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Dialectical Behavior Therapy With Suicidal Adolescents

Dialectical behavior therapy is a form of cognitive behavioral therapy (CBT). Marsha M. Linehan developed DBT in the late 1980s. It was originally developed as a treatment method for suicidal individuals struggling with borderline personality disorder (BPD). Borderline personality disorder is a severe mental health illness. It is listed in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), and is characterized by unpredictable moods and behaviors and a long-term pattern of unstable relationships. Evidence has shown that dialectical behavior therapy has also become useful in treating individuals with other mental health ailments (e.g. eating disorders, depression, bipolar disorder, substance abuse, etc.). Nowadays, DBT is more widely known an evidence-based form of psychotherapy that is intended to help individuals who have difficulty with emotional regulation and/ or are exhibiting self-destructive behaviors.

DBT Overview

Dialectical behavior therapy is conducted in three different therapeutic settings, each with distinct goals. DBT includes weekly individual therapy sessions, weekly group DBT skills sessions, and phone coaching (between sessions) when needed. The individual therapy sessions provide one-on-one support where an individual can go over any challenging situations that have arisen throughout the week as well as enable the individual review the lessons learned in the group skills sessions. The phone coaching allows a young person twenty-four hour access to support between sessions, should crisis arise. DBT group skills sessions focus on four skill modules, which include the following:

  • Core mindfulness: this area focuses on improving an individual’s ability to accept and be present in any given moment. The skills in this module help individuals learn to the importance and value of slowing down and taking pause instead of succumbing to intense emotions and acting in destructive ways. 
  • Distress tolerance: focuses on increasing an individual’s tolerance of negative emotion as opposed to attempting to avoid or escape from it. The skills in this module help individuals learn various techniques for handling crisis (e.g. distraction, self-soothing, improving the moment, etc.). 
  • Emotion regulation: focuses on helping an individual identify, name, understand the function of, and regulate their emotions. The skills taught in this module are intended to help an individual learn to decrease the intensity of their emotions, sit with and experience strong emotions that are causing problems in one’s life, without impulsively acting on them.
  • Interpersonal effectiveness: focuses on increasing individual’s communication strategies. The skills taught in this module help an individual learn to identify what their own needs are in a relationship and develop assertive and effective communication methods to ensure those needs are met in a healthy way. 

The entire DBT program typically lasts about six months long, as six weeks are allocated to focusing on each of the four DBT skills modules. There are some partial options that focus only on certain modules, which would reduce its overall duration. Depending on the needs of the individual, there are some longer options that repeat each module, doubling the time it takes to complete the program. 

Suicidal Teens

Adolescence is a stage in one’s life that is filled with immense growth. It is a time when young people are faced with countless lessons to help prepare for the future and learn the tools needed to effectively navigate adulthood. It is to be expected that teens will experience a wide range of emotions, including extreme sadness, frustration, and even despair at some points in their youth. However, it is imperative to seek professional guidance in situations where a teenager’s emotions become so overwhelming that he or she becomes suicidal. The combination of the four DBT skills modules help a young person learn to acknowledge, accept and learn from difficult emotions that arise and experiences that occur throughout one’s life. DBT also helps an individual learn to communicate in an authentic and assertive fashion that can help improve relationships and simultaneously increase one’s sense of self-worth.

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