Adolescent Dialectical Behavior Therapy (DBT) Program

This program, initially developed for adults by Dr. Marsha and adapted for teens and families by Drs. Alec Miller and Jill Rathus, has the most research-backed evidence supporting its effectiveness for teens experiencing high-risk behaviors such as suicidal thinking and acting, self-harm, substance abuse, or risky interpersonal relationships. It includes the following components:

• Weekly Individual DBT Therapy
  • Including Pretreatment, Diary Card Completion, and Behavioral Chain Analyses
• Multi-Family Skills Group
  • 24-session, 2-hour weekly skills group with 3-6 teens and parents/guardians attending together
• Phone Coaching
• As Needed Parent Consultation Sessions

Within this program, treatment begins with a comprehensive assessment and includes a pretreatment phase (usually about 4-6 weeks) where teens and their families identify their goals and targets for treatment, build motivation and commitment to the program, and review the treatment formats, theories, and limits.

Designed for teens and families that temporarily require a more intensive level of care than standard outpatient DBT to help manage:

• Intense emotions
• Negative communication cycles
• Impulsivity
• High-risk behaviors

Program Structure

Our program consists of two phases:

• The Intensive Phase, which lasts 3 months and includes all services below. This phase consistents of different groups sessions across four days/week, with individual therapy integrated into the program.
• The Step-Down Phase, during which families finish the Multi-Family Skills Group over another 12 weeks while transitioning individual care to long-term outpatient therapists within the community and/or back to referring therapists.

Services

• Multi-Family Skills Group (MFSG; 24 weeks)
• Teen skills Generalization Group (2x/week for 12 weeks)
• Parent/Guardian Skills and Consultation (1x/wk for 12 weeks)
• Individual DBT Sessions with DBT Phone Coaching (1x/wk for 12 weeks)
• Additional As-Needed Parent Sessions and Parent Phone Coaching

MFSG-Skills Only Instruction

This program is for teens and their parents/guardians who have already established effective care with a treatment team that includes weekly individual therapy but would benefit from augmenting their treatment with family DBT skills. This is an adjunctive, group-based program where teens continue with their existing treatment while also attending the MFSG described above with their parents/guardians. This program is not recommended for teens experiencing high-risk behaviors or difficulty regularly attending appointments, and referrals are made on a case-by-case basis in consultation with the existing treatment team.

Adolescent DBT Grad Group

For those teens that have completed the MFSG with a full graduation (either within this clinic or within another clinic), we also offer a weekly Adolescent DBT Grad Group. This teen-only group includes a mindfulness practice followed by peer-to-peer consultation on applying skills. It is for teens that have effectively learned the DBT skills and have not engaged in any recent risk behaviors but would benefit from additional support in applying the DBT skills to their everyday life.  It runs for 1 hour per week for 12 weeks, although teens can recommit to multiple rounds of grad group as needed.