Adolescent Dialectical Behavior Therapy - IU

1 Adolescent Dialectical Behavior Therapy Skills TrainingMelissa Butler, , HSPPWhat is DBT? Dialectical Behavior Therapy Developed by Marsha LinehanDevelopment of Adolescent DBTAlec Miller, PsyDJill Rathus, PhDDBT is helpful for people who have trouble controlling and regulating their emotions What the Heck is DBT? Created by Esmee Shaller at University of California San FranciscoDialectics Two opposites can be true at the same time Create a new way of viewing the situationComponents of Adolescent DBT Weekly Individual psychotherapy Additional Family Therapy Sessions Multifamily Group Skills Training Youth and ParentTelephone Coaching Therapist Focused Consultation TeamsComponents of Adolescent DBT: Weekly Individual Psychotherapy Adolescent DBT Skills Training Modules Mindfulness Distress Tolerance Emotion Regulation Interpersonal Effectiveness Walking the Middle PathMODULE 1: Mindfulness SkillsWhat is Mindfulness?

2 Paying attention On purpose In the present moment Non-judgmentallyExamples of Mindfulness Practice Mindful Breathing Mindful Observation Mindful Eating Mindful Listening Walking the LineMODULE 2: Distress Tolerance SkillsDistress Tolerance Skills focus on tolerating and surviving crises Skills Include: Crisis Survival Skills Reality Acceptance SkillsTIPP Skills used to change body chemistry quicklyTemperatureFour Square BreathingRepeat at least 4 Muscle Relaxation for KidsDistraction Techniques Count Backwards from 100 by 7 (or from 20 by 3) 5-4-3-2-1 Grounding Exercise Alphabetize DVD collection Count Freckles, Ceiling tiles, anything Say alphabet backwards Find the RainbowCrisis Survival Kit Usually includes a list of 10 tools and an actual kit of itemsRadical Acceptance When faced with a difficult problem: You can problem-solve Change how you feel about the problem Accept it Stay miserable (no skill use) Make things worse (act on urges) When you can t solve the problem or change your emotions about the problem, try acceptanceRadical Acceptance Skill of accepting the things you can t change(Miller, Rathus, & Linehan, 2017, )MODULE 3.

3 Emotion Regulation SkillsEmotion and Naming the function of obstacles to changing and labeling unwanted Vulnerability to Negative extreme emotions and difficult situations Ride the Wave SkillOpposite Action Each emotion has an action urge (sad = shut down, isolate) Practice doing the opposite (opposite action = be active, be with people)Pleasant Events List accumulate positive emotions Meditating, yoga Watching TV Going for a walk Listening to music Taking a bath Coloring Painting nails Pet dog Call a friend Read a book Lighting candles Getting a massage Go out for coffee Being alone Daydreaming DancingMODULE 4: Interpersonal Effectiveness Asking for what one needs Saying no Managing interpersonal conflicts Skills to maintain close and intimate relationshipsDEAR MAN Describe the situation Express your feelings Assert and ask for what you want or say no Reinforce -the person by stating positive benefits Mindful and stay focused on what you want Appear confident Negotiate be willing to give to getGIVE Skills keeping the relationship Gentle be nice and respectful, no attacks, no threats, no judging, no sneering Act Interested Validate with words and actions that you understand the other person s feelings and thoughts Easy Manner smile, use humor, leave attitude at the doorModule 5: Walking the Middle PathSkills Covered: Works on balancing acceptance and change Validation skills Behavioral Change StrategiesValidation vs.

4 InvalidationInvalidationIncreased Conflict & DistressValidation Validation communicates that a person s feelings, thoughts, and actions are understandable Invalidation communicates that a person s feelings, thoughts, actions in a particular situation make no sense. manipulative stupid overreaction attention-seeking, or not worthy of time, interest, or respect We can invalidate with the best of Jane: I m a terrible person. Jenny: What are you talking about? You re great. Validation The Validation skill is rated by adolescents and parents as the most helpful (Rathus et al., 2015)DBT Resources Behavioral Tech LLC Mindfulness: Apps: Stop, Breathe, Think, & RelaxMeta-analyses: Cook & Gorraiz(2016) Iyengaret al. (2018)Randomized Clinical Trials: Mehlumet al. (2014). McCauley et al. (2018)Evaluating Adolescent DBT: Does it Work? DBT Skills Training Alone shows promise but more data neededValentine et al.

5 (2015) Contact InformationMelissa A. Butler, , HSPPI ndiana University School of Medicine, Department of PsychiatryEmail: P., & Rathbone, B. (2015). Parenting a Teen Who Has Intense Emotions. Oak Land: New Harbinger , M. (2015). DBT Skills Training Handouts and Worksheets 2ndEdition. New York: The Guilford , M. (2015). DBT Skills Training Manual 2ndEdition, New York: The Guilford , J., & Miller, A. (2014). DBT Skills Manual for Adolescents. New York: Guilford Publications.