What is DBT?
Dialectical Behavior Therapy, or DBT, is a type of therapy that was designed to help individuals manage difficult emotions and improve relationships. DBT was originally developed as an intervention for adults experiencing intense emotional distress and has since been adapted for children and teens. DBT can be effective in helping children and teens with anxiety, impulsivity, and frustration. DBT can also be effective in helping with relationship quality, school performance, and self-esteem.
There are four main areas of DBT. Together, these four areas can help clients to handle daily challenges and develop skills that can support their mental well-being over time.
Listed below are the four different areas:
Mindfulness: This is meant to help clients to remain in the present moment
Distress Tolerance: This is meant to teach clients how to handle difficult situations without turning to impulsive or harmful behaviors
Emotion Regulation: This is meant to help clients to identify, understand, and manage their own emotions.
Interpersonal Effectiveness: This is meant to help client to build communication skills, learn to set boundaries, and develop healthy relationships with their friends and family
What does it mean to be dialectical?
The term “dialectical” refers to the balance between two opposing forces. Essentially, this means finding the middle ground between two opposite ideas. In therapy, understanding dialectics means helping the client to understand the numerous complexities of life.This can help individuals to restructure black-and-white thinking while understanding areas that they may need to grow. For example, if a teen client is fighting with a friend, they may think “I am really mad at them right now”. In session, we will work on understanding that you can be mad at someone AND still really care about them. Then we will work towards emotion regulation and communication skills to take some important steps towards change.
Different Interventions Using DBT
Here are a few examples as to how I might use different DBT strategies in session:
Frustration Tolerance:
Kids and teens often struggle dealing with frustration which may lead to explosive or impulsive behavior. In session, we may begin to target emotion regulation and mindfulness skills. An example of this might be to teach clients to connect with their 5 senses by taking time to notice things that they see, hear, touch, smell, and taste. This may help the client to shift their focus and begin to use other skills.
Radical Acceptance:
This skill teaches clients to acknowledge situations that they may not like or control. For instance, if a client is upset about a rule that they don’t like, we may discuss in session how accepting the situation may ultimately make them feel better. In session, I will explain that they may not be able to control the situation, but they can control their reactions.
Impulsivity Management:
A DBT skill used to help reduce impulsive behavior is the STOP skill. This skill encourages clients faced with making an impulsive decision to Stop, Take a step back, Observe their thoughts and feelings, and Proceed Mindfully. In the session, the client and I will talk through different situations to practice this skill and to help the client learn to process a situation before acting.
Emotion Regulation and Mindfulness:
These are skills that may be difficult for clients at first. The goal for these strategies are to teach clients different coping skills to use. This can be initially helpful for clients to help them to lessen negative behaviors such as yelling, hitting, and many others. Different coping skills may be deep breathing, body scans, or even listening to music. These techniques can help clients to learn practical ways to regulate their emotions and begin to feel more in control.
How I Implement DBT in Session
My approach to therapy is often integrated. This means that I tailor treatment to fit the individual needs of each client by blending elements of DBT with other therapeutic strategies. I also focus on creating a collaborative space where clients feel comfortable talking about their emotions and practicing different skills.
When introducing DBT to children and teens, I always want to make sure to explain things in a way that clients can understand. In the first few sessions, I begin with teaching clients mindfulness and distress tolerance skills because these skills provide immediate tools for symptom management.
Conclusion:
In summary, DBT offers children and teens skills to help them understand and manage their emotions, build resilience and handle challenges in life with confidence. With practice and guidance, clients can independently use skills in frustration tolerance, radical acceptance, and emotion regulation at home. Every client is unique, and DBT’s flexibility means that treatment can be a truly personalized approach. The adaptability ensures that each client feels supported in a way that meets their personal needs and empowers them to thrive beyond therapy.
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At Cutting Edge Counseling of the North Shore, we're proud to offer our services to clients in Northbrook and the surrounding communities, including Glenview, Deerfield, Highland Park, Wheeling, Northfield, Glencoe, Winnetka, Buffalo Grove, Riverwoods, Lincolnshire, Prospect Heights, Vernon Hills, Mount Prospect, Arlington Heights, and Des Plaines. Our commitment is to provide personalized and effective therapy to help you achieve your goals.
Written By,
Jordan Adamson, LPC
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