Dialectical Behavior Therapy






The Comprehensive Dialectical Behavior Therapy (DBT) Program for Adolescents at the Center for CBT is the first of its kind in Middlesex County. The overarching goal of the program is to help adolescents build a life worth living. This is achieved through providing adolescents with validation and positive regard while at the same time guiding them to make positive behavioral changes in their lives. Through a supportive and goal-oriented therapeutic environment, adolescents and their families will learn new and effective ways of thinking and acting.

DBT is a gold standard treatment for individuals who have difficulties with emotional regulation and other complex challenges. Originally developed to treat individuals with borderline personality disorder, DBT has been adapted, studied, and found to be effective for helping adolescents dealing with multiple problems, including chronic difficulties with managing emotions, maintaining healthy interpersonal relationships, tolerating distress, and controlling impulses. Research also indicates that DBT helps to reduce suicide attempts, self-harming behavior, and hospitalizations while improving social functioning, coping, and quality of life. Many adolescents who have had unsuccessful stints with other therapies have had success in DBT.

The Core Skills Taught in DBT

DBT is comprised of five core skills which are taught to teens and their parents.

Mindfulness: The ability to observe and experience the present moment without judgment.  Individuals learn to notice their emotions and to experience them—without always acting upon them.

Emotion Regulation: Helping teens and their caregivers learn behavioral and cognitive techniques for reducing their vulnerability to, and enhancing their ability to cope with, overwhelming emotion.

Distress Tolerance: Helping teens and their families learn ways to get through difficult moments without making impulsive decisions they may regret.

Interpersonal Effectiveness: Assertiveness and other communications skills are emphasized with the aim of helping individuals achieve their goals, maintain healthy relationships, and maintain their self-respect even after conflicts.

Walking the Middle Path: Learning to live a more balanced life and avoid the emotional and behavioral extremes that frequently lead to stress.

Components of DBT Treatment

The comprehensive DBT treatment program for adolescents at the Center for CBT includes group therapy, individual therapy, and in-the-moment phone coaching. Through a supportive and goal-oriented therapeutic environment, adolescents and their families will learn new, healthier ways of thinking and acting.

Multi-family Skills Group: DBT Skills group focuses on teaching participants skills in mindfulness, tolerating painful emotions in difficult situations, interpersonal effectiveness, managing emotions, and walking the middle path. The highly structured, skill-oriented group for teens and their parent(s) takes place once per week and lasts one hour and forty five minutes. It has a class-like format with handouts, take-home exercises, and experiential activities, but there is no expectation that group members share information that is uncomfortable. Research has shown that caregivers’ involvement makes treatment more effective because caregivers learn to serve as coaches for their children and benefit from learning the skills themselves.

Individual Therapy: During individual therapy, adolescents apply the skills they have learned in group to their specific challenges. The DBT therapy process is structured and collaborative in terms of identifying behaviors targeted for change, generating solution strategies, applying skills learned in group, and improving decision-making skills.

Phone Coaching: Adolescents and the caregivers are encouraged to call their therapists between sessions for brief phone calls during any challenging situations to discuss strategies to effectively cope. These “coaching calls” help teens and their parents to generalize the skills they are learning to their real-world environment.

Parent/Family Sessions: Sessions with parents/caregivers, with and without their adolescent, are provided on an as-needed basis.

Should you be considering DBT?

DBT is designed to addresses individuals experiencing a broad range of problems. If your teenager has experienced some of the following challenges, he or she may benefit from DBT:

  • Mood swings
  • Anger problems
  • Ups and downs in relationships
  • Thoughts that you would be better off dead
  • Multiple suicide attempts
  • Self-injurious behaviors (e.g., cutting)
  • Problematic behaviors such as binging and/or purging or skipping school
  • Intense feelings of emptiness
  • Dissociation or fear that others are purposely out to harm you
  • Traumatic experiences
  • Lack of compliance or motivation in previous treatments
  • Previous therapy did not work for you

Participation in comprehensive DBT requires the ability to attend weekly individual therapy for the adolescent and group therapy for the adolescent and parent(s). Though the time commitment is significant, this format is necessary to treat the complex problems that DBT addresses.


Ready to join our Adolescent DBT Program?

If your adolescent (ages 13-18) is struggling with one or more of the types of challenges described above, please feel free to contact us for more information about our program.