Dialectical Behavioral Therapy (DBT) is for teens with attachment, anxiety, trauma, Post-Traumatic Stress Disorder (PTSD) and other mental health issues. Here is information and resources about how DBT skills can help children with attachment disorder (RAD) or other challenges.
What is DBT?
Dialectical Behavioral Therapy (DBT) is a cognitive behavioral model that provides specific skills for coping with life’s stresses and challenges.
DBT takes a skills-driven approach to manage persistent symptoms of maladaptive behaviors.
Here are some of the areas that DBT can help treat:
- Borderline Personality Disorder (BPD)
- ADHD (Attention Deficient Hyperactive Disorder) and ADD (Attention Deficit Disorder)
- PTSD (Post-Traumatic Stress Disorder)
- trauma history
- Reactive Attachment Disorder (RAD)
- ASD (Autism Spectrum Disorder)
- depression, bi-polar disorder (BPD) and grief
- anger issues and explosive disorders
- mood disorders
- personality disorders
- Obsessive-Compulsive Disorder (OCD)
Many of the skills in DBT can be helpful for anyone experiencing emotional sensitivity or big feelings. A child with a poor attachment or history of trauma and loss is often highly activated when they feel complex feelings. They have a difficult time returning to a calm state of mind.
5 DBT Skills that Help Teenagers Cope
Here are skills that adolescents learn during DBT treatment.
Mindfulness is a technique used in DBT that is focused on paying attention to the moment. Letting go of thoughts about the past or future and exercising the ability to stay connected to what is happening right now is important to emotional regulation.
Everyone can benefit from strengthening their mindfulness muscles. Children with RAD, anxiety, and trauma can become overstimulated when provided to much visual or auditory stimulation. Learning the skill of quieting the mind and turning down the volume on external stimulation is a skill that is extremely beneficial.
Tolerance is another critical DBT skill. The ability to tolerate distress or uncomfortable situations is typically very low in children with attachment disorders and other mental health issues. It is often difficult to get a child with behavior challenges to “stay in” a difficult conversation.
When someone is experiencing a high level of emotional sensitivity or reaction to uncomfortable feelings, they can benefit from working on distress tolerance. DBT offers several skills and techniques to increase the patients’ ability to navigate distress and build up a tolerance.
The body may be telling us to fight, flight or freeze in moments that are uncomfortable or hard. DBT stays focused on the notion that you can do hard things, and that getting to the other side of a hard conversation is possible and to your benefit.
A third skill taught in dialectical therapy is social skills. DBT breaks down steps on how to get what you want in relationships, while also using empathy.
Empathy is a complex concept for a child with mental health problems, especially those with RAD.
Putting yourself in someone else’s position is a complex exercise that requires personal insight. Empathy is a struggle for most teens, and it especially proves to be difficult for attachment disorder teenagers.
Emotional regulation is a key component taught in this type of therapy. Emotional regulation is the steps required to return a person to their baseline emotions. For example, if you are a typically optimistic person who has flashes of anger, your baseline would be optimistic.
The purpose of emotional regulation is not to dismiss feelings. Instead, it is to teach patients to experience the feeling, name it, and move through the feeling. This is a skill that many children from hard places are lacking. They may be able to identify feelings such as anger, hurt or rejection, but lack the ability to acknowledge the feelings.
Emotional regulation is an especially important skill for those who are experiencing PTSD triggers and likely to be engaged in high-risk behaviors. It is unhelpful for them to act in a stage of elevated mood, as much as it is unhelpful (and even potentially dangerous) for those around them.
The final DBT skill to highlight is radical acceptance. Radical acceptance is the idea that you can acknowledge or observe something, then accept it at face value. To radically accept is not to say you agree with or support what you are observing. It simply means you see it and you accept that it is occurring.
How to Find DBT Near Me
To find DBT therapy near you, search for “DBT therapy near me” and your city and state. You can also search psychologytoday.com for therapists in your area and by therapy type.
There are many DBT worksheets, workbook, activities available for purchase. While these could provide some benefit, this type of intensive therapy is best done by a trained therapist, and often in a group setting.
Does DBT Work for Teenagers with RAD?
As a parent of children with RAD, I see a lot of behaviors that I never thought I would see in my home. We have parented children with rages, aggression and toileting behaviors, to name a few.
I am often speechless when describing the struggle to the treatment team. I feel like this can’t be my life, and I must be doing something seriously wrong as a parent if this is the behaviors occurring in my home.
The reality is I am parenting children with an extremely rare attachment disorder. I radically accept my shortcomings as a parent, AND I accept that my child’s behavior is often out of control. You see, it can be both.
My child can be out of control, and I can be a good parent. In addition, my child can have destructive behaviors AND be a good person. I accept both.
These skills are but a few things taught in DBT therapy. It is a treatment model that can provide useful skills and education for children and families supporting children with RAD.