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Dialectical Behavior Treatment for Adolescents


DBT for Adults  |  DBT for College Aged Students

DBT for Adolescents & Families  |  DBT for Friends and Families


Adolescence is a formative period of intellectual, social, and emotional growth. Given the mounting responsibilities with which today’s youth are confronted, it is necessary that adolescents learn ways to prioritize their mental health in addition to other obligations. If your child is between ages 11 and 18 and experiencing self-defeating thoughts, difficulty controlling emotions, problems with friends or family, mood swings, or problematic behaviors that impair functioning at school or in the home, we recommend pursuing a consultation for our comprehensive Adolescent Dialectical Behavior Therapy (DBT) program.

Dialectical Behavioral Therapy for Adolescents

DBT for adolescents was developed by Dr. Alec Miller, Dr. Jill Rathus, and Dr. Marsha Linehan. Both staff psychologists on the Adolescent DBT team at AICT were intensively trained and mentored by Dr. Miller. This evidence-based approach is the gold standard of treatment for individuals suffering from emotion dysregulation, identity confusion, interpersonal difficulties, impulsivity, risky behaviors, and teen-parent conflict. AICT’s comprehensive Adolescent DBT program incorporates emotion regulation skills, distress tolerance skills, interpersonal effectiveness skills, parent-teen problem-solving skills, and mindfulness skills for adolescents requiring more comprehensive treatment than standard Cognitive Behavioral therapy (CBT). 

DBT is particularly effective for those adolescents not benefitting from standard treatment. Our program is best suited to adolescents struggling with one or more of the following:

  • Difficulty Regulating Emotions
  • Intense Anxiety, Depression, and/or Anger
  • Adolescent/Parent/Family Dilemmas
  • Substance Abuse
  • Self-Harm
  • Eating Disorders
  • Relationship Conflicts
  • Inattention
  • Confusion about Identity

Individual DBT for Adolescents

Individual DBT for Adolescents consists of weekly 45 minute sessions to help adolescents become more knowledgeable and confident in their ability to: (1) understand and learn to manage overwhelming emotions, (2) work through difficult situations, and (3) improve relationships. Individual DBT engenders a sense of mastery and a forum for adolescents to work on confidential treatment issues.

DBT Adolescent and Multi-Family Skills Training Group

Adolescents and their parents attend a 90 minute weekly skills group for 16 weeks. The format is designed to teach adolescents and their parents a new and effective skill set organized in the following five modules: (1) Mindfulness, (2) Emotion Regulation, (3) Distress Tolerance, (4) Interpersonal Effectiveness, and (5) Walking the Middle Path. This group helps adolescents to replace problem behaviors with skillful ones and helps parents to understand and effectively help their adolescent become more adaptive in managing day to day emotions and behaviors. The 16-week group, which is concurrent with individual therapy, is a 4 month commitment. Both the adolescent and parent(s) are required to attend. New families will be invited to join the group when each new skill module is introduced, which occurs every 4-5 weeks.

Skills Coaching

Each adolescent and parent who partakes in the Adolescent DBT Program is provided with the additional service of between-session telephone consultations both for crisis situations and situations where the adolescent or parent is having difficulty applying skills. By remaining accessible between sessions, therapists encourage adolescents to call for skills coaching so as to generalize the skills they’re learning to the real-life situations and stressors of their day-to-day environments.

The DBT Adolescent and Multi-Family Skills Training Group meets on Monday, Tuesday, and Thursday evenings 7:00 – 8:30 pm. New members will be able to join the group every 3-4 weeks.

Frequently Asked Questions about DBT

What can we expect from the group experience?
Many people have different ideas about what group therapy is like. DBT offers a structured group format and is often described by group members as a skills-based class - with the benefit of validation from other families going through similar issues. The group leaders prioritize teaching new skills each week to increase each group member's effectiveness and quality of life. Each group begins with a short mindfulness exercise followed by a review of skills practice and the introduction of new skills. Group leaders use didactics, games, role plays, and experiential learning. Group members are strongly encouraged to participate throughout the discussion but are never forced to speak about any specific personal issue.

What happens if my adolescent has to miss more than 4 sessions/groups due to school, extracurricular activities, camp, or vacation? Or what if the parent(s) miss more than 4 groups due to outside obligations?
 
