Adolescence is an incredibly difficult period in one’s life. The mere physical maturation that a teenager endures during his or her adolescence is immense. One’s teenage years are filled with exponential physical, emotional, and mental growth, which can be confusing, difficult to manage and at times seemingly impossible to navigate. Many teens will attempt to manage the evolving changes they are experiencing with unhelpful coping mechanisms and/ or turn to self-medicating tactics (i.e. drugs and/ or alcohol) before seeking guidance from others. It is a rather challenging undertaking as a parent or guarding to distinguish the differences between typical teenage behaviors and those that should be considered red flags. If there is any concern that a teen may be exhibiting atypical behavior, it may be beneficial to consult a professional, so as to assure the teenager’s safety. There are a variety of therapeutic methods that can be helpful for teenagers to learn useful coping mechanisms, both for those with an identified mental health diagnosis as well as those without.

Dialectical Behavior Therapy

Dialectical behavior therapy (DBT) is a psychotherapy that is based off of the principals of cognitive-behavior therapy (CBT). In the late 1980, Psychologist Marsha Linehan developed DBT to help treat individuals with borderline personality disorder (BPD). It has since been rendered an effective method of treatment for many other mental health conditions. It is helpful in treating issues related to emotional dysregulation. Emotional dysregulation is a term used within the mental health field to denote irrational, poorly modulated emotional responses. DBT focuses on teaching four core skills: mindfulness, distress tolerance, interpersonal effectiveness, and emotion regulation. 

In order to successfully impart the core skills, dialectical behavior therapy is comprised of different therapeutic components, which include:

  • Individual therapy sessions: one-on-on therapy sessions allow a teen to work in a co-creative fashion with his or her mental health clinician to identify prohibitive, damaging, and maladaptive thoughts and behaviors. Through positive reinforcement, individual therapy sessions motivate change and emphasize a teen’s strengths, which helps to repair and improve his or her sense of self. They are also focused on enhancing the teenager’s motivation and the practice of applying certain DBT skills learned to specific, relevant challenges.  
    • Diary cards: a diary card is a tool used as a means to track one’s emotions throughout the week, identify which DBT skills were used and determine if they were helpful. A teenager’s diary card will be reviewed in with his or her therapist during each individual therapy session. This can help to shed light on areas during the week that the teen struggled and how to better implement the DBT skills so as to prevent the reoccurrence of future, unnecessary pitfalls.
  • Group skills therapy sessions: skills training provide teens with an opportunity to learn DBT skills alongside of other teens experiencing similar challenges. Group therapy sessions also provide a safe, controlled environment for the participants to practice implementing the newly learned DBT skills.
    • Homework: assigning homework is an integral component of group skills therapy, as it encourages teens to continue to practice the DBT skills in their everyday lives.
  • Coaching: during the time between individual therapy sessions and group therapy sessions, a client may encounter difficult to navigate situations and/ or find him or herself in crises. Phone coaching is used during these times to offer in-the-moment support. A teenager can call his or her clinician for assistance with implementing DBT skills and/ or obtain support and guidance with managing difficult situations that arise in everyday life. 

Any mental health clinician that offers dialectical behavior therapy as a form of treatment is also obligated to participate in DBT consultation teams. These teams are made up of other mental health professionals. They are an essential resource for clinicians, as they offer outside insights, useful perspective and needed support for working with high-risk, difficult to treat clients. 

Worksheets

As was previously noted, homework is integral to the dialectical behavior therapy process. The full DBT course and skills curriculum typically runs approximately six months long. Around six of the twenty-four weeks is allocated to each of the four core skills, respectively. There are certain worksheets that are associated with each of the core skill modules. Although a mental health clinician will likely yield a more successful outcome, it is possible for an individual to do DBT on his or her own. This, however, is not recommended for adolescents. The worksheets used in DBT can be accessed online, or even purchased in a printed form. There is a reason mental health professionals are trained in delivering various therapeutic modalities, and in order to acquire the proper guidance regarding the worksheets, an individual must request help from a qualified mental health professional.