Dialectical Behavior Therapy

Dialectical behavior therapy (DBT) is a state-of-the-art, evidence-based form of cognitive behavioral therapy for teenagers and adults who experience significant trouble managing their emotions, thoughts and behaviors. Current research suggests that DBT may also be effective for preadolescents (aged 9 – 12) who struggle with intense emotions, disruptive behaviors, and challenging relationships.

In order to more effectively manage intense emotions that can lead to impulsive decision-making and problematic behaviors, patients participating in DBT learn how to practice mindfulness — fully being present in the moment and focusing on one thing at a time, without judgment — along with new problem solving skills. When mindful awareness is combined with effective problem solving skills, sensitive and emotionally reactive preteens, adolescents, and young adults have the tools to respond flexibly to difficult and stressful life experiences.

This approach has helped preteens, teenagers and young adults who struggle with any or all of the following:

  • Impulsive/disruptive behaviors
  • Frequent mood swings
  • Self-injurious and suicidal behaviors
  • Depression and anxiety
  • Family and peer conflict
  • Anger outbursts
  • Eating disordered behaviors
  • Drug or alcohol abuse
  • Poor coping skills

Considerable research has been conducted on DBT for adolescents and adults, and multiple randomized controlled research trials have demonstrated its effectiveness. At the Child Mind Institute, we treat many young people who struggle with emotional ups and downs and assist families who want to help their children manage these intense emotional fluctuations. DBT is an excellent option for those who want a comprehensive treatment that teaches emotional, behavioral and cognitive skills.

DBT focuses on skills training in five main areas:

  • Understanding, managing and regulating emotions
  • Tolerating distress and crises without making problems bigger
  • Maintaining satisfying relationships with others
  • Increasing self-awareness, expanding one’s ability to recognize alternative points of view and managing emotional situations
  • Increasing problem solving skills, learning validation and effectively managing differences of opinion with family members

Our team of expert clinical psychologists and board-certified child and adolescent psychiatrists encourages preteens, teenagers and young adults to healthfully cope with painful emotions and take action towards positive self-care.

Treatment Approach and Services

Evaluation: All new patients to the Child Mind Institute will be given a comprehensive diagnostic evaluation by one of our team clinicians, in part to determine if DBT is the best therapeutic intervention for them. Full diagnostic feedback and treatment recommendations will be given as part of the evaluation. Current patients will participate in a consultation for the same purpose.

Treatment:

Participants in the adolescent and young adult DBT programs agree to commit to the following core components for 6 months of treatment, with an option to repeat. Participants in the preadolescent DBT program agree to commit to the following core components for 8 months of treatment, with an option to repeat.

DBT Skills Training Group: Each DBT program member participates in a weekly group to learn skills in the five main areas outlined above.

  • Preadolescent and Parent Skills Groups – Ages 9-12 (weekly for 60 minutes): Preadolescents and their parents/caregivers attend concurrent but separate DBT groups to learn the core DBT skills. Parents will learn how to enhance their own coping ability while supporting their child’s use of DBT skills to manage emotions and solve interpersonal problems.
  • Adolescent Multifamily Skills Group – Ages 12-18 (weekly for 90 minutes): Teens and parents/caregivers attend group together to learn core DBT skills. Parents learn how to more effectively communicate with their children, enhance their own coping skills and empower their child to use DBT skills to deal with problems.
  • Young Adult Skills Group – Ages 18-25 (weekly for 90 minutes): Young adults attend group with peers who experience similar concerns. Separate parent consultation is available for young adults who would like support from their parents in the treatment process.
  • Graduate Group for Adolescents (weekly): Teens who have completed the Multifamily Skills Group are eligible to participate in this group aimed at helping them continue to practice their DBT skills while receiving consultation and support from peers.

DBT Individual Therapy (1 – 2 sessions each week): Participants work on specific problem behaviors and apply techniques learned in the skills group to their goals.

Skills Coaching by Phone: Available to help participants apply skills in the moment they are needed, before high-risk behaviors occur.

Medication Management as Needed

Consultation Team: Our clinicians meet regularly as a consultation team to support one another and think creatively about the best ways to help teens and their families.

DBT Parent Management Training (as needed): Parents have the opportunity to work on specific problem behaviors and parenting goals by combining techniques learned in the skills group with parent management training.

For more information, please contact Gabby Gottschall at gabby.gottschall@childmind.org or call (646) 625-4257.

Our Team

Jill M. Emanuele, PhD
Jill Emanuele, PhD

Senior Director, Mood Disorders Center

Child Mind Institute

Laura Berssenbrugge, MS

Clinical Extern, Anxiety Disorders Center, Mood Disorders Center

Child Mind Institute

Lindsay Brand, PhD
Lindsay Brand, PhD

Associate Psychologist, Mood Disorders Center, Anxiety Disorders Center

Child Mind Institute

Janine Domingues, PhD
Janine Domingues, PhD

Clinical Psychologist, Anxiety Disorders Center

Child Mind Institute

Stephanie Dowd, PsyD
Stephanie Dowd, PsyD

Clinical Psychologist, Mood Disorders Center

Child Mind Institute

Lindsey Giller, PsyD

Clinical Psychologist, Mood Disorders Center

Child Mind Institute

Alexandra Hamlet, PsyD
Alexandra Hamlet, PsyD

Clinical Psychologist, Mood Disorders Center

Child Mind Institute

Anne Josephson, MsED

Clinical Extern, Anxiety Disorders Center, Mood Disorders Center

Child Mind Institute

Anna Loiterstein, MS
Anna Loiterstein, MS

Clinical Extern, Anxiety Disorders Center, Mood Disorders Center

Child Mind Institute

Amanda G. Mintzer, PsyD
Amanda G. Mintzer, PsyD

Clinical Psychologist, Anxiety Disorders Center

Child Mind Institute

Wendy N. Moyal, MD
Wendy Nash Moyal, MD

Child and Adolescent Psychiatrist

Child Mind Institute

Stephanie Samar, PsyD

Clinical Psychologist, Mood Disorders Center

Child Mind Institute

Michelle Silverman

Clinical Extern, Anxiety Disorders Center, Mood Disorders Center

Child Mind Institute

Sol Wahba, MA

Clinical Extern, Anxiety Disorders Center, Mood Disorders Center

Child Mind Institute

Emma Zoloth, PsyD

Associate Psychologist, Anxiety Disorders Center, Mood Disorders Center

Child Mind Institute