Our DBT program for adolescents, led by some of the first Credentialed DBT Practitioners in Australia, is experienced and extensively trained in DBT. Please visit our website for more details about our team!
At the Gold Coast DBT Clinic, our Dialectical Behaviour Therapy for Adolescents Program (DBT-A) focuses on helping youth and their families to master the challenging bridge from adolescence to adulthood. Often fraught with behaviours that are difficult to understand, adolescence can be chaotic at worst and difficult at best. Like standard DBT, DBT-A helps with the problematic actions sometimes used to deal with extreme emotional intensity. The treatment has been modified to include a more specific focus on commitment strategies, parent and teen skills training, and a skills module entitled “Walking the Middle Path.”
For DBT to be successful, the treatment has to do two things effectively: (1) teach skills that people need in order to move closer toward a young person’s life goals, and (2) help people cultivate an ability to work these skills into a young person’s daily lives.
Component One, DBT Skills Training: DBT skills are taught through our eighteen-week DBT skills group which is based on Marsha Linehan’s updated curriculum and our trauma informed approach. When a young person signs-up for the DBT skills group we ask that a commitment be made to attend the entire eighteen-week course. We offer these groups in the late afternoons and evenings and in two nine-week modules with two weeks break for school holidays.
Our DBT skills group is run very much like a seminar or workshop. The group meets once per week for ninety minutes. Participants are provided with a range of resources in person and online that reinforce the skills taught in group each week.
Homework corresponds with the DBT skills taught in a particular week and is assigned at the end of each group. The following week all participants present their application of skills to the group for further development and application of the skill set for homework.
We run two types of group skills training programs, DBT-A+ and DBT-A.
Our DBT-A+ program invites one parent/guardian/key support to attend the group with a young person. Usually a DBT-A+ group will consist of four adolescents and one support for each young person. In addition to learning the DBT skills, parents also learn through the skills training group how to understand and respond to specific adolescent behaviours and to encourage the use of skills at home.
Our other type of program, DBT-A, is attended only by young people. We teach the same skills as the DBT-A+ program with between eight and ten young people allocated to each group.
Our skills training curriculum teaches the following DBT skills which are arranged in two nine-week modules:
Core Mindfulness: teaches participants how to focus the mind, direct attention, and to observe and describe what they are feeling and thinking in the moment without judgement. These skills can help to people develop a more stable sense of who they are, and can help reduce reactivity to painful thoughts and emotions.
Distress Tolerance: targets impulsivity by teaching young people how to effectively distract and soothe themselves while considering pros and cons of their actions. These skills typically replace problem behaviours such as self-injury, substance use, binge eating, and angry outbursts.
Emotion Regulation: addresses emotional sensitivity, rapid mood changes, and other unregulated moods such as chronic depression, anxiety, or anger. Learning how to identify and label emotions, how to increase positive moods, and how to make one less vulnerable to negative moods are examples of specific skills that we cover in this module.
Interpersonal Effectiveness: addresses difficulties in maintaining consistent and rewarding relationships by teaching skills such as how to ask for what you want, how to say no in an effective way, and how to maintain a sense of self-respect and independence in the face of external pressure.
Middle Path: targets extreme and non-balanced thinking and behaviours. These skills involve learning about common areas of conflict and polarization, both internal and external, and reducing this conflict by learning methods to change behaviour, as well as methods of validation and acceptance.
Component Two, Individual DBT psychotherapy: This is the main way of developing and refining the ability to apply skills taught in DBT skills group to daily life. DBT skills group participants usually meet individually with their therapist one to two times per week for a fifty-minute session. As is the case with the DBT skills group, when individuals enrol in individual DBT psychotherapy we ask that individuals make an eighteen-week commitment.
Phone coaching: This part of the treatment is designed to promote skills use where it matters most – in daily life. When our clients feel unsure of how to approach a particular situation, they are encouraged to contact their individual therapists for help in using DBT skills. When enrolled in a DBT-A+ program phone coaching is offered to the support person rather than the young person. The support person provides coaching of the young person and when any challenges arise, use the individual therapist as a support through phone coaching.
Commitment Strategies: We ask young people to commit to making certain behavioural changes even though they have not learned to master them. “Commitment strategies” are a cornerstone of DBT treatment. They arose from evidence suggesting that people were more likely to behave in a particular way if they agreed to do so beforehand. Many young people have not often experienced the consequences of their behaviours and may feel immune to them. Given this, young people are often encouraged or mandated by parents, teachers, therapists or friends to seek treatment, and may not be “motivated” initially to attend therapy. In the context of individual therapy, special commitment strategies are used to help young people understand the precipitants of their behaviours, the consequences, both positive and negative, of their behaviours, and the implications for behaviour change.
Weekly therapist consultation team: Our DBT treatment team meets weekly for ninety minutes to share feedback and discuss methods to ensure effective and compassionate treatment. We spend time problem-solving difficulties that interfere with client progress in treatment and help keep each other practicing within a dialectical framework.