ABSTRACT
Dialectical behavior therapy (DBT) is an evidence-based treatment for suicidal and self-harming adults and adolescents. DBT was initially developed for adults who meet criteria for borderline personality disorder, a diagnosis with a particularly high fatality rate. However, adaptations have been successfully applied to individuals with other potentially dangerous or destructive emotionally driven behaviors including disordered eating, aggression, substance use, and anxiety-based avoidance (Dimeff & Koerner, 2007), and has been effectively adapted for children and adolescents. DBT is a cognitive-behavioral treatment that focuses on increasing emotion regulation skills and decreasing impulsive ineffective responses to emotions. The ultimate goal of DBT is to decrease self-destructive and ineffective behaviors while creating a “life worth living” (Linehan, 1993, p. 129). DBT balances acceptance of both the client as he or she is and the function of his or her (maladaptive) behaviors, with a relentless focus on change. Change procedures include skills training, exposure, cognitive modification, and the use of contingency management (Linehan, 1993). Comprehensive DBT treatment includes four components: (1) individual therapy; (2) a skills training group for adolescents and parents (either combined or separate); (3) out-of-session coaching; and (4) a consultation team for therapists (Linehan, 1993). This chapter focuses specifically on the skills training group component of comprehensive DBT.
