours. These meetings aim partly to support the treatment team and act as a forum for discussing cases and applying DBT principles to the case.
The Roles of The Treatment Team in DBT
The treatment team is the main resource for delivering effective treatment to the patient. They are responsible for caring for the patient through the entire treatment period. All team members play different roles depending on their expertise. For instance, the therapist is responsible for working closely with patients to help them develop skills to manage their emotions and behaviors. A psychiatrist, on the other hand, would be responsible for providing medication management for underlying conditions. Other mental health professionals may lead group therapy and skills training sessions depending on their expertise.
The Daily Routine of DBT in Residential Treatment
The daily routine of DBT in residential treatment normally involves structured therapy sessions, skills training, and recreational activities. Additionally, the routine may include additional support and coaching from the treatment team as may be required. To monitor progress, the teens are required to record their emotions and behaviors in DBT diary cards twice a day.
How to Choose the Right Residential Treatment Program for Your Teen
Factors such as the
- Program’s Philosophy,
- Their staff qualifications and experience,
- Treatment approach,
- Location,
- Cost is very important when choosing a residential treatment program for your teen.
Questions You Can Ask When Evaluating a Residential Treatment Program
Asking questions about the residential treatment program you are considering for your teen helps you better understand the program and determine whether it is suitable or not. Some of the key questions to ask about a residential treatment program include the following:
- What is the program’s success rate in treating conditions similar to that of your teen?
- What qualifications and experience do the staff have?
- What is the staff-to-patient ratio?
- What types of therapy and treatment modalities are used in the program?
- What is the program’s policy on family involvement, and how often will you be able to communicate with your teen?
DBT Teen Residential Treatment at Key Healthcare
At Key Healthcare, we believe in the power of healing and the potential of youth. Our center is more than just a treatment facility; it’s a haven of hope in Malibu’s heart. With each sunrise, our serene surroundings offer a new beginning for teens struggling with mental health challenges. Here, every teenager is seen, heard, and valued, embarking on a personalized journey towards resilience and self-discovery. Our wide range of services ensures that each individual’s unique needs are met with the utmost care and expertise, setting the foundation for a future filled with possibility.
DBT for Teens by Key Healthcare
- Part of the teen treatment programs at Key Healthcare.
- Teens participate in individual and group therapy sessions employing DBT to address mental health conditions and substance abuse.
- Key Healthcare also offers a comprehensive residential treatment program, providing a supportive environment for adolescents to overcome challenges.
Here are the key details about Dialectical Behavior Therapy (DBT) for Teens offered by Key Healthcare, presented in pointers:
Components of DBT
- Individual Therapy Sessions
- Group Skills Training
- Phone Coaching
- Mindfulness (Middle Path)
- Distress Tolerance
- Interpersonal Effectiveness
- Emotion Regulation
Insurance Coverage of Teen DBT
Key Healthcare works with most health insurance providers, potentially covering up to 100% of the costs.
Preparing for DBT in Teen Residential Treatment
Steps to take before starting DBT in residential treatment: Before taking your teen for DBT residential treatment, you must prepare them on what to expect and ensure that they are ready and committed to the process. This normally involves discussing the treatment plan with them, setting realistic goals and expectations, and addressing any concerns or questions they may have concerning the treatment.
How to Involve Your Teenager in The Preparation Process
Involving your teen in the preparation process can help them become more invested and committed to their treatment, improving the chances of successful treatment. If you do not know how to involve your teen in the preparation process actively, here are some tips you can rely on:
- Discuss with your teen the treatment’s benefits and potential challenges they may face.
- Encourage your teen to express their feelings and concerns about the treatment.
- Try as much as possible to involve them in the decision-making process. For instance, consider their opinions on the preferred treatment facility you choose.
- Partner with the treatment team to create a personalized and individualized treatment plan that meets your teen’s needs and goals.
Incorporating DBT Skills into Daily Life
your teen must incorporate the DBT skills they learn daily to help them cope with the distress outside of therapy. As a parent or guardian, you have a role to play in this. Ensure your family helps your teen settle back in and continue healing after therapy. Some of the strategies for practicing DBT skills as a family may include mindfulness exercises, active listening, and using “I” statements to express emotions.
Maintaining DBT Progress After Residential Treatment
One of the recomended ways of maintaining DBT progress after residential treatment is through aftercare programs. Aftercare programs such as support groups and individual therapy can help your teen continue to build upon the skills learned in residential treatment. As a parent or caregiver, you can support your teen’s ongoing progress by encouraging their involvement in aftercare programs, practicing DBT skills as a family, and promoting a healthy and positive lifestyle.
Conclusion
DBT is undoubtedly one of the most effective therapy treatments for teenagers who struggle with various mental health problems.DBT stands out as the best option for your teen to recover from trauma and other mental health problems. At the end of DBT therapy, a teenager will be able to manage and cope with their emotions and behaviors while also helping them build their self-worth and self-awareness.
Frequently Asked Questions (FAQs)
By teaching mindfulness, emotion regulation, distress tolerance, and interpersonal effectiveness, DBT helps individuals manage their emotions and cope with distress. Additionally, DBT therapists work with their patients to develop safety and intervention plans to use during crises.
DBT addresses co-occurring disorders by addressing all the issues that are contributing to mental health problems. It not only focuses on the patient’s mental health but also looks into and addresses other areas of the patient’s life, such as their relationships.
Yes. DBT can be used in combination with medication. However, medication is not always required and is typically used to manage symptoms that may be difficult to control through therapy alone.
When taking your teen for DBT treatment, prepare them adequately for the treatment by discussing with them what DBT is and what it involves, what to expect, and setting realistic goals. During the treatment, be patient and understanding, and continue encouraging your teen to attend therapy and participate in the group sessions. While at home, help your teen practice the skills they have learned in therapy and provide a safe and supportive environment.
Normally, DBT treatment should last between six to twelve months. The specific duration will depend on the needs and progress of a patient.
