Dialectical Behavioral Therapy (DBT)

Tools From An Effective Therapeutic Intervention

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I have been asked time and again about Dialectical Behavior Therapy (DBT), a therapy originally developed by Dr. Marsha Linehan for treating borderline personality disorder in adults, which has become an effective and popular intervention for working with young people, and it has even been borrowed by parenting sources giving everyday advice on challenging parent child relationships. There are many interesting aspects of this therapy that have relevance to us all. In fact, DBT is being used to treat teens who struggle with drug misuse, eating disorders, ADHD, depression, and anxiety.

With children, DBT combines principles of cognitive-behavioral therapy (CBT) with mindfulness practices, and is tailored to address the developmental needs of the child. It’s the combination of understanding emotions without judgment (mindfulness) and specific skills to manage these emotions (CBT), in everyday life.

You have probably heard enough of me talking about the importance of mindfulness for children and adults (check out the 5 Principles of Parenting for loads of mindfulness exercises for you and your kiddos). There’s rich science supporting the idea that mindfulness practices can help kids build self-control, attentiveness, empathy, and respect for family members and classmates — all while reducing stress. School-based mindfulness programs have been shown to help children balance their emotions and reduce bullying. Still, fewer than 2 percent of American kids meditate or incorporate mindfulness practices into their routines. The exercises in my book are so short and doable, I highly recommend finding a way to make them a weekly if not daily habit. 

As an essential component of DBT, mindfulness teaches children to be present in the moment and bring awareness to their sensations, thoughts, and feelings, without judgment. Through a series of breathing and observation exercises, mindfulness practices work to offer children the chance to notice their emotions, identify triggers, and accept their feelings without rushing to form an opinion of them. 

DBT also focuses on emotion regulation skills that enable children to find more effective ways to manage the emotions that they feel. These skills include identifying emotions, naming them, and finding appropriate or adaptive outlets and behaviors to manage them. These skills also work to help children tolerate feelings of distress when they have them. Instead of focusing on fixing problems, or distracting from distress, DBT works to help children find soothing techniques and visualization exercises that ease hard moments, and promote confidence in a child’s ability to face challenges in healthy ways.

DBT also includes skills around interpersonal effectiveness, or how to work with and manage others. These skills include managing social cues, healthy ways to make friends, strategies to resolve conflicts, and tools to help children express their feelings or thoughts appropriately.

Implementing DBT with children involves therapy sessions with the child and family. Parents also learn DBT skills so that they can model and reinforce them at home, and create consistency in their child’s lives. Finally, DBT involves social skills and training groups to role-play and practice new lessons with others.

So, what lessons can we all take from the 4 main principles of DBT - mindfulness, emotion regulation, distress tolerance, and interpersonal effectiveness? The good news is that all of these concepts are easily practiced at home in small and simple ways.

Mindfulness: There are SO many ways to practice mindfulness with our kids. One suggestion is a belly to belly breath. Try hugging your child and matching your breathing to theirs. This works at any age (although getting some of the teens to do it can be tricky). Stay as long as you both think it is fun, and allow your two nervous systems to help each other regulate.

Emotion Regulation: During a difficult moment, try having your child visualize riding the waves of their emotion. Instead of fighting against their emotion, riding the wave allows your child to feel the emotion they are having and then allow it to fade to its natural conclusion.

Distress Tolerance: The concept of radical acceptance focuses on letting your child feel exactly how they want to, and accepting a situation exactly as it is. From there, your child can decide how to move forward. For example, your child may need to hear, “This situation sucks and is unfair. You are upset and angry and that makes sense. Now what do you want to do about it?”

Interpersonal Effectiveness: One way to help your child practice reacting to, and interacting with, others, is to promote perspective-taking skills. Try asking your child to put themselves in the mindset of a friend and telling you about an argument from their perspective. Let your child tell you what the other person may be thinking or feeling as a tool to help them to see the perspective and complexity of human relationships.

These are all practices we can use in our daily lives, and ones we can all benefit from. 

We are all in this together, and I look forward to hearing your thoughts!

A quick reminder to buy my first book, The Five Principles of Parenting, and write a review from wherever you order. Reviews really help to get the book noticed, and to spread the word. Please especially rate and review any books purchased on Amazon (it shockingly really, really matters!). Also, when you receive the book, snap a quick pic with it and post on social media. Share one thing you love about it and help me to get more copies into the hands of parents in your community. Tell a friend about the book, or about something you found helpful in the book. Parents look to each other for advice, and I’d love to be a part of the support you pass on to your loved ones.