What Comprehensive DBT-A is:
- Comprehensive Dialectical Behavior Therapy for adolescents (DBT-A) is an adapted full model DBT therapy program specifically designed to support adolescents and their families. DBT-A was created to help adolescents with intense, fluctuating emotions who engage in impulsive or self-destructive behavior to regulate their emotions. DBT-A was also designed to help teens with emotion regulation difficulties interact more effectively with peers and family by decreasing impulsive, angry, or indirect interpersonal behaviors.
- DBT has a considerable amount of research support and is considered the gold standard treatment for Borderline Personality Disorder (BPD) in adults. Though DBT-A can be helpful for teens at risk of developing BPD, it is considered broadly effective for any teen that struggles with intense emotions, impulsive behaviors, self-harm or suicidality, and interpersonal interactions. DBT-A is adapted to be more targeted and relevant to the needs and problems facing teens and their families, and it is currently our only intervention supported by research to consistently show positive outcomes for adolescents across these various problem areas.
- The TAP Clinic offers a traditional comprehensive DBT-A program that is implemented with fidelity to the model articulated by the initial treatment developer, Dr. Marsha Linehan. Several therapists also offer DBT-PE for teens in need of DBT with active PTSD symptoms.
What Does Comprehensive DBT-A Entail?
Comprehensive DBT-A is a therapy that requires a level of therapist training, particular treatment components, and a particular style of therapy.
Therapist Training:
To conduct Comprehensive DBT-A, your DBT-A therapist must have very high level training in DBT. The gold-standard of this training is achieving the Linehan Board Certification (LBC), which you can learn more about here.
Treatment Components
- Weekly individual therapy for the teen with a Comprehensive DBT-A therapist.
- Weekly skills training for both teens and caregivers, usually in a multi-family DBT-A group. At least one caregiver is expected to attend these skills sessions as part of their teen’s treatment. This is an essential component to the therapy’s effectiveness and potential success. To learn more about our DBT-A groups, click here.
- Phone coaching for both teens and parents to increase skills use between sessions.
- Therapist participation on a DBT Consultation Team.
Style of Therapy
- DBT-A requires a specific format and style of individual therapy. This includes a diary card to track your teen’s treatment goals, behavior chains to understand impulsive behaviors, and a treatment hierarchy to guide what is discussed each week.
- Comprehensive DBT-A multi-family groups are required to cover specific skills content from the DBT-A skills manual. This includes the skills of Mindfulness, Distress Tolerance, Emotion Regulation, and Interpersonal Effectiveness. An additional module, Walking the Middle Path, is specific to DBT-A and helps to address common issues that occur between teens and their families.
- Both individual and group DBT-A are skills-focused. Unlike some other forms of talk therapy, a Comprehensive DBT-A program is quite structured and sessions are focused on learning and practicing particular skills.
Is Comprehensive DBT Right For Your Teen & Family?
Comprehensive DBT-A is a multicomponent, intensive treatment and is not right for everyone. We are most likely to recommend Comprehensive (or "full model") DBT-A for teens if:
- Your teen experiences their emotions as easily triggered, intense, and requiring a long time to return to baseline.
- Your teen engages in impulsive behaviors in an attempt to regulate their emotions (e.g., self-injury, substance use, binge eating, risky sexual behaviors).
- Your teen has difficulty in interpersonal interactions due to their emotions. This could include difficulty getting along with peers, engaging in problematic interpersonal communication behaviors (e.g., yelling, threatening), or difficulty effectively asking for what they need when upset. These emotional and interpersonal skills deficits cause significant problems in your adolescent’s ability to attend school, build and maintain relationships, and complete tasks of daily living.
- If this does not describe your teen, or only partially describes your child, they may be a better fit for other skills programs such as the Unified Protocol (UP).
Adjuncts to the Comprehensive DBT-A Program:
Depending on the teen or family needs, the following adjunct treatments may be part of your teen’s comprehensive program:
DBT Family Therapy
- DBT for families utilizes the behavioral principles and skills of standard DBT and applies them across the family unit in family therapy sessions. Family members are taught how to apply DBT skills to familial interactions, how to better validate and understand others’ points of view, and how to apply behavioral principles more effectively.
Behavioral Parent Training (BPT) (for parents only)
- Behavioral Parent Training uses behavioral principles and skills to the parenting framework. Parents are taught how to use their own DBT skills to increase effective communication, set and maintain parental expectations, and increase positive interactions with their teen or adult in the DBT program.
What DBT treats