Dialectical Behavioral Therapy

A cognitive-behavioral approach to therapy

Teen Dialectical Behavioral Therapy (DBT) is a cognitive-behavioral approach to therapy, focused on the connections between teens’ social interactions and their Mental Health Disorder symptoms.  Originally designed to help treat people with Borderline Personality Disorder, the treatment approach is designed around the premise that certain people who experience extreme fluctuations in mood often tend to experience more intense, significant reactions to stimulation, which are often sustained for a longer-than-average period of time.  These people tend to stay in this “heightened state” longer than others, before they’re able to return to a more “baseline” level.  The goal of Teen DBT is to teach teens coping mechanisms and skills to deal with their fluctuations in mood, and to help the teens make positive changes in their lives, which will lead to more healthy and sustainable moods, overall.  Teen Dialectical Behavioral Therapy can be thought of as similar to Cognitive Behavioral Therapy, but with a less strict emphasis on being a goal-oriented approach, and with careful attention to providing teens with a balance of acceptance and positive change-oriented strategies.

Teen Dialectical Behavioral Therapy has evolved to be included in treatment plans for many different Mental health Disorders and symptoms thereof, especially including treatment for teens experiencing severe Depression, suicidal thoughts, Bipolar disorder, Self-Harm, or other illnesses that result in extreme mood fluctuations or lows.  The therapy progresses from most urgent/prevalent issues (such as ensuring the teens’ physical safety, in cases of suicidal thoughts or Self-Harm cases) to less urgent issues, in order of relevance, with the goals in mind of making sure the teens remain physically safe, that they remain in treatment, and that they make positive changes to their lives, through the treatment process.

Though Adolescent Dialectical Behavioral Therapy has a number of similarities to different therapy approaches, there are a number of functions and strategies that are unique to DBT, alone. Some of these include the Support Strategy, Structuring the Environment, teaching skills to help teens regulate emotions, the Dialectical philosophy, and Mindfulness.  The Structure Support of DBT is essentially therapists working with teens to help restore a positive self-image, and help the teens to build on their strengths, rather than focusing on their weaknesses. Structuring the Environment involves therapists both providing teens with a safe place of non-judgement in which to experience treatment, as well as teaching teens ways in which they can alter their own environments (i.e. not hanging out with a particular harmful crowd), in order to be more successful.   Therapists also work with teens to help them evaluate the ways and times they respond strongly to things, and how to better manage their reactions to such strong emotions.  The Dialectical philosophy refers to the balance of therapists helping teens know that they are accepted just as they are, while they’re also being encouraged to make positive changes, in order to move forward and grow.  And therapists also teach Mindfulness to teens, which is a concentration upon being fully present and noticing oneself and one’s environment, without judgment.  Over time, by teens learning to be fully engaged in the situation they’re currently in, without reacting to it one way or another, they also learn to observe themselves in situations, which in turn, helps them to better manage and notice their reactions.

At Paradigm, Dialectical Behavioral Therapy is used in conjunction with a number of other approaches and techniques, as therapists design a treatment plan best suited for each individual teen.  Similarly, some of the principles and tools of DBT might also be incorporated to other forms of treatment.

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