When working with parents and teens, I use something called DBT which stands for Dialectical Behavioral Therapy. I usually give a brief overview of it to the parents of my client, but I find myself lacking the time to fully clarify how DBT skills are helpful to their teen. I won’t deny DBT is a mouthful and the term “dialectical” isn’t something we often hear in the grocery store or anywhere else for that matter. After all, my mom still jokes that DBT stands for Diabolical Behavioral Therapy because of a miscommunication the first time she heard it. Therefore, I have decided to write this blog post to give a more comprehensive explanation of DBT skills, why I use them, and how they can ultimately help teens as they grow and change in therapy. I hope it is useful to any parent, teen, or curious friend or family member of mine who is wondering why my mom is going around telling them I use diabolical therapy.
So, What are They?
DBT skills consist of four sections, each of which is focused on a different skill set that can help your teen in various ways. Those four sections are Mindfulness, Distress Tolerance, Emotional Regulation, and Interpersonal Effectiveness.
You may have heard the term ‘mindfulness’ before in other contexts. The easiest way to think about it is to imagine the opposite. What does a mindless person look like? Are they scrolling through social media without interacting with it? Watching a show but remembering none of it after? Parking their car at home but not remembering the drive? These are all examples of what it looks like to be mindless. So, let’s take the opposite. Mindfulness is being in the present moment, paying intentional attention to what you are doing and participating fully in it. It is the opposite of autopilot.
Distress Tolerance can be broken down into the two terms “distress” and “tolerance.” Now, what is distress? In colloquial terms, it is feeling very upset or uncomfortable. And tolerance? It is the act of allowing something to exist without trying to change it. Putting that together, distress tolerance is allowing an uncomfortable feeling to exist without trying to change it. It’s tolerating discomfort. You may be surprised to find that many of these skills involve distraction. But isn’t distraction just avoidance? It’s actually not. Distress tolerance skills teach acknowledgement of the painful feeling before use of distraction. They also teach to always go back to the feeling once it has cooled down enough to be processed. In that way, distraction is not avoidance.
Next is Emotional Regulation. These skills work specifically with regulating emotions as well as processing them. It also teaches about emotions, what their purpose is, and how we can impact them with our thoughts and actions. Some of the skills focus on how to have more pleasant emotions in your life, both short term and long. Others are about how to cope with painful emotions. One of my personal favorite skills teaches how to look at the facts of a situation and base your interpretation on those facts rather than on how you feel in the moment. Overall, these skills are used to process and regulate our emotions.
Lastly is Interpersonal Effectiveness. Just as it sounds, these skills help with relationships. They aid in building healthy relationships through the use of three types of skills. One involves getting someone to do what you want (or asking for what you need in a relationship), the next is building and maintaining positive relationships, and the last focuses on maintaining your self respect. These three parts of relationships build the interpersonal effectiveness triangle. All three are needed in healthy relationships and the goal is to do all three effectively at the same time. Get too much of what you want? You become manipulative and narcissistic. Give of yourself too much in order to maintain a relationship? You become a doormat. Hold too tightly to your self-respect? You become cold hearted and unable to be vulnerable. Each one is needed for a relationship to succeed.
Now, How Do They Help My Teen?
Now that you have a basic understanding of what DBT skills are, we are going to talk specifically about how they can help your teen. Each section of skills helps your teen in a different way.
Let’s think about mindfulness. We know that a mindless teen is likely to do what they want because they are not considering the consequences. A mindless teen will lash out with every emotion because they don’t know what they are feeling or why they are feeling it. However, mindful teens are more likely to pay attention to consequences, think through their actions, and be more in control of their own mind. They will notice thoughts they are having that are inaccurate and work to change them. They know what they are feeling when they are feeling it and can respond accordingly. Mindfulness is so fundamental to healthy living because if we do not know what is going on in our own minds, or if we are not aware of the world around us, we react blindly to our every whim.
Distress Tolerance helps teens tolerate distress. Sounds pretty basic, I know. However, it is so vital to teach teens how to deal with the painful emotions that they find themselves in. Think about a teen who is experiencing crippling anxiety every time they take a test. What would it look like if they were able to tolerate that anxiety to the point where they still felt it, but were able to study and focus and feel confident anyway? How about a teen who gets dumped and is overwhelmed with sadness. That teen may shut themselves away in their room for days on end or refuse to eat or cry without ceasing. What would it be like if that teen could feel that sadness, but go on functioning anyway? This is what it looks like for teens to tolerate painful emotions.
Now, Emotional Regulation is probably my favorite out of the sections (though I know we aren’t supposed to have favorites– shhh don’t tell Distress Tolerance I said that.) The reason is because it teaches teens how to separate their emotions from their behavior. Teens learn that they can’t control their emotions, but they can choose how to behave when they are feeling dysregulated. This section also teaches that emotions often lie to us. They may feel like that person in their class hates them, and they could be right, but they could also be wrong. This thought helps teens to realize that they don’t know everything and acting on their emotions can often end up being more hurtful than helpful. They also learn ways to process their emotions and how to ride them out like a wave on the ocean. This section ultimately helps teens feel more in control of their emotions and be less likely to lash out impulsively without thinking through their actions.
Interpersonal Effectiveness skills help teens have healthy relationships. These relationships can include friendships, romantic partnerships, parents, teachers, and more. They are given fundamental skills that can be applied to every relationship they have. Therefore, these skills are for those of you who are struggling with your relationship with your teen. They will help your teen learn how to appropriately ask for what they need from you and compromise and negotiate when that thing isn’t possible. Your teen will learn how to and when to speak kindly and use humor rather than using attitude or talking back. They will learn what their values are and what it looks like to act in accordance to those values. They will also learn how to navigate having different values from you. They will learn conflict management and how to think about an argument from the other person’s perspective and not just their own. They will learn how to set boundaries and how to say no without being harsh or hurtful. These skills will help your teen be more effective and kind in every relationship they have.
There you have it. Hopefully by reading this blog post you have come to understand why I love DBT skills so much and why I believe every teen needs to learn at least some of them. I hope you have identified places where these skills could be helpful not only for your teen, but also for your whole family. Don’t get me wrong, even though I am focusing on teens, pre-teens and adults can also benefit from learning these skills. The hope of teaching them to teens and pre-teens is to prevent them from making some of the mistakes you may have made as a teen or adult. If you think back to your teenage days, what sort of difference might have these skills made in your life? I will leave you pondering that thought and end this blog post here.
From DBT® Skills Manual for Adolescents, by Jill H. Rathus and Alec L. Miller. Copyright 2015 by The Guilford Press.