Created on August 5, 2017. Last updated on November 15th, 2020 at 04:21 pm
Alec L. Miller, PsyD & Jessica Passman, PsyM
Dialectical behavior therapy (DBT) for adolescents is an evidence-based treatment originally developed for suicidal, multi-problem adolescents. It has since been adapted for a broader range of adolescents who present with emotional and behavioral regulation challenges. Moreover, while DBT started as an outpatient psychotherapy intervention, it has been utilized in a range of other clinical and non-clinical settings such as schools.
DBT synthesizes a variety of theoretical perspectives, including cognitive-behavioral, mindfulness/acceptance, biosocial, and a dialectical philosophy. The biosocial theory of emotional dysregulation posits that a teens’ “5 problem areas” (i.e., 1) reduced focus/awareness, 2) impulsivity, 3) emotion dysregulation, 4) interpersonal problems, and 5) teen-family challenges) evolve from a transaction between a biological vulnerability and an invalidating environment. The DBT treatment improves emotion regulation and reduces invalidating behaviors in the environment, and it offers 33 skills that map onto the 5 problem areas, including a) mindfulness skills, b) distress tolerance skills, c) emotion regulation skills, d) interpersonal effectiveness skills, and) walking the middle path skills.
Comprehensive DBT includes 5 modalities intended to address 5 functions:
Source(s): Mehlum, L., Tormoen, A., Ramberg, M., Haga, E., Diep, L., Laberg, S., Larsson, B., Stanley, B., Miller, A.L., Sund, A., Groholt, B. (2014). Dialectical behavior therapy for adolescents with repeated suicidal and self-harming behavior: A randomized trial. Journal of the American Academy of Child and Adolescent Psychiatry, 53(10), 1082-1091. DOI: https://doi.org/10.1016/j.jaac.2014.07.003
Miller, A.L., Gerardi, N., Grayling, K., Mazza, J.J., Dexter-Mazza, E.T., & Rathus, J.H. (under review). Delivering Comprehensive School-Based DBT (CSB-DBT)
Miller, A. L., Rathus, J. H., & Linehan, M. M. (2007). Dialectical behavior therapy with suicidal adolescents. New York, NY: Guilford Press.
Rathus, J. H. & Miller, A. L. (2015). DBT skills manual for adolescents. New York, NY: Guilford Press.
Rathus, J.H., Miller, A.L., Berk, M.S., & Halpert, R. (2020). DBT with adolescents: A review of the research. Handbook of Research on Dialectical Behavior Therapy. Bedics, J (Ed). Elsevier.