Adolescence is a time in one’s life that is filled with difficult lessons, emotional growth, physical and emotional maturation, surging hormones, and a newfound need for autonomy. Children are faced with countless trials and tribulations, many of which they are ill equipped to effectively navigate without support. An adolescent’s brain is not yet fully developed, and though some young people may appear as adults externally, internally they are operating with an underdeveloped pre-frontal cortex. This is the area of the brain that reins rational thought, impulse control, executive planning, and more. Instead, adolescents using the amygdala (area of the brain that governs one’s emotions, impulsivity, emotional behavior, and motivation) instinctively process external stimuli. The fact that young people are often viewed, as hypersensitive, impulsive, wildly emotional beings should come as no surprise. Hence, it is often difficult to distinguish between typical adolescent behavior and child behaviors that may be indicative of larger issues and could benefit from professional guidance. 

What Is DBT

Dialectical behavior therapy (DBT) is a psychotherapy that is based off of the principals of cognitive behavioral therapy (CBT). In the late 1980s, Psychologist Marsha M. Linehan developed DBT to help better treat individuals with borderline personality disorder (BPD). It has since been rendered an effective method of treatment for many other mental health conditions (e.g. depression, bulimia, binge-eating disorder, bipolar disorder, post-traumatic stress disorder, substance use disorder, etc.). Further, 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. 

Next Steps

Being charged with the responsibility to safeguard your child’s mental wellbeing could feel incredibly overwhelming, especially when it becomes evident that they are in need of professional support. Fortunately, there are an abundance of highly qualified DBT providers in Los Angeles, California that specialize in treating children. In order to narrow down your options consider the following tips:

• Ask your child’s pediatrician: request recommendations from your child’s pediatrician.
• Check out some online sources: many mental health providers have websites available for potential clients to review and/ or are included in an online compilation of reputable mental health professionals, such as:
  • Psychology Today 
  • DBT Los Angeles
  • DBT Therapy In Los Angeles

• Ask your network of trusted family and friends for references: chances are more people than you are aware of within your network are connected to mental health professionals—tap in and see if anyone can refer you to someone in his or her professional network to work with your child.

Each mental health clinician renders services that are directly informed by his or her personal and professional experiences, education, and personality. Be sure to interview any potential provider prior to making any commitment, as it is essential to make an informed decision. It is important to bear in mind that every young person is unique and will respond distinctly not only to the array of therapeutic modalities available, but also to the variety of mental health providers. 

Disclaimer: 

The information above is provided for the use of informational purposes only. The above content is not to be substituted for professional advice, diagnosis, or treatment, as in no way is it intended as an attempt to practice medicine, give specific medical advice, including, without limitation, advice concerning the topic of mental health.  As such, please do not use any material provided above as a means to disregard professional advice or delay seeking treatment. 

Dialectical behavior therapy (DBT) was originally developed to treat chronically suicidal individuals with Borderline Personality Disorder (BPD). Since Marsha M. Linehan developed DBT in the late 1980s, it has become not only the gold standard form of treatment for individuals with BPD, but also has shown efficacy in treating other mental health ailments (e.g. substance use disorder, bulimia, bipolar disorder, attention-deficit hyperactivity disorder, etc.), Dialectical behavior therapy is based on the cognitive behavioral therapy (CBT) approach, but DBT places greater emphasis on the psychosocial aspect of therapy. Dialectical behavior therapy includes three distinct therapeutic settings: weekly individual psychotherapy sessions, weekly group DBT skills training sessions, and intermittent phone coaching. DBT focuses on providing therapeutic skills in four primary areas, which are: 

• Core mindfulness: the practice of being completely present and aware in the moment 
• Distress tolerance: becoming tolerant of pain in difficult situations instead of attempting to change it
• Emotion regulation: decreasing emotional impulsivity, learning to manage and shift intense, problematic emotions   
• Interpersonal effectiveness: authentically advocating for one’s own wants and needs in a relationship in a way that is both self-respecting and non-damaging

Within each therapeutic setting the four DBT modules are reinforced. Six weeks are typically allocated to learning skills specifically related to each of the four modules, respectively. Hence, it generally takes about six months to complete the entire DBT program. 

