How Dialectical Behavioral Therapy (DBT) Helps Adolescents Suffering from Self-Harm Behavior

Dialectical behavior therapy (DBT) is a structured form of psychotherapy that contains a strong educational component, helping to provide skills for managing intense emotions and negotiating social relationships.

DBT was originally developed to stop the impulse of self-harm for chronically suicidal patients. Since then, it’s since become the go-to treatment for borderline personality disorder (BPD), emotion dysregulation, and, more recently, a number of other psychiatric conditions.

DBT contains both group instruction and individual therapy sessions that are conducted weekly for six months to a year.

At Sidhu Psychiatric in Palm Harbor, Florida, our board-certified psychiatric mental health nurse practitioner Kanwaljit “Kavi” Sidhu NP-C, PMHNP-BC, provides both psychiatric services and medication management, the former of which may use dialectical behavioral therapy. Here’s what you need to know about DBT and how it can improve thoughts of self-harm.

How and why DBT works

DBT is an evidence-based treatment program that helps people with mental health conditions where regulating emotions is a problem. It’s recently come to be used with substance use disorders, major depressive disorder, bipolar disorder, attention-deficit/hyperactivity disorder (ADHD), and eating disorders.

Patients who can benefit from DBT the most include those struggling with emotional regulation, engaging in self-destructive behaviors, and having interpersonal difficulties. Most of these haven’t found success with other therapeutic approaches.

The term “dialectical” refers to finding a balance between two seemingly opposing concepts: acceptance and change. DBT patients must learn to accept themselves, their emotions, and their thoughts as they are, without judgment. They also need to work toward making positive changes to build a life worth living.

DBT treatment therefore involves teaching patients the skills they need to accept what is and help them make the necessary changes. The term “behavior” is used because DBT helps people learn to identify problematic behaviors and replace them with new, more effective ones.

DBT is skills-based and “in the moment,” where the person needs to find a better solution to a given problem while it’s occurring. They need to practice their skills between sessions, so they can expect homework assignments. An example might be to focus on taking specific, concrete steps to master a given relationship challenge.

Patients keep a diary tracking their emotions and impulses, which gives them an awareness of their feelings, an understanding of which situations are problematic for them, and information to gain control over their own behavior.

In their individual sessions, patients review the situations and feelings they faced the prior week and actively discuss ways of behaving that might have delivered a more positive outcome.

The 4 key areas of DBT

DBT focuses on providing therapeutic skills in four critical areas.

1. Mindfulness

Mindfulness lets patients accept what they’re experiencing and be present in the current moment by acknowledging how fleeting emotions can be. This diminishes the power of emotions to control their actions.

In addition, being present-focused slows down emotional reactivity, affording people time to summon healthy coping skills while in the middle of a distressing situation.

2. Distress tolerance

This area provides the patient with the ability to tolerate negative emotion rather than needing to escape from it or acting in ways that make difficult situations worse.

3. Emotional regulation

These strategies give people the power to manage and change intense emotions that repeatedly cause problems in their life.

4. Interpersonal effectiveness

Interpersonal effectiveness techniques teach a person how to communicate with others in an assertive way that maintains self-respect and strengthens relationships. Here, learning how to ask directly for what you want diminishes resentment and hurt feelings between individuals.

Are you interested in learning more about how dialectical behavioral therapy can help you or your teen move away from self-harm and control your emotional responses? Sidhu Psychiatric can help. Call our office at 727-382-1383, or contact us online today.