This is a common concern for many parents. The easiest approach is to make your best effort to attend weekly sessions and groups. We understand that a variety of things can come up during the 4-month period, which is why we allow for 4 absences. If this is not realistic, it is best to speak with Dr. Taylor and Dr. Horowitz to arrange for a tailored approach that will best accommodate your adolescent and family needs. Past clients have made up missed groups or sessions in the next cycle or in extra sessions with their individual therapists.

Can my adolescent participate in the group without attending individual therapy?
Unlike the CBT program, the DBT program requires attendance in both individual and group sessions for the 16 week period.

What if my adolescent is currently in an inpatient facility or partial hospitalization? How do we make the transition to outpatient services?
Clients can enter into the Adolescent DBT Program as part of their discharge plan following hospitalizations depending on the hospital's recommendations and goodness of fit. Given the uniqueness of each case, it is best to speak directly with Dr. Taylor or Dr. Horowitz about your adolescent’s circumstance to see if this is the appropriate level of care at this time.

What are other problems that are addressed in individual and group DBT for adolescents?

Other topics addressed in treatment include but are not limited to the following: poor self-image, peer pressure/bullying, trichotillomania, social isolation, school refusal, self-punishing behaviors, emotional numbness and depression, academic difficulties resulting from emotional instability, romantic relationships, divorce, and sibling rivalry.

For additional questions or to schedule a consultation for DBT, please contact Dr. Victoria Taylor or Dr. Melissa Horowitz at (212) 308-2440 or by e-mailing intake@cognitivetherapynyc.com.

Melissa D. Horowitz, Ps.yD., Director of Eating Disorders and Weight Management Program, Clinician, received her doctoral degree from the Philadelphia College of Osteopathic Medicine. She is a New York State licensed psychologist with extensive experience in cognitive behavior therapy (CBT), dialectical behavior therapy (DBT), social problem-solving, motivational interviewing and mindfulness-based approaches. She works primarily with adolescents, adults, couples and families. Dr. Horowitz specializes in the treatment of eating disorders and body image concerns in both men and woman. She also treats and specializes in mood and anxiety disorders, including generalized anxiety, social anxiety, separation anxiety, obsessive compulsive disorder, panic disorder and phobias. Additional areas of expertise include body dysmorphic disorder, personality disorders, trichotillomania, substance abuse and chronic health issues. Dr. Horowitz has been intensively trained in working with adolescents and adults struggling with low frustration tolerance, impulsivity, poor problem-solving skills, interpersonal conflicts and self-injury. Dr. Horowitz understands the need for a structured and supportive environment when addressing personal challenges that arise during different life stages, and the effects they may have on one’s education, career, family, romantic relationships and health. Dr. Horowitz provides supervision and presents on topics relating to CBT and DBT.

Victoria Taylor, Ph.D., Director of Child and Adolescent Services, Clinician, is a New York state licensed psychologist who earned her doctorate in Clinical Psychology from Northwestern University and her bachelor’s degree from McGill University. Dr. Taylor specializes in cognitive-behavioral therapy (CBT), dialectical behavioral therapy (DBT), mindfulness-based therapies, acceptance and commitment therapy (ACT), and trauma-focused therapies. She completed her pre-doctoral internship at Montefiore Medical Center, and is intensively trained in DBT for high-risk, suicidal adolescents and adults.  Dr. Taylor treats mood disorders, anxiety disorders, personality disorders, substance abuse, trauma, and ADHD in children, adolescents, and adults. Dr. Taylor believes that successful therapy stems from a close, non-judgmental alliance between therapist and client, and offers evidence-based interventions specific to clients' needs in a warm and compassionate atmosphere. She provides particular understanding and guidance around the difficulties inherent in identity development among adolescents, college students, and young professionals. Dr. Taylor also has extensive experience and a specific interest in helping clients struggling with issues specific to the LGBT community. Along with Dr. Horowitz, Dr. Taylor runs our Adolescent DBT program, and is also the program director for our Parenting and Family Enrichment Program.  She recently collaborated on a book chapter on the transdiagnostic nature of DBT, as well as on a review article comparing CBT, ACT, and DBT. Dr. Taylor has taught seminars on DBT to medical students and provides DBT supervision to graduate students.