DBT In Los Angeles

Every individual is different and is likely to have a distinct response to the different options of therapeutic treatment modalities available. Prior to committing to DBT, it is helpful to make sure the mental health provider is a good match. Fortunately, there is a plethora of highly qualified and exceptional mental health providers that offer dialectical behavior therapy services in Los Angeles, California. Due to the vast number of potential DBT providers in Los Angeles, beginning the search for DBT therapy can seem overwhelming. Consulting your primary care physician (PCP) can be an excellent start to your search. Often PCPs are able to provide recommendations for DBT therapists, and in situations where they may be unable to do so, they will certainly be able to refer you to someone within their professional network that is able to point you in the right direction. Word of mouth recommendations can yield positive results, so it may behoove you to check with your family and friends and see if anyone has any recommendations. There are also a variety of online resources that can help you find a DBT provider in California. For example, Psychology Today has compiled a list of qualified mental health professionals that offer DBT services in Los Angeles. It is important bear in mind that not all mental health clinicians will resonate with every client. Further, each mental health clinician brings with them differing educational backgrounds, professional experiences, and personalities, all of which are woven into their practice.

Disclaimer: 

The information above is provided for the use of informational purposes only. The above content is not to be substituted for professional advice, diagnosis, or treatment, as in no way is it intended as an attempt to practice medicine, give specific medical advice, including, without limitation, advice concerning the topic of mental health.  As such, please do not use any material provided above as a means to disregard professional advice or delay seeking treatment. 

Psychologist, Marsha M. Linehan, developed dialectical behavior therapy (DBT) in the late 1980s as a means to more effectively treat chronically suicidal individuals diagnosed with Borderline Personality Disorder (BPD). DBT is a type of cognitive behavioral therapy (CBT) that places greater emphasis on the psychosocial aspect of therapy. Since its inception, dialectical behavior therapy has been and remains the gold standard method of treatment for individuals diagnosed with BPD, and has also proven effective in treating individuals with eating disorders (e.g. anorexia, bulimia, etc.), severe anxiety, substance use disorder, other personality disorders, and certain mood disorders. DBT is comprised of three distinct settings: weekly individual therapy sessions, weekly DBT group skills training sessions, and phone coaching. 

4 Skills Modules

DBT utilizes four main strategies for teaching individuals skills that help with effectively changing their behaviors. They include the following, as provided by Behavioral Tech: 

1. Mindfulness: the practice of remaining present and fully in the moment at any given time
2. Distress Tolerance: learning to tolerate pain in challenging situations, without changing it or escalating it
3. Interpersonal Effectiveness: increasing one’s self-awareness through learning to advocate for one’s own wants and/ or needs by saying no and/ or expressing one’s desires while maintaining self-respect 
4. Emotion Regulation: learning how to understand, shift and/ or change unwanted emotions 

The entire DBT program (provided skills modules are not repeated) usually lasts about six months long, as approximately six weeks are allocated to each of the four skills modules. 

COVID-19 DBT Modifications

The swift arrival of the extraordinarily contagious novel coronavirus (SARS-CoV-2), also known as COVID-19, quickly plunged all corners of the world into a universal pandemic. In efforts to slow the spread of COVID-19, America implemented strict stay-at-home orders for all non-essential workers, closed schools, prohibited in-restaurant dining, shuttered movie theaters, museums, sports and exercise clubs, and more. Mental health treatment services are included on the list of essential businesses and provided they adhered to the evolving health and safety protocols set forth by the CDC, they were able to remain open and operational throughout the pandemic. 

Although many mental health providers were able to facilitate dialectical behavior therapy for their clients, several modifications, including shifting certain therapeutic settings, were implemented in order to accommodate the continuously evolving safety guidelines. While the precise adjustments are left to the discretion of each mental health provider, commonly implemented changes to the DBT therapeutic settings included: 

• Individual sessions: 

• Hold the weekly individual therapy sessions remotely over videoconference platforms (e.g. Skype, FaceTime, Google Meet, Zoom, etc.)

• Hold the weekly individual therapy sessions in person, while both clinician and patient remain masked and a minimum of six feet apart

• DBT group skills training sessions:

• Hold the weekly sessions remotely over videoconference platforms (e.g. Skype, Google Meet, Zoom, etc.)

• Hold the weekly sessions in person, in a highly ventilated location (e.g. outdoors), while all members present remain masked, and seated a minimum of six feet apart

• Phone coaching: this component does require much modification for COVID-19, as it is already carried out in a socially distant fashion.

