DBT: A Family Based Approach

Does your teen struggle with emotional instability and impulse control? Are unhealthy behaviors such as self harm, suicide attempts and substance abuse developing in an attempt to compensate for this lack of emotional control? Do these behaviors create barriers to establishing healthy, positive relationships with others?

If so, you may overhear the following:

What is the point of me changing if my parents stay the same?

I’m not the only one with problems. My parents need help, too.

My parents are making it worse!

Current evidence-based research shows that Dialectical Behavior Therapy (DBT) is a highly effective model to treat those who demonstrate difficulty regulating their emotions. DBT Skills Groups offer the possibility for change and a means to reduce harmful behaviors. In this group, therapists teach and demonstrate specific skills for group members to practice daily outside the group meeting. Group members observe how other in the group practiced the skill while sharing their own experiences. This reciprocal sharing reinforces skill practice and builds competency and mastery.

DBT Skills Group at In Step

During In Step’s long history of working with adolescents and their parents, we identified unmet needs expressed by both parents and their teens. Teens often stated that they were the only one in the family expected to change while expressing a deep need for parental support and understanding. On the other hand, parents shared their frustration with knowing how to help their teen and/or controlling their own anger. So, to address these unmet needs, we offer a more comprehensive DBT skills model where both parents and their adolescent meet in separate groups. In this way, a family-based commitment to behavior change is possible.

The Skills Based Approach

The identical skills program is simultaneously taught in both the parent and adolescent skills group. Mindfulness skills teach how to live more in the present moment and to experience life “as it is.” Distress Tolerance shows teens and parents how to tolerate uncomfortable experiences instead of trying to change the experience or emotion.
Self-advocacy and self-respect are taught using Interpersonal Effectiveness skills. Finally, teens and parents learn how to identify emotions and/or reduce their intensity and impact through mastery of the Emotion Regulation skills.

The Group Experience of Change at In Step

Recently, four families graduated from our DBT group and were extremely grateful for the experience and each individual’s willingness to engage, commit and work for improvement. While the families spoke of their own specific progress, the group therapists witnessed each families significant growth. For example, one teenager with social anxiety struggled to speak publicly in group but later exhibited social confidence by making eye contact, sharing experiences and initiating conversations. Another teen first willfully rejected that the skills would help, but set aside her vulnerabilities resulting in an improved relationship with her family, peers and teachers.

Parent feedback is overwhelmingly positive:

The skills are becoming who I am.
I no longer see experiences as “black and white.”
Even though it’s tough at times, when I stay in the moment, I’m so much more effective as a mom and wife.

In the parent group, there is a clear need for group validation of the parents’ experiences and emotions. Additionally, parents become willing to accept their adolescent as they are while simultaneously working for desired change. In DBT, this radical acceptance is by far one of the most challenging yet rewarding skills to embrace. As parents work through this process, they become more effective at parenting and more emotionally available and supportive to their teen. Parents shared how this collectively benefits their family and how liberating it is for them as individual parents.

Teen feedback shows how DBT skills have helped:

I’m just happier. I’m not thinking about bad stuff anymore.
I really used my “what” skills.
After using my STOP skills, my urge subsided.

Group leaders observed how teens’ emotions and behaviors were tempered as skills were practiced. One parent realized how the group was helping when she overheard her daughter talking about how she practiced mindfulness skills with her friend. Aside from the teens “ah-ha!” moments in group, leaders were most humbled when teens shared their experiences outside of group. One teen described efforts to teach DBT mindfulness skills to a friend who also struggles with similar emotional and relationship issues.

DBT Skills Group
is offered weekly and In Step is accepting new families. Please call our office with any questions you may have or if you’d like to schedule an initial assessment for your family.