Dialectical behavior therapy (DBT) for teens is an evidence-based approach that can teach adolescents practical skills for managing intense emotions, tolerating distress, improving communication, and responding to difficult situations without relying on impulsive behaviors.
DBT may be especially helpful for teens who experience extreme mood swings, self-harm urges, suicidal thoughts, or difficulty calming down once emotions become overwhelming.
What’s more, DBT can help teens better understand their experiences and learn specific strategies to cope in everyday life. To help you determine if DBT could be effective for your teen, this page explores:
Dialectical behavior therapy, usually called “DBT,” is a form of psychotherapy that was developed by the American psychologist Marsha Linehan. DBT was originally used for people who were experiencing chronic suicidal behavior and borderline personality disorder.
However, it has since been adapted for adolescents and other populations who experience a wide range of mental health issues.
Treatment usually involves core skills, including:
However, the main goal of treatment is to help people learn to balance two opposite ideas at the same time. This is achieved by encouraging them to accept their current reality while learning how to change unhelpful behaviors.
Traditional talk therapy usually involves some form of exploring:
DBT typically includes these conversations, but places an emphasis on learning and practicing concrete skills.
This means that a teen may leave therapy with something specific to try during the week, sometimes called “therapy homework.” For example, instead of discussing anger only after an argument has happened, a teen might learn how to:
Adolescent DBT also often includes more family involvement than adult DBT. Parents or caregivers may learn the same skills as the teen so that everyone can have a shared language for emotional regulation and conflict resolution.
Research from the National Institute of Mental Health (NIMH) found that parents of teens receiving DBT reported using more DBT skills themselves during and after treatment.[1] This shows us that family involvement in teen DBT treatment can support the entire family in learning and using new skills.
DBT has strong research support for teens experiencing suicidal behavior and self-harm. A randomized clinical trial involving suicidal teens found that DBT produced greater reductions in suicide attempts and self-harm than a supportive therapy comparison treatment.[2]
A later meta-analysis also found that DBT for adolescents was associated with reductions in both self-harm and suicidal ideation.[3]
However, DBT skills are also frequently used for mental health issues aside from suicidal ideation and self-harm. For instance, it may be incorporated into treatment when teens struggle with:
When it comes to treating mental health concerns, DBT places a heavy focus on developing skills that teens can use in everyday life. It does so by targeting four core areas.
Mindfulness is the practice of being in the present moment without immediately judging or reacting to what is happening.
Mindfulness during moments of high emotion can help create space between an experience and the reaction to it. A teen might practice noticing:
Sometimes a teen cannot immediately change the situation that is causing distress. Distress tolerance can help teens get through intense moments without making the situation worse or attaching meaning to it.
This is different from pretending the situation is acceptable or enjoyable. Instead, it is focusing on acknowledging that they can survive this moment without adding to it.
Emotional regulation in DBT teaches teens that emotions serve a purpose and are not the problem. Instead, the difficulty tends to arise when emotions become so highly intense or long-lasting that they begin to control the teen’s behavior.
Research on DBT for teens has shown that improvements in emotional regulation were associated with reductions in distress and self-harm.[4] It does so by helping adolescents:
Being able to manage emotions internally does not automatically make relationships with others easier. Teens also need skills for communicating how they feel and what they need.
Interpersonal effectiveness focuses on navigating relationships while balancing getting a need met and maintaining self-respect. This could include asking a teacher for help, communicating hurt feelings to a friend, or setting a boundary.
Mission Prep is here to help you or your loved one take the next steps towards an improved mental well-being.
Within each core DBT skill, there are typically different practice skills that help teens build their competence. These skills include:
Wise Mind often links up with the core skill of mindfulness. The concept acknowledges that we tend to approach a situation using three different types of mindsets:
The Wise Mind helps teens avoid allowing the strongest emotion in the room to make every single decision.
TIPP stands for:
The TIPP skills strategy is intended to help with physical activation when emotions become extremely intense. For example, a teen who is furious may not be ready to have a thoughtful discussion about the conflict. So they may need to start by bringing the intensity down enough to think.
This skill is often associated with emotional regulation and involves asking whether the intensity of an emotional response matches the facts of the situation.
Checking the facts does not mean telling a teen that their feelings are irrational or that the situation is all made up. The feeling is real, and the goal is to examine whether an assumption is intensifying it. The teen needs to work to separate observations from interpretations.
Opposite action is the process of identifying the urge connected to an emotion and acknowledging when that emotion does not fit the facts or acting on it would be ineffective. Then it involves choosing a behavior that moves in the opposite direction.
For example, depression may create the urge to stay in bed and cancel plans. Following that urge may provide temporary relief, but prolonged isolation can sometimes deepen depression. Therefore, opposite action may include going on a short outing or reaching out to a friend.
Radical acceptance is a skill often used in DBT. It is the practice of acknowledging reality as it currently exists instead of spending additional energy fighting against the fact that it happened. Examples include accepting:
Radical acceptance means recognizing what has happened and deciding what to do next that is within your control.
Mission Prep provides treatment for teens experiencing various mental health conditions. Mental Health support is a phone call away – call 866-901-4047 to learn about your treatment options.
See our residences in Southern California’s Los Angeles & San Diego areas.
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Strong emotions are not something that teens need to eliminate. But they do need tools for understanding those emotions, communicating their needs, and making choices that support the life they want to live. Dialectical behavior therapy (DBT) for teens can provide a structured way to build those skills.
At Mission Prep Teen Treatment, we offer a variety of treatment programs and therapy services to support adolescents experiencing emotional dysregulation, anxiety, depression, self-harm, and other mental health concerns. Treatment is individualized so that teens can receive the combination of therapy, family support, clinical care, and skills development that is appropriate for their needs.
Whether your teen could benefit from residential treatment at one of our locations, or something more flexible like an outpatient mental health program or virtual telehealth to treat their mental health concerns, our team can help.
Mission Prep Teen Treatment accepts insurance and is in-network with most major providers. We are happy to help you check your insurance coverage for mental health care.
Contact us online or call 866-901-4047 to speak with a caring member of our team who can answer any questions you might have. Reach out for a free, no-obligation conversation.
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If you have any concerns about whether DBT is the right approach for your teen, the following answers to questions we commonly receive may help.
A comprehensive DBT program usually includes multiple components, and treatment may involve:
The length of adolescent DBT depends on the program and the teen’s needs, treatment goals, and symptom severity.
Early signs of improvement may look like:
Parents should be cautious about only evaluating progress by considering whether emotional episodes have completely disappeared. Instead, they should aim to observe overall behavior patterns. Skills often require repetition and support before a teen can use them independently during a crisis.
DBT can be an impactful form of treatment, but a teen may also require medication, treatment for substance use, medical care, or a higher level of mental health treatment.
If there is an immediate risk of suicide or inability to remain safe, emergency intervention may be necessary regardless of whether your teen is actively engaged in DBT treatment.
Call 911 or go to the nearest emergency department if there is an immediate risk of harm. In the United States, you can also call or text 988 for crisis support.
When looking for a DBT therapist for teens, ask providers what they mean when they say they offer DBT. Some clinicians provide comprehensive DBT, while others provide therapy informed by DBT principles or teach DBT skills alongside other treatment modalities.
Questions to ask include:
Are You Covered for Mental Health Treatment?
We’re in-network with many providers. Call us at 866-901-4047 to verify your benefits and find out how much your plan will cover
Find out if Mission Prep is right for you by reaching out to us and speaking with one of our admissions representatives.