Dialectical behavior therapy aims to teach individuals healthy coping mechanisms and useful techniques for managing stress, regulating emotions, and improving relationships with others. Rest assured, regardless of the modifications, every mental health clinician that continued providing DBT services during the pandemic did so with deep consideration for his or her client’s physical and mental wellbeing, and rendered services in the safest manner possible. 

Disclaimer: 

The information above is provided for the use of informational purposes only. The above content is not to be substituted for professional advice, diagnosis, or treatment, as in no way is it intended as an attempt to practice medicine, give specific medical advice, including, without limitation, advice concerning the topic of mental health.  As such, please do not use any material provided above as a means to disregard professional advice or delay seeking treatment. 

Dialectical behavior therapy (DBT) is a type of cognitive behavioral therapy (CBT) that places primary emphasis on the psychosocial aspect of therapy. Intended as a means to better treat chronically suicidal individuals and those diagnosed with borderline personality disorder (BPD), Marsha M. Linehan developed DBT in the late 1980s. The purpose of DBT is to teach individuals applicable skills that enable them to effectively manage painful emotions and decrease conflict in relationships. Dialectical Behavior Therapy is composed of four components that include:  weekly individual therapy sessions, weekly group skills classes, 24/7 skills coaching with the therapist and DBT Team Consult for the therapists.  Research shows that DBT has the best result if patients stay in treatment for a minimum of one year; our program asks that patients commit to an initial six months and then renew their commitment at the end of each six month period. 

Four DBT Modules

DBT group skills training sessions specifically focuses on providing distinct therapeutic skills in the following four key areas:

• Mindfulness: the practice of being fully present and aware in the moment 
• Distress tolerance: becoming tolerant of pain in difficult situations instead of attempting to change it
• Emotion regulation: decreasing emotional impulsivity, learning to manage and shift intense, problematic emotions   
• Interpersonal effectiveness: authentically advocating for one’s wants and needs in a relationship in a way that is both self-respecting and non-damaging

Dialectical behavior therapy provides a somewhat differentiated teaching strategy when introducing and teaching DBT skills. This is helpful because DBT is mindful of the fact that all individuals learn and retain information differently. For example, some individuals may be primarily visual learners, while others may be experiential learners. Through the three different components of DBT (individual therapy sessions, DBT group skills training sessions, and skills coaching) the unique and nuanced needs of each individual are sure to be aptly accommodated. Further, DBT group skills training session facilitators assign homework, including DBT worksheets, to be completed by participants when they are not in session.  

DBT Worksheets

DBT worksheets are an integral tool used throughout the DBT process. In order to fully implement the information addressed during DBT group skills training sessions, participants are provided with relevant DBT worksheets that they are expected to complete. There are certain DBT worksheets that directly relate to specific topics covered in the different DBT group skills training sessions. 

As such, there are a variety of DBT worksheets that are assigned at different times throughout the program. There are some random DBT worksheet templates that are easily accessible on the Internet. For individuals interested in accessing a more complete, chronologically organized set of DBT worksheets, please feel free to refer to any of the following DBT supportive resources and publications:

• DBT Skills Training Manual and DBT Skills Training Handouts and Worksheets, 2nd Edition by Marsha M. Linehan
• The Dialectical Behavior Therapy Skills Workbook (A New Harbinger Self-Help Workbook) by Matthew McKay
• Dialectical Behavior Therapy Workbook: The 4 DBT Skills to Overcome Anxiety by Learning How to Manage Your Emotions. A Practical Guide to Recovering from Borderline Personality Disorder by David Lawson
• The Expanded Dialectical Behavior Therapy Skills Training Manual: DBT for Self-Help and Individual & Group Treatment Settings 2nd Edition by Lane Pederson and Cortney Pederson

DBT relies on supportive resources, including workbooks and worksheets, to help reinforce the skills taught during group DBT skills training sessions and to provide additional opportunities for participants to continue to practice implementing the learned skills.

Disclaimer: 

The information above is provided for the use of informational purposes only. The above content is not to be substituted for professional advice, diagnosis, or treatment, as in no way is it intended as an attempt to practice medicine, give specific medical advice, including, without limitation, advice concerning the topic of mental health.  As such, please do not use any material provided above as a means to disregard professional advice or delay seeking treatment.