Jane is a 16- year- old sophomore in high school. Her parents recently found out that for the past six months, she has been cutting herself with razors. Although she attempted to hide the faint scars on her arms, her mother noticed them when they were washing the dishes together. Jane's mother describes her as a sensitive and emotional girl - she has tremendous empathy for those around her and is very loving; however, she often gets angry over seemingly little things and has difficulty calming herself down. Jane's friendships have been strained lately; her mother describes new friends entering in and out of her life almost weekly. Additionally, Jane's mother is concerned because the number of arguments between Jane and her family members have increased this past school year, making it very tense in the household.

What is Dialectical Behavior Therapy?

Dialectical Behavior Therapy (DBT) is a form of cognitive behavioral therapy designed to treat individuals with difficulty regulating emotions and behaviors. It was originally developed for adult women who were chronically suicidal and has become an evidence based treatment for adults diagnosed with Borderline Personality Disorder. DBT has since been adapted for multi-problem teens and their families. The goals of this treatment are to replace problem behaviors with more adaptive ways of coping with distress and to help individuals create a life worth living. DBT is considered an effective therapeutic approach for teens who exhibit the following types of behaviors:

  • Difficulty regulating emotions (including chronic moodiness or extreme reactivity and sensitivity to environmental triggers)
  • Suicidal thoughts or attempts
  • Impulsive behaviors (e.g., self-injury, purging, substance use, truancy)
  • Chaotic relationships with peers and adults
  • Sense of emptiness or confusion about self
  • Family conflicts

DBT is a comprehensive treatment that integrates behavior therapy (change strategies) with aspects of Zen practice (acceptance and validation strategies). The application of these strategies can help teens achieve a more balanced life.

How does DBT treatment typically proceed?

Evaluation

All teens will have a comprehensive initial evaluation with a member of our team at the NYU Child Study Center. This process will determine if the teen will benefit from the DBT model. It will also identify specific problem behaviors to target in treatment and assist the team in learning the needs of the particular family. The initial evaluation includes a two to three hour clinical interview with parents and teen and a feedback session to review treatment recommendations.

Treatment

The NYU Child Study Center Adolescent DBT Program includes weekly individual therapy, a weekly skills group, and telephone coaching. A description of each portion of the program is below:

Weekly individual therapy
Each teen in the program works individually with a therapist who is an active member of our DBT consultation team at the NYU Child Study Center. Individual therapists weave together acceptance and change based techniques to decrease life-threatening behaviors (e.g., suicidal thoughts, self-injury), therapy interfering behaviors (e.g., missing sessions, coming late to sessions), and quality of life interfering behaviors (e.g., purging, substance use, missing school). Additionally, the clinician coaches the teen on ways to apply the skills learned during the multifamily skills group to his or her individual life to assist the development of effective coping skills.

Weekly multifamily skills group
The weekly multifamily group is an 18-week skills oriented group for both teens and parents. We have found that the inclusion of parents has made the treatment more effective in that parents learn to serve as coaches for their child as well as benefit from learning the skills themselves. This group is didactic in nature, with handouts, homework exercises, and experiential activities practiced weekly.

Telephone coaching
Telephone coaching is utilized to help teenagers generalize the use of new, adaptive coping in the real world. Teens are encouraged to call their individual therapist when they have urges to engage in problem behaviors. Subsequently, the clinician will help them problem solve and identify coping skills to practice in the moment.

For more information or to schedule an appointment please contact an intake coordinator at (646) 754-5000 or e-mail us at services@aboutourkids.org.

Our Clinicians

Our team of seasoned clinicians and Cognitive Behavioral Therapists has received intensive training in Dialectical Behavior Therapy.

Aleta Angelosante, PhD

Lori Evans, PhD

Sam Fasulo, PhD

Sameena Groves, PhD

Daniela Montalto, PhD

Carrie Spindel, PsyD

Sarah Trosper, PhD

Andrea Vazzana, PhD

Fellows

Emily Becker-Weidman, PhD