Dialectical Behavior Therapy (DBT) is an evidence-based talk therapy that helps teens manage overwhelming emotions, stop harmful behaviors, and build healthier relationships. At Newport Academy, DBT is a key part of individualized treatment plans, helping adolescents with conditions like depression, anxiety, self-harm, substance use, and eating disorders.
DBT teaches four essential skill areas:
Interpersonal Effectiveness – Balancing your needs with others’, communicating assertively, and maintaining self-respect.
Mindfulness – Staying in the present without judgment, noticing thoughts and feelings clearly.
Distress Tolerance – Ending destructive patterns by building resilience, including radical acceptance of situations beyond one’s control.
Emotion Regulation – Learning to name emotions, change unhealthy emotional reactions, and act in ways that support wellbeing.
Key Takeaways
- Dialectical Behavioral Therapy was originally developed to address symptoms and behaviors associated with Borderline Personality Disorder. However, today DBT skills are used for many different mental health conditions and behavioral disorders.
- DBT skills for teens cover four distinct areas: mindfulness, distress tolerance, emotion regulation, and interpersonal effectiveness.
- Adolescent DBT also utilizes prescribed approaches to strengthen relationships by helping teens engage in healthy conflict, respect others’ viewpoints, and express their own wants and needs.
- At Newport Academy, each teen’s individualized treatment plan includes DBT skills along with a wide range of other clinical and experiential modalities.
The History of Dialectical Behavioral Therapy
DBT is a branch of psychotherapy that was originally developed by Marsha Linehan, PhD, as a way to treat individuals with suicidal thoughts who were diagnosed with Borderline Personality Disorder (BPD). People with BPD often experience extremely intense emotions that can be difficult to manage and cause a great deal of chaos and conflict in their lives. They typically react with bursts of anger, crying, and passive-aggressive behaviors.
Borderline Personality Disorder can also manifest as poor self-image, disordered eating, substance use, instability in interpersonal relationships, lack of impulse control, and suicidal ideation. DBT was designed to help reduce these BPD symptoms. However, DBT skills are now used not just for BPD-related issues. They are also helpful in addressing maladaptive behaviors occurring as a result of other mental health conditions, including trauma, depression, and anxiety. Therefore, DBT has evolved to become a common treatment modality for children and adolescents.
The term “dialectical” comes from the idea that bringing together two opposites in therapy—acceptance and change—will produce better results than either one does alone. One unique aspect of DBT is the focus on acceptance of a person’s experience as the first step in the process of changing negative behaviors.
How Does DBT for Teens Work?
DBT research has shown that DBT is effective in treating many disorders, including teen substance use disorder, depression, post-traumatic stress disorder (PTSD), and eating disorders. DBT is known for helping teens cope with and regulate their emotions.
In addition, DBT shares many concepts with Cognitive Behavioral Therapy. The main objective of DBT is to first stop a destructive behavior, then work on the negative thinking patterns that lead to that behavior. The goal of DBT for teens is to teach adolescents the skills they need to cope with and change unhealthy behaviors.
Adolescent DBT approaches typically have two main components: individual therapy sessions and DBT groups for teens. Individual sessions with teens emphasize problem-solving behavior for any issues or problematic behaviors. They also focus on decreasing and dealing with post-traumatic stress responses from previous trauma in the teen’s life, Moreover, DBT activities for youth also focus on improving their self-confidence and self-esteem.
“An essential DBT framework is the idea that we don’t cause all of our problems, but we are responsible for managing our reaction to our problems. Ultimately, we are all doing the best that we can with what we have—and we can do better, be better, live and love better. This is a foundational dialectical belief.”
Leigh McInnis, LPC, Newport Executive Director, Virginia
What Does DBT for Teens Help With?
Adolescent DBT skills are used to address a wide range of mental health conditions and behavioral disorders, including:
- Borderline personality disorder
- Self-harm
- Substance use disorder
- Eating disorders
- Depression
- Post-traumatic stress disorder
- Anger issues
- ADHD
The Four DBT Skills for Teens
In group therapy sessions, which are led by a trained DBT therapist, teens learn skills from one of four different DBT modules: mindfulness, distress tolerance, emotion regulation, and interpersonal effectiveness.
Mindfulness
Mindfulness is an ancient practice that revolves around being aware, without judgment, of what’s happening in the present moment, both inside and around you. Over the past decade, mindfulness has become a key part of mental health treatment because of its many benefits to mental health and emotional well-being. Studies suggest that mindfulness can reduce anxiety and depression, improve memory and focus, help people manage stress, and lead to greater satisfaction in relationships.
Mindfulness DBT skills for teens can help them learn how to be more aware of, and eventually accept, their emotions. The goal isn’t for teens to try to clear their mind or stop thinking, but rather to become aware of their feelings instead of getting lost in them. They also learn to observe and acknowledge their emotions without self-judgment. For example, if they feel anxious, they might simply state to themselves, I notice that I am feeling anxious, without judging or trying to change the feeling.
Distress Tolerance
Adolescents sometimes feel that their problems are simply out of their control. It’s common for a teen to think, This isn’t fair or I shouldn’t have this problem, although it often makes them feel worse. DBT activities for teens focused on distress tolerance help them learn to become less reactive and emotional when they experience difficult emotions.
Radical acceptance is a term used to describe a healthier way of thinking in stressful situations. Instead of focusing on how much they want something to be different, teens learn through DBT to recognize and accept the problem or situation as it is. When they learn to accept and tolerate what is out of their control, they feel less anxiety, anger, and sadness when dealing with the situation.
Emotion Regulation
When a teen experiences an emotion, a behavior usually comes with it. If they are angry, they might fight or argue. If they are sad, they might withdraw from friends and family. Some of these behaviors are instinctive, while others might be conscious choices.
DBT teaches teens how choosing a different action in these situations can help regulate their emotions. For example, if they usually yell when they’re angry, they can try talking quietly and calmly instead. If they tend to withdraw when they are sad, they can call or visit a friend. DBT also encourages them to focus on the positive aspects of an experience, rather than the negative.
Interpersonal Effectiveness
The last of the four DBT modules is interpersonal effectiveness. Interpersonal effectiveness skills help teens understand how their behavior affects their relationships, so they can make positive changes. Learning how to balance our own needs with the needs of others can be challenging at any age. DBT includes three different skills that can help teens achieve this goal: objective effectiveness, relationship effectiveness, and self-respect effectiveness:
- Objective effectiveness focuses on how to clearly express your own needs or desires.
- Relationship effectiveness teaches how to foster positive interactions with others.
- Self-respect effectiveness supports teens in ensuring that they don’t betray their own values and beliefs for approval or to get what they want.
DBT Skills for Teens and Families
In addition to the skills listed above, DBT therapists may also be trained in specific programs and modules developed specifically for teen and families. DBT-A (DBT for Adolescents) was developed to include parents or other caregivers in the skill-building process. This might take place in family therapy sessions or as separate sessions for teens and for parents.
In addition, DBT for teens and families is the main focus of the Walking the Middle Path approach. Walking the Middle Path teaches both parents and teens new skills for decreasing conflict, building stronger communication, and seeing each other’s point of view.
Dialectical Behavioral Therapy for Adolescent Relationship Building
Included in the Interpersonal Effectiveness category of DBT skills are three approaches that are used to strengthen adolescent relationships. These scripts are often featured in DBT worksheets for youth.
- DEARMAN (Don’t Let Your Emotions Run Your Life) is a helpful script with reminders of what to say when you are requesting a want or need. The DEARMAN approach encourages individuals to consider mutual benefits as opposed to just the benefit to oneself.
- GIVE (Gentle – Interested – Validate – Easy) provides guidance on how to engage in a conflict with someone, with the intention of maintaining the relationship. The entire premise of GIVE is to speak in a way that invites the other person to want to engage with you. This involves demonstrating interest in their side of the conflict, and working to understand and validate their experience.
- FAST (Fair – Apologies – Stick to Values – Truthful) reinforces self-respect by encouraging you to remember your values, to be truthful, and to not have double standards. Fairness is reinforced in FAST—and putting yourself in another’s shoes allows you to have realistic expectations for them, and to engage compassionately with them.
Because adolescent DBT offers clear and practical steps, it can be particularly effective in helping teens shift negative thoughts and behaviors. A DBT workbook for teens provides a way for clients to engage with these skills at their own pace, with the guidance of a trained DBT therapist.
DBT for Teens as Part of a Newport Academy Treatment Plan
In summary, DBT for teens is an essential part of Newport Academy’s integrated approach to teen treatment. We use adolescent DBT skills and other evidence-based modalities to treat the underlying causes of maladaptive and high-risk behavior. DBT also provides healthy coping skills and helps teens grow their self-awareness and accountability.
In addition to Dialectical Behavioral Therapy, each client’s tailored treatment plan includes a variety of evidence-based clinical and experiential modalities to support healing and growth. These include Cognitive Behavioral Therapy, mindfulness, EMDR, and creative arts. Contact us today for a free assessment and get started on the path to healing.
Frequently Asked Questions About DBT for Teens